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December 15, 2008

Buying Long-Term Health Care insurance: oh, fun!

My parents -- all of whom are old -- have Long Term Care insurance. For years I felt that it was almost their ethical duty to have this insurance, although I myself had no obligation to insure myself. Apparently my unexamined assumption was that they were old and getting older, and would get infirm enough to require care in their final years, whereas I was young, and therefore would never become old and infirm, and thus never need LTC insurance. In my 50th year this delusion has begun to dissipate.

Then I had to overcome my reluctance to get involved in one of the uglier products the insurance industry provides in our capitalist economy. Profitting from old age and frailty is reprehensible. A civilized society should care for its weaker members at government expense. (Call me a socialist, that's fine.) But I persuaded myself that this is the way it is, and the longer I delay, the higher the premiums will be.

I went to the site of a company that provides LTC policies to federal employees, and began the process of educating myself in the bewildering jargon and options. Within 30 minutes I was a veritable expert -- compared to 30 minutes before -- but I still had questions. You can choose between a three-year, five-year or unlimited term of coverage. Of what use is this if, for example, after your three years elapse you still need to pay someone to empty your bedpan? The website encourages you to call if you have questions, so I called and was promptly connected to a knowledgeable and courteous gentleman. He explained to me that the majority of people who require LTC are dead in about 2.7 years. Fifty percent of policyholders therefore choose the 3-year option, thus placing a grim but rational bet against their survival. Another 30% take the 5-year option. And what of the other 20%? They are generally in two categories: either they have high enough incomes that they just don't care about the higher premium, or else they have a nasty family history of longevity and Alzheimers.

Much as I would like to fancy myself a clear-eyed and courageous realist, having to make this choice is troubling. The temptation is to choose "unlimited", almost as if doing so would make my lifespan unlimited. On the other hand I am disgusted at the idea of giving more money than necessary to a for-profit venture that benefits from human beings' decline into helplessness and death. I sat in front of the computer for a while, playing with different options in their interactive rate-quoting thingy.

A few days later I came across a blog entry by Jane Gross describing how large insurers like Conseco have been fucking their LTC policyholders -- I paraphrase, to be sure -- by wrongly denying claims and erecting all manner of bureaucratic obstacles in the hope that the customer will die before they have to pay. The program I am considering involves different companies, but the current financial meltdown teaches us that even the largest and oldest of financial services companies are subject to collapse. By the time you need to file a claim, they may have disappeared; if not, they may fuck you.

This dirty business is emblematic of the orgy of greed and incompetence that has been dragging these United States down the toilet. People like Gore Vidal have been telling us for years that the American empire is in decline. Kevin Phillips compares our collapse to those of the English, Spanish and Dutch empires of centuries past. Perhaps these closing days of the Bush administration are the final movement of some glorious symphony of decadence and corruption, the fantastic scandals of Governor Bagojevich and Bernie Madoff exploding like great fanfares of brass and tympanies.

As it turns out, however, there is nothing to be gained by failing to procrastinate about buying my LTC policy until the eve of my next birthday. Rates are tied to age, but a 50.01-year-old is treated the same as a 50.99-year-old. So I can wait until my next birthday approaches, well into the Obama administration. If I don't get hit by a bus, and if Obama hasn't established the socialist utpoia that the right so dreads, I will deal with LTC insurance in the spring.

Posted by Professor B at December 15, 2008 5:32 PM

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