Elder Law Prof Blog

Help make CRS reports open to all

Seventeen partners in the OpenTheGovernment.org coalition and others sent letters on Wednesday, March 28, to Speaker of the House Nancy Pelosi, and to the members of the House Administration Committee and the Senate Rules Committee urging action to ensure no-fee online public access to all CRS (Congressional Research Service) reports.  The public deserves free, fast online access to CRS reports that cost taxpayers $100 million annually, the Center for Democracy & Technology (CDT) and OpenTheGovernment.org said in letters to House Speaker Pelosi and other Hill leaders. CRS reports have "never been made available in a consistent way to members of the public," the letters said. Lawmakers can give reports to constituents on request -- a "slow, unreliable process," and of little use since the public doesn't know what CRS publishes, groups said. CRS recently tightened curbs on how researchers share public information and who has access to information, they said. It would be a "trivial expense" for the Library of Congress to increase capacity and add public access to the password-protected CRS database Congress uses. Private companies sell the reports, and CDT's OpenCRS.com collects reports from members of Congress. They have been downloaded 3.5 million times -- but only making all reports searchable online will "sate those demands and help produce a better-informed electorate," the letters said. Signatories included the American Library Association., the Electronic Frontier Foundation and the National Security Archive.

http://www.openthegovernment.org/

Ed:  CRS reports enable voters and scholars to examine and evaluate claims about, e.g, the long term costs/benefits of tax cuts, the true truth about deficits and government debt, and how well particular agencies are doing their jobs.  Get more info about making taxpayer-funded research avalable to taxpayers at  opencrs.com 

Testosterone and Alzheimer's--is there a link?

RESEARCHERS in Perth have made a groundbreaking discovery into the prevention of Alzheimer's disease, after showing that boosting testosterone levels in the body can lower levels of a toxic brain protein linked to the development of the crippling condition.  Preliminary results from a clinical trial of West Australian men, presented at the prestigious Royal Society of Medicine in London, show that not only does the use of a testosterone cream lower the protein beta amyloid but importantly it appears to improve memory.  Professor Ralph Martins, of the Sir James McCusker Foundation for Alzheimer's Research at Hollywood Private Hospital, said from London that he was excited by early results from an ongoing trial of healthy men aged 50 to 72 who had a testosterone deficiency and only mild signs of memory loss.  They have been treated at Perth's Well Men Centre using a WA-made testosterone cream, and the trial follows an earlier study of guinea pigs which showed the treatment reduced their levels of beta amyloid.

 

Desperate for more info?  Visithttp://www.smh.com.au/news/science/alzheimers-tackled-by-testosterone-boost/2007/03/29/1174761669462.html

Last WWI female vet passes away

In 1916, Charlotte L. Winters called on the secretary of the Navy and asked why women weren't allowed to enlist.  A year later, she had begun her military career.  This week, Mrs. Winters - the nation's oldest female military veteran - died in her sleep at the Fahrney-Keedy life care community in Boonsboro. She was 109.  "She is the last female World War I veteran," American Legion spokeswoman Ramona E. Joyce said yesterday.  With Mrs. Winters' death, there are only four surviving U.S. veterans from the "war to end all wars," according to the Scripps Howard News Service, which tracks living veterans of that war. Since the beginning of the year, six - including Mrs. Winters on Tuesday - have died.

Read more about this extraordinary woman in the Baltimore Sun.

Turkey: many seniors choose institutional care over family care

A survey conducted by the Social Services and Child Protection Agency (SHCEK) reveals that a majority of senior center residents have living relatives but that they prefer to live in centers because of a lack of care from their relatives. The research was carried out in connection with the Project on Reducing Social Risk (SRAP). It also estimates that 9 percent of the Turkish population will be over the age of 65 by 2010. Nearly half, 45 percent, of participants in 63 senior centers in 46 provinces noted they were from rural areas. A majority of them are widowed and undereducated; 59 percent of the survey participants did not even finish primary school. However, the research also shows that those who are waiting for admission are relatively better educated; 90 percent of male senior center inhabitants and one in three females were previously employed. More than half of surveyed seniors do not benefit from any social security or pension system.

According to the research, 85 percent of respondents have at least one living relative, whereas 14 percent have none. Half of the seniors who have one relative noted they were able to see their relatives at least once a month and half indicated they were being financially supported by their relatives. Thirty eight percent of center residents who have been living there for a relatively long time described the center as "home," 20 percent as "place to live in," and 22 percent as "a residential place with hard conditions." Their stated reasons for living in the centers are "difficulty in living alone," a wish "not to be a burden on the family," "inability to take care of [him/herself] in daily life" and "health reasons."

Read more in Today's Zaman.

CA assembly committee approves death with dignity bill

Legislation that would allow the terminally ill to obtain life-ending drugs from their physicians was approved by an Assembly committee Tuesday as supporters made their fourth attempt to get the proposal to the governor's desk.  The Judiciary Committee's 7-3 vote marked the third time the panel has approved essentially the same bill since 1999.  The two previous measures died on the Assembly floor, and a third bill failed in the Senate. But supporters have some additional clout this year. Assembly Speaker Fabian Nunez, D-Los Angeles, has signed on as a co-author, which could assure the proposal of passing the Assembly.  "I'm saying the prognosis (for the bill) is healthy," another co-author, Assemblywoman Patty Berg, D-Eureka, said after the vote. "I'm saying the prognosis is we're going to win this one."  Even if the bill makes it out of the Legislature, it could face a veto by Gov. Arnold Schwarzenegger, who has said the issue should be decided by voters rather than the Legislature and governor.

Read more in the SF Chronicle

Elder Justice Act to be re-introduced

Via Sally Hurme: Senators Lincoln and Hatch will be reintroducing the Elder Justice Act today, and most likely Representatives Emmanuel and King will be introducing it in the House this week. Stay tuned.

NYT article on long term care insurance problems creates a firestorm

On Monday, the New York Times published an article this week on the long term care industry--specifically, policy issuers' refusal to pay benefits when owners go into long term care.  Those of us who have studied long term care insurance have lonog been aware of this issue, but promoters of LTCI, including the authors of the Deficit Reduction Act of 2005, have ignored the problem and have continued to support private LTCI as a solution to the nation's coming need for a rational system of financing long term care for the elderly.  I received numerous suggestions to post the article.  The article has also generated a firestorm of criticism of the industry and calls in the Congress for investigations.  Here's a small sample of reactions nationwide:

Klobuchar calls for insurance investigation
http://www.startribune.com/587/story/1083733.html

Leading Industry Critic Charges Long-Term Care Insurance Carriers With Bad Faith / Racketeering http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/03-28-2007/0004555010&EDATE=

Senator Clinton Calls for GAO Investigation of Impact of Widespread Insurance Claims Denials for Long Term Care, http://www.allamericanpatriots.com/m-news+article+storyid-21784.html

A new insurance worry
http://www.palmbeachpost.com/opinion/content/opinion/epaper/2007/03/28/a12a_longterm_edit_0328.html

Fidelity estimates a retiree needs $107,500 for health care costs

Rising health care costs are eating up more of retirees' savings, with a 65-year-old couple retiring this year needing about $215,000 to cover medical costs over the rest of their lives, Fidelity Investments said Tuesday.  The $215,000 represents a 7.5 percent increase from Fidelity's estimate last year of the amount a typical U.S. couple would need during retirement to pay for health care, including medical and surgical expenses as well as prescription drugs.  That increase is slightly higher than the average annual increase of 6.1 percent since Fidelity began calculating retiree health care expenses five years ago. Since then, the highest increase came in 2005, when the estimate rose 8.6 percent.  The cost estimates generally track inflation in health care expenses. Fidelity, the nation's largest mutual fund manager and a provider of retiree financial services, projects health care costs will rise about 7 percent per year.  Those costs are rising faster than overall inflation because of increasingly expensive medical technologies, costlier prescription drugs and longer life expectancy, said Brad Kimler, senior vice president for Fidelity Employer Services Co., a division of Boston-based Fidelity. Fidelity estimated that 32 percent of the $215,000 estimate _ up from $200,000 a year ago _ would be for Medicare coverage premiums for expenses from doctors' visits, outpatient hospital care and prescription drugs.  Another 35 percent of the expenses would come from other cost-sharing provisions of Medicare, including co-payments and deductibles. Out-of-pocket costs for prescriptions would account for another 33 percent.

Note:  The estimate assumes retirees have no employer-provided health care coverage.

Source:  Houston Chronicle/AP

Stating the obvious....

From a recently released GAO report on saving Social Security:

Fourteen of 17 proposals GAO reviewed provided GR (general revenues) 1) as needed to maintain trust fund solvency or (2) as specified by formula, amount, or source. Nine of the 17 achieved “sustainable solvency” under OCACT’s definition using the first approach. This type of unlimited transfer poses the greatest potential risk to the federal budget, especially when combined with benefit guarantees. In proposals reviewed, amounts of GR under both types of approaches ranged up to about twice program shortfall.

In all proposals using GR, the GR was reallocated from the non–Social Security budget. While any additional revenue to the trust fund will help solvency, unified federal budget effects depend on the type of revenue—whether it is new revenue (additional payroll tax revenue or GR that is new to the federal budget) versus reallocated GR. Absent other changes, new revenue would improve the long-term fiscal imbalance while reallocated GR would do nothing to address it. Although raising taxes (payroll or other) or cutting benefits would have tangible consequences for taxpayers and beneficiaries, e.g., less take-home pay or smaller benefit checks, the consequences of transfers from the non–Social Security budget in the form of reallocated GR are less likely to be clearly observable. Reallocated GR, however, is not free. Regardless of how GR is provided to Social Security, it must be paid for at some point. The question is when, and by whom.

Duh. 

Read the report.

Dems say they support universal health care

But, except for Edwards, they don't say who will pay...

All seven Democrats who attended a forum sponsored by the Service Employees International Union and the Center for American Progress claim to support extending health care coverage to the nearly 50 million uninsured Americans.   But only John Edwards, who appeared with his wife, Elizabeth, said he'd pay for it by raising taxes, rolling back President George W. Bush's tax cuts for the wealthy.  "We didn't get enough details from the other candidates on how they would pay for it," said SEIU secretary-treasurer Anna Burger.

Source:  Newsday
Full story:  http://www.newsday.com/news/local/longisland/politics/ny-ushill255144740mar25,0,7989803.story

Indiana-Indiapolis law prof to assist state in developing long term care strategy

A team of experts from Indiana University will help the state devise a long-term strategy to confront the growing cost of health care and possible changes to the way it is delivered in the state.  The group will hold a series of public hearings in late spring or summer aimed at developing a single plan that tackles three problems: the rising cost of health care, uneven quality of care and the growing number of Indiana residents with little or no insurance.  “We want to build consensus around some policy options,” Eric Wright, director of IU’s Center for Health Policy, said in announcing the initiative Wednesday with Family and Social Services Administration Secretary Mitch Roob.  Wright will lead the IU team with Eleanor Kinney, co-director of Hall Center for Law and Health at the IU law school in Indianapolis.  Experts in health administration, economics and medicine also will participate.  Wright noted that Massachusetts and California in recent months have put forward their own plans to provide universal health care, but no solution is going to fit every state, so Indiana must develop a plan particular to its needs.The plan would look into the future as far as 25 years, but if it comes together in time, the plan could go before the General Assembly next year.

Read more at Fort Wayne.com.

President opposes plan to bolster SCHIP

The Bush administration reassured worried health insurance executives Thursday that it strongly opposes efforts to cut their payments and use the savings to expand a separate insurance program for children.                

Health and Human Services Secretary Mike Leavitt said that cutting managed care payments to insurers serving the elderly is part of a broader effort by some lawmakers to get the federal government to run health care.  "There are those who want the government to do the market's job," Leavitt told members of America's Health Insurance Plans, a trade group. "They want to steer Americans into a government run, one-size-fits-all plan."  Democratic lawmakers have listed the expansion of the State Children's Health Insurance Program as their top health priority this year. Their goal: Increase enrollment in the program from about 6 million children to about 12 million. The cost would be about $75 billion over five years _ triple current funding.  Many Democrats say some of the money necessary for an expansion should come from the managed care plans that enroll Medicare beneficiaries. Leavitt said the Democrats also wanted to expand the program to middle-income adults.

Read more in the Houston Chronicle.

Ed: How well is the market doing its job in the Medicare Advantage arena?  Well, a recent study of MA plans showed that the cost to the government per beneficiary substantially exceed the cost per beneficiary enrolled in traditional  Medicare.  Hmmm. ....

Ireland: Should women forced to quit receive a pension?

The government’s upcoming Green Paper on pensions will examine whether women who lost their pension after they were forced to leave work should be entitled to a state pension.

Under the marriage bar, which was abolished in 1973, women working in the public and civil service had to resign as soon as they married. Many of these women lost their cover under the social welfare system when they left work, and either did not qualify for a state pension when they retired, or only qualified for a smaller state pension.  ‘‘Women have been atrociously discriminated against in pensions over the years,” said Pensions Ombudsman Paul Kenny. ‘‘Women were not just forced to leave jobs in the civil and public service because of the marriage bar; they were also expected to leave jobs in semi-state companies.

Read more at The Post.ie.

Not elder law: KU fan rests for eternity...inside a basketball...

Mary Oliver had made up her mind. And a million incredulous looks from the funeral director wasn't about to change it.  Her beloved Donald would spend eternity inside a basketball.  Well, what was left of Don. His cremated ashes. Maybe, said the director, as politely as possible, we could imprint the urn with a basketball.  Nope, said Mary. No imprint. The genuine article. Leather and everything. The family had the perfect one available, a ball Don's granddaughter, Caley Onek, and her brother had given him as a birthday present. A section of the ball was cut away. The plastic bag of ashes was carefully tucked inside, and the section replaced.  They really hooped it up at Don's service as well. Final Four hats were positioned up and down a small ladder.  Pictures of the 23 Final Fours Don and Mary had attended shared space with a big bouquet decorated with mini basketballs, stickers and jerseys. 23 consecutive Final Fours when a nasty cough set in early last year. A trip to the hospital revealed the worst possible news.
Don had lung cancer. Of course, he felt terrible. He must have. For the first time in 23 years, Don and Mary skipped last year's Final Four.  Don seemed to be holding his own. Then, last August 1, Don and Mary were preparing to attend -- what else? -- a game. Mary walked out to the car and saw Don on the ground.  An ambulance was summoned, but it was too late. Seventy-year-old Don Oliver was dead from a blood clot to the heart. 

Donald Oliver loved basketball. No, he really loved basketball. As a boy growing up in Miller, Kan., he played all the time.  His passion translated throughout the family. His daughter played in high school, then coached at Allen County Community College in Iola.  His granddaughter plays for Flinthills High School in Rosalia, and plays to continue in college.  Don would attend her Monday night game, then his grandson's game on Tuesday night. The area's college teams, Emporia State and Washburn University, weren't ignored either.  Nor was the state's powerhouse, the University of Kansas. Don wouldn't drive to those games in Lawrence. Too far.  Instead, he'd fly, wearing the KU cap with the giant Jayhawk perched on top.  "He had a passion for the game that I couldn't even describe,'' said Caley.

Read more in the Sarasota Herald Tribune.

Ed.--What can I say but Rock Chalk Jayhawk Go KU!

Congressmen want to withhold Medicare payments to tax-delinquent docs

Doctors and other health care providers who owe the federal Treasury more than $1 billion in back taxes are still receiving government checks for treating Medicare patients.  In one case, a doctor received nearly $100,000 in Medicare payments during the first nine months of 2005 despite a $600,000 overdue tax bill. The doctor owned several homes, including one overseas.  Another physician gambled millions of dollars and purchased a luxury car — while defaulting on an installment agreement with the IRS that required monthly payments of $10,000. Medicare paid that physician about $100,000 in 2005.  In all, congressional auditors estimate that more than 21,000 physicians and other health care providers are abusing the federal tax system. The taxes that went unpaid for just the first nine months of 2005 exceeded $1 billion, and investigators believe that estimate to be a conservative one. Lawmakers want the Health and Human Services Department to participate in a payment system that would allow the government to garnish a percentage of the Medicare reimbursements going to tax scofflaws.  "What you see are cases of folks who are really living the good life," said Sen. Norm Coleman, R-Minn. "These are not folks who are scraping by, and somehow, just by timing, they can't meet their obligations.  In recent years, the Senate Committee on Homeland Security and Governmental Affairs has investigated an array of contractors who benefited from government payments even as they declined to pay federal taxes.  Now, the committee, in particular its Permanent Subcommittee on Investigations, is focusing on the health care system. It asked the Government Accountability Office to determine if physicians and other health care providers have unpaid federal taxes and, if so, to determine the magnitude of the problem.  "Our investigation found abusive and potentially criminal activity," the GAO's investigators are expected to tell the subcommittee on Tuesday. "Many of these individuals accumulated substantial wealth and assets, including million-dollar houses and luxury vehicles, while failing to pay their federal taxes."

Source: Kaiser Family Foundation/AP/Houston Chronicle.

Ed:  I have a better idea.  Prosecute them and throw them in prison.

Elder Law Prof blog featured on Blawgsearch

Elder Law Prof Blog is this week's featured site at blawgsearch.justia.com, one of FindLaw founder Tim Stanley's current projects.  Check out Justia.com for the Supreme Court Center, legal podcasts, and more. 

High cost drugs and the value of a few more weeks of living...

     The Los Angeles Times on Sunday examined the "new generation of hyper-expensive cancer drugs" that tend to extend lives by only a few months. According to the Times, the high prices of the drugs, which can cost as much as $100,000 for a year's supply, and their relatively limited health benefits "have sparked arguments among policymakers and medical professionals about what to do with the growing number of people who are depleting their life savings on the drugs, or worse, who can't get them at all." Drug companies and some patients "insist even incremental gains" in their health "are worthwhile," even as the cost burden of such drugs grows for patients, who increasingly are paying percentages of treatment rather than copayments, according to the Times. In addition, because insurers typically pay for FDA-approved drugs, the cost of covering the treatments "would eventually spill into the nation's overall medical bill and therefore would raise everyone's insurance premiums," the Times reports. FDA approval of the drugs for use in early-stage cancers also could significantly expand usage, which could increase health care costs overall. Some physicians have begun to offer payment plans to patients who use the drugs, and some biotech drug manufacturers have placed caps on patient spending. For example, patients can receive Amgen's Vectibix for no cost after copays for the drug exceed 5% of their adjusted gross income. Meanwhile, patient advocacy groups, such as Breast Cancer Action, are pushing for legislation that would limit the prices drug companies could charge for biotech drugs. Peter Neumann, director of the Center for the Evaluation of Value and Risk at Tufts-New England Medical Center, said, "In terms of the cost of a life saved, it's possible other areas of medicine, like better disease prevention or better cardiovascular care, may be more effective" (Costello, Los Angeles Times, 3/18). 

                         

Reported by Kaiser Family Foundation and the LA Times.

Statistics Canada: A Portrait of Canadian Seniors

This report depicts the demographic characteristics, health and wellness, living arrangements, social networks and social participation, security from crime and victimization, work patterns and related activities, income and expenditures, and lifestyles of the population aged 65 and over. It examines many of these issues, where data allow, in terms of different age groups within the senior population, for example those aged 65 to 74 and those aged 85 and over. Information are also presented for individuals in the 55 to 64 age range.  The report also includes a chapter on Aboriginal seniors and a chapter on immigrant seniors.  It presents the most comprehensive statistical picture of the situation of Canada's senior population with data drawn from a wide array of sources including the census, as well as other surveys such as the National Population Health Survey, General Social Survey, Canadian Community Health Survey, and Survey of Labour and Income dynamics.

Get it here.

Thanks to Laura Watts of the Canadian Centre for Elder Law Studies for bringing this to my attention.

Adult adoptee seeks share of IBM fortune

On an island liberally sprinkled with the affluent and well-connected members of such clans as Bush, du Pont, Rockefeller and Cabot, the Watson family occupies a special place.  The family, descendants of Thomas J. Watson Sr., the founder of I.B.M., owns more than 300 acres worth nearly $20 million on the northern tip of this sea-splashed idyll 90 miles northeast of Portland. Over four decades, various Watsons summering here have flown helicopters and other aircraft; driven antique cars and collected scrimshaw. The family has held an annual square dance at their compound, Oak Hill.  Recently, though, the Watson name has surfaced in a different context, a most unusual lawsuit. It concerns Olive F. Watson, 59, granddaughter of the I.B.M. founder and daughter of Thomas J. Watson Jr., the company’s longtime chief executive; and Patricia Ann Spado, 59, her former lesbian partner of 14 years.  In 1991, Ms. Watson, then 43, adopted Ms. Spado, then 44, under a Maine law that allows one adult to adopt another. The reason, Ms. Spado has contended in court documents, was to allow Ms. Spado to qualify as an heir to Ms. Watson’s estate.  But less than a year after the adoption, Ms. Watson and Ms. Spado broke up. Then in 2004, Ms. Watson’s mother died, leaving multimillion-dollar trusts established by her husband to be divided among their 18 grandchildren.  Re-enter Ms. Spado with a claim: Because she was adopted by Olive F. Watson, she said, she is technically Thomas J. Watson Jr.’s 19th grandchild and is therefore eligible for a share of the trusts.

Read more in the NYTimes.

St. Thomas (FL) law review call for papers on elder law issues

March 14, 2007 CALL FOR PAPERS

Symposium Issue:  Elder Law The St. Thomas Law Review invites contributors to their symposium issue on Elder Law.  This new symposium will be the St. Thomas Law Review’s First Annual Elder Law Issue, as the Review has deemed this to be an important and ongoing topic warranting academic attention.  The first issue will be published in the 2007-2008 academic year. This could include topics such as nursing homes, wills and trusts, health law, estate planning, Medicare/Medicaid, guardianship, etc.  This list is in no way exhaustive of the possibilities! We are flexible on length.  Please contact me directly if you might be interested in contributing.    Ms. Jordan Erickson St. Thomas Law Review Article Solicitation Editor, 2007-2008 [email protected]