The idea is that older people and people with disabilities would make a compact with government agencies wherein the individual will pay a fair share of long-term care services and then receive government support. To become a compact participant an individual would pledge an amount equal to half his or her assets, not counting the home. There would also be special discounts for people with very little assets. As an alternative, individuals with greater assets could pledge the cost of three years in a nursing home instead of half of their assets. Once the pledge money is spent, the participant will then receive government subsidy to pay for future long-term care services at the equal of the Medicaid rate. In the future, each beneficiary would be entitled to receive services funded by the compact in accordance with the assessment of need and a plan of care. Each individual would be asked to pay an additional 10 percent of the cost and would have an annual participation fee which would not be greater than 25 percent of their income.

The idea of the plan is to provide some peace of mind for those older people who have the constant worry that should they be unfortunate enough to become ill, the assets that they have saved all their lives would be dissipated. This plan, if accepted in New York, would provide the possibility for peace of mind.

There are many benefits for the individual. Eliminating the uncertainty of relying on the Medicaid program, which is in constant flux, is the main benefit. Knowing that one could preserve assets after a certain amount has been spent will be highly beneficial. There would no longer be the concern that in the future, additional assets or income would have to be spent, and there would not be the concern, as there is with Medicaid, that after death, liens could be attached or state recovery could be attempted. Services could be provided by any provider instead of having to rely strictly on Medicaid providers. In addition, those involved with the compact could purchase long-term insurance to cover their responsibility, and theoretically the policies should cost less because the cost would be limited.

There are critics of the plan. Once again, we hear rumblings about "multimillionaires" being able to artificially limit their expenses. It is mind boggling how this big lie has spread. As I have said over and over again, my clients are not multimillionaires but middle class hardworking people. However, the multimillionaire lie has consistently been an effective argument to turn public opinion against those who are in danger of being financially destroyed by illness. Hopefully, the legislature and governor will give serious consideration to the compact plan as a way to alleviate the financial burden and the stress on New York's older population.