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Is Medicaid Planning Ethical?

Posted on: July 28th, 2017 by Mark R. Friedman

The New York Times recently published a thought-provoking article by Ron Lieber on the ethics of Medicaid planning. The article posed the question of whether it’s ethical to engage in Medicaid planning, to preserve assets for other family members while qualifying for Medicaid to pay for long term care.

As NJ elder care attorneys, Medicaid and long term care planning are a large part of our practice here at FriedmanLaw. I have helped dozens of clients save tens or hundreds of thousands of dollars against long term care costs. Larry has helped hundreds, perhaps thousands of clients with Medicaid planning over the years.

So we know a thing or two about it.

Sometimes friends or colleagues ask me in a social setting whether I’m comfortable with the ethics of Medicaid planning or whether I think it’s good for society to help people avoid paying long term care costs and instead shift the cost to the government. My response is that every technique we use is perfectly legal, and indeed provided for in Medicaid laws. But it can’t be denied that long term care Medicaid costs society a lot of money and increases the state and federal budget deficit.

That said… I’ve never had a client question me on the ethics of Medicaid planning. It’s fine to question the practices of others, or the practices of society. But when it comes to your own money, even the staunchest fiscal hawks tend to suddenly recognize the ethical rightness of Medicaid planning.

Long term care is incredibly expensive. In our area of central and northern New Jersey, nursing homes typically cost more than $120,000 per year. Faced with those kinds of overwhelming costs, it’s easy to see why people want to engage in Medicaid planning – because all of their money will be wiped out afterwards. When it’s your spouse who might be left impoverished, or you face the prospect of losing an inheritance you were counting on to pay for your children’s education, I find that for most people, ethical concerns about society and the deficit usually evaporate.

That’s not to say that the cost of long term care isn’t an important issue. It is. As our population ages, funding long term care for everyone who needs it is going to become a larger and larger share of our federal and state budgets. If we still want to fund education, infrastructure, law enforcement, the environment, the military, etc. (which we should), then we need to come up with better and more efficient ways to provide custodial care to seniors and people with disabilities.

I always keep my ears open for “creative” proposals, and one of the most interesting I’ve heard is robot caretakers. It may sound far-fetched, but robots are being developed now to do things like administer medication, assist with mobility, and provide supervision and even companionship. If we could have five robot caretakers, remotely controlled by one human monitoring each one on a staggered schedule (say, one for five minutes, then the next, etc.), we could multiple the effectiveness of each caretaker. That would allow more people to stay in their homes longer, saving money and leading to happier and healthier citizens.

In the meantime, if you or a loved one may need long term care and you’re interested in preserving assets for other family members, please call FriedmanLaw at 908-704-1900.

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