Medicaid Planning: When Ethics Meets Reality

https://www.nytimes.com/2017/08/09/opinion/medicaid-planning-when-ethics-meets-reality.html

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To the Editor:

Re “The Ethics of Trying to Qualify for Medicaid,” by Ron Lieber (Your Money column, July 22):

I am an elder care attorney and routinely do Medicaid planning, helping clients in need of long-term care to preserve assets for family members while qualifying for Medicaid. As a professional, I have a duty to advocate for my clients. But as a citizen and taxpayer, I am often asked whether it’s ethical to help people who can pay for long-term care to instead shift that cost to the government.

I’ve found that those concerns typically disappear when people are actually faced with the enormous costs of long-term care. With New York City-area nursing homes often costing more than $140,000 per year, even wealthy people and lifelong savers can quickly lose everything. Faced with this reality, even the staunchest fiscal hawks tend to suddenly recognize the ethical soundness of Medicaid planning.

It is right and good to question spending as a society, but when it’s actually you who may have to leave your spouse impoverished, or lose an inheritance that you were counting on to pay for your children’s education, people tend to reorient their ethical compass.

MARK R. FRIEDMAN BRIDGEWATER, N.J.