Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: THURSDAY, January 28, 1993 TAG: 9301280356
SECTION: EDITORIAL PAGE: A10 EDITION: METRO
SOURCE: Ray L. Garland
DATELINE: LENGTH: Long
GOOD TIMES, HARD TIMES
THE 1993 VIRGINIA General Assembly is getting off to a slow start, awaiting a deluge of new bills that it cannot possibly digest before adjournment Feb. 27. But a few interesting items are perking along:Let the good times roll: Del. Jerrauld Jones, D-Norfolk, wants to bring riverboat gambling to Virginia's Tidewater and has rolled a seven before a House subcommittee.
The bill probably won't make it all the way through at this session, but it's an idea whose time has clearly arrived. Six other states, primarily in the Mississippi basin, have done the same thing, joining a host of others that see various forms of gaming as the golden fleece for what ails a post-industrial economy.
"If we can't do this," Jones warned, "my downtown waterfront is going to die." That's funny. When I saw it last month, the Norfolk waterfront seemed remarkably alive and was preparing to break ground for a new baseball park. But why cavil? This is what we are and where we're going.
That vast enterprise of recycling dollars known as the Virginia Lottery was brought in with a whoop by a vote of the people themselves. That the state's overall position is weaker now than when the lottery started will convince few that we can afford to dispense with this marvelous balm.
If the state itself is going to conduct a scam of this magnitude, there's no logical reason for denying private enterprise. Besides, a riverboat sounds like a lot more fun than standing in line at a convenience store.
Under the B: State Sen. Benjamin Lambert, D-Richmond, is the latest in a long line trying to tame the beast unleashed nearly 20 years ago when the assembly authorized gambling for charity.
Last fall, the Richmond Times-Dispatch conducted a massive investigation of bingo in the Richmond metro area, and reporting some shocking facts. In Richmond, official reports showed bingo "sales" of $4.3 million, and contributions to charitable sponsors of only $122,648, or 2.9 percent. In suburban Henrico County, the charities did a tad better, getting just over 8 percent of the take.
But it was documented that a close associate of the vice chairman of the Henrico Board of Supervisors had collected $354,000 in one year from rentals on games in a building he owned - a handsome rate of return for a building the county assessed at only $491,000. State law had specified "current, fair-market rental" for the use of such premises.
Lambert's bill, which is expected to pass, would grant localities additional power to regulate bingo, and would limit the number of organizations for which an operator may manage games and raffles. But this is largely a cash business: It's extremely doubtful that many localities have either the staff or the will to make a thorough job of seeing to it that bingo is the good clean fun, all in a good cause, that was advertised when state legislators opened this particular Pandora's box.
The only real solution - and it wouldn't stand a prayer of passing - is to restrict games to premises under the complete control of the charities, with contractors out of the business entirely.
Making a Start: The Joint Commission on Health Care, chaired by state Sen. Stanley Walker, D-Norfolk, has produced a timely report on how the state might deal with what is fast becoming a national feeding-frenzy before it gets completely out of hand.
That would be the practice of transferring assets to children or other heirs to make certain that when the time comes for someone to enter a nursing home, it will be Medicaid that picks up the tab. A book on how to do this has been a national best seller, and it's a hot topic on the radio and TV talk-show circuit.
As Del. Ford Quillen, D-Scott, put it: "The children bring the parents in. They think everybody's worked hard for their assets and they don't want to see them used up in a nursing home. They think it's the government's job to provide long-term health care." Walker and Quillen would like to see the legislature adopt proposals moving back the time limitation for the legal transfer of personal assets from 30 months, and requiring clerks or court to make property checks on Medicaid applicants. They would also make it illegal to shelter assets in annuities or trusts, and would allow the state to recover assets from the estates of recipient's spouses. The trick now is to predict the approximate moment at which a person will require nursing-home care and make certain that all or most assets have been transferred out of their names prior to that date. In Virginia, at least, it doesn't seem to be a big problem yet, but it's clearly coming as more people find out what they must do.
State auditors estimate that only about 8 percent of Medicaid recipients now in Virginia nursing homes have used legal maneuvers to shelter about $14 million in assets, or less than 2 percent of the annual cost of the whole program.
The Reality: Medicaid patients now occupy about 60 percent of nursing-home beds, but reimbursement in many cases is barely sufficient to pay for a reasonable standard of care.
Private-pay patients undoubtedly get slightly better care. But it's probably true, as nursing-home operators claim, that the additional money they pay helps a bit in making the overall structure work.
If the government is going to pay the whole freight, one of two things will happen: Costs will rise even more rapidly than they have, or such standards of care as exist will be further eroded.
For most middle-class people worrying about transfer of assets, I'm convinced there is a better solution: Take the dollars they are now putting in Medicare-plus policies that end up paying a relatively small share of routine costs, and put those dollars in good nursing-home insurance. There were some bad nursing-home policies out there a few years ago, but this is now an avenue offering reasonable protection at fairly reasonable cost.
An explosion in the cost of providing long-term care is coming. The government will never find a way to fund this on a completely fair and actuarially sound basis, but many Americans can do it for themselves, and should.