KIRKLAND, Wash. — President Obama, backed by Congressional leaders, has called for affordable, accessible, high-quality health care for all Americans. “But that won’t be enough,” says Denise Gott, “unless it also embraces the long term care needs of millions of longer-living Americans.” Gott is Chairman of the Board of LTC Financial Partners LLC (LTCFP) — — one of the nation’s most experienced long term care insurance agencies. “If President Obama’s three goals — universal coverage, choice, and cost control — are to be met,” Gott says, “provision for long term care must be part of the legislative mix.” Obama’s goals, in his own words, are listed below, followed by Gott’s reasoning.

1. Obama: “All Americans have to have quality, affordable healthcare.”

Gott’s response: “About 46 million Americans, close to 1 in 6, lack health insurance, but many times that number lack long term care insurance. Only about 9 million Americans have it — out of a population of more than 300 million. And among those at greatest risk, 45 and older, more than 9 in 10 go uncovered. Does it make sense to protect ourselves from shorter-term illnesses or injuries, and neglect the longer-lasting ones?”

2. Obama: “Americans have to be able to choose their own doctor and their own plan.”

Gott’s response: “It’s great for people to have options. For example, to stick with their employer’s health plan, or opt for a public alternative (if one is legislated). But when it comes to long term care, choice today is very limited. The majority who lack LTC insurance face a bleak, narrow prospect. They must spend down their assets to pay their bills; to qualify for public assistance through Medicaid, they must in effect become poor; and then they’re forced into an often overcrowded nursing home when they might prefer home care or assisted living.”

3. Obama: “The rising cost of healthcare has to be brought down.”

Gott’s response: “The government estimates that healthcare could consume one fifth of the economy in ten years, up from one sixth today. Clearly that huge drag needs to be moderated. But reflect on this: 77 million Baby Boomers are set to retire, contributing predictable long term care costs of hundreds of billions to trillions over the next two or three decades. Shouldn’t we moderate these costs too?”

Gott’s recommendations to the President and Congress:

* First, include strong long term care provisions in the legislative package you’re now crafting. LTC is the unseen elephant in the room.

* Offer substantial new tax incentives to help people afford long term care insurance as a part of their overall health package.

* Offer substantial new tax incentives to companies that include long term care options in their health benefit plans.

* For people who can’t afford long term care premiums, modify Medicaid to allow a choice of home care or assisted living in addition to nursing-home care.

* Avoid creating a new form of public insurance covering long term care. Instead, reform Medicaid to serve the same purpose in an affordable manner.

* Avoid forcing people to buy long term care insurance. Instead, rely on communication and persuasion. For example, add a tax-deduction checkbox to the Federal income tax return; or create a well-publicized Internet gateway to independent long term care insurance advisors.

* To control costs, rely heavily on prevention in the long term care arena, just as for shorter-term health needs. A great many adult-onset diseases, ranging from diabetes to Alzheimer’s, may be avoided or minimized through proper diet, exercise, and stress control. Consider incentives for individuals, insurers, and employers who promote good health later and later in life, with shorter periods of down time.

“Now’s the time to make your views known to the White House, your Senators, and Congressional representatives,” says Gott. A simple way to do that is to submit a form or dial a phone number found at — Gott also encourages citizens to write their favorite TV show to suggest a segment on LTC. “When something gets on Oprah, Good Morning America, The View, or 60 Minutes,” she says, “Washington listens.”