Marc Cohen went back a long way with Josh Wiener.
For decades, they debated the substance and detail of one of the most pressing social and economic challenges of our times – how to pay for the long-term services and supports increasing numbers of older Americans depend upon. Cohen, now co-director of the LeadingAge LTSS Center @UMass Boston, was one of more than a dozen experts speaking last week at a Washington symposium to honor Wiener, a leading figure in the field who died in January. Cohen’s comments begin about 48 minutes into a video of the entire event.
“I knew and frankly sparred with Josh for nearly 40 years on the issue of long-term care financing and, in particular, on the respective roles that could be played by the public and private sectors in addressing the challenge,” said Cohen.
He recalled a presentation to the National Governors Association that took place in 1988. Both men appeared at the event and found themselves at the opposite ends of the political spectrum. Wiener argued for the need for a public social insurance program. Cohen made the case for supporting growth in the private insurance market.
“What I did not fully realize then, was that in fact we were both advocating for a solution with the same goal in mind: moving the financing system away from one that was welfare-based and toward one that was insurance-based,” said Cohen. “Where we differed in our approach was on the proper balance between the private and public sector roles.”
Many years of experience and data on the subject led Cohen and co-authors Judith Feder and Melissa Favreault, both of the Urban Institute, to propose a new kind of LTSS financing solution earlier this year. It combines the public insurance and private coverage Wiener and Cohen debated for so long — conflicting approaches that could in fact support each other.