Done with respect for the law and compassion for the elders that are being protected, Medicaid planning is both prudent and ethical.  Within the United States, no one yet has a right to basic health care and long-term care. Instead, better care goes to people who can afford to pay for better care. The individual whose dire health care needs force him to "spend down" to Medicaid benefits loses his ability to pay for his other basic needs (such as food, shelter, and clothing, as well as other health care and long-term care goods and services). Within this system, Medicaid planning is not only ethically justified -- it is imperative to the individual's quality of life.

For seniors over the age of 65, Medicaid is equivalent to federally-subsidized long-term care insurance, just as Medicare is equivalent to federally-subsidized health insurance.  Congress accepts the realities of Medicaid Planning through rules that protect spouses of nursing home residents, allow Medicaid Asset Protection via the purchase of qualified Long-Term Care Insurance policies, allow the exemption of certain types of assets, and permit individuals to qualify even after transferring assets to a spouse or to a disabled family members or to a caregiver child.  To plan ahead and accelerate qualification for Medicaid is no different than planning to maximize your income tax deductions to minimize your income taxes.   It is no different than taking advantage of tax-free municipal bonds.  It is no different than planning your estate to avoid estate taxes.

For two additional and more lengthy articles on why Medicaid Planning is ethical, please see http://www.tn-elderlaw.com/medicaidplanning.aspx and http://www.elderlawanswers.com/elder_info/elder_article.asp?id=1175.