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Financing reform for long-term care: strategies for public and private long-term care insurance



Financing reform for long-term care: strategies for public and private long-term care insurance



Journal of Aging and Social Policy 7(3-4): 109-127



The way the nation provides for the financing and delivery of long-term care is badly in need of reform. The principal options for change are private insurance, altering Medicaid, and public long-term care insurance. This article uses the Brookings-ICF Long-Term Care Financing Model to evaluate each of these options in terms of affordability, distribution of benefits, and ability to reduce catastrophic out-of-pocket costs. So long as private insurance is aimed at the elderly, its market penetration and ability to finance long-term care will remain severely limited. Affordability is a major problem. Selling to younger persons could solve the affordability problem, but marketing is extremely difficult. Liberalizing Medicaid could help solve the problems of long-term care, but there is little public support for means-tested programs. Finally, universalistic public insurance programs do well in meeting the goals of long-term care reform, but all social insurance programs are expensive and seem politically infeasible in the current political environment.

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Accession: 046094155

Download citation: RISBibTeXText

PMID: 10183219

DOI: 10.1300/j031v07n03_07


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