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The Rise in Old Age Longevity and the Market for Long-Term Care

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Author Info
Darius Lakdawalla
Tomas Philipson

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Abstract

This paper analyzes how markets for old-age care respond to the aging of populations. We consider how the biological forces, which govern the stocks of frail and healthy persons in a population, interacct with economic forces, which govern the demand and suppoly for labor-intensive care. Many economists have argued that aging will raise the market demand for long-term care, and hence price and quantity through classic market effects. We argue that the direct effect of aging is to lower the demand for market care by incresing the supply of home production. By influencing the length of frail lifetimes, aging may also have a further indirect demand effect, which may reinforce or counteract the direct negative demand effect. By providing healthy spouses, the marriage market provides care-givers for home production of long-term care; therefore, growth in old-age longevity may lower the demand for market production. Growth of elderly males serves to contract the long-term care market becuase it eases the scarcity of men in the old-age marriage market; growth of females serves to expand market care because it worsens the scarcity of men. These predictions lend themselves to an interpretation of the rapid deceleration in output growth that has taken place in the US over the last two decades, despite a constant rate of longevity growth and enormous growth in demand subsidies: since growth in elderly males has risen dramatically relative to growth in elderly females, the rate of long-term care growth has slowed significantly. We test our predictions empirically using state- and county-level evidence on the US market for long-term care in nursing homes over the last three decades. The evidence provides support for our predictions concerning the response in output growth to aging and the contraction of output due to the aging of males.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 6547.

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Date of creation: May 1998
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Handle: RePEc:nbr:nberwo:6547

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I1 - Health, Education, and Welfare - - Health

References listed on IDEAS
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  1. Axel Borsch-Supan & Laurence J. Kotlikoff & John N. Morris, 1988. "The Dynamics of Living Arrangements of the Elderly," NBER Working Papers 2787, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  1. Craig William Perry & Harvey S. Rosen, 2001. "Insurance and the Utilization of Medical Services Among the Self-Employed," NBER Working Papers 8490, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  2. Atsue Mizushima, 2008. "Intergenerational Transfers of Time and Public Long-term Care with an Aging Population," Economics Working Papers ECO2008/36, European University Institute. [Downloadable!]
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  3. Olivia S. Mitchell & John Piggott & Satoshi Shimizutani, 2004. "Aged-Care Support in Japan: Perspectives and Challenges," NBER Working Papers 10882, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  4. Kristin J. Kleinjans & Jinkook Lee, 2006. "The link between individual expectations and savings: Do nursing home expectations matter?," Economics Working Papers 2006-05, School of Economics and Management, University of Aarhus. [Downloadable!]
  5. Gerard J. van den Berg & Maarten Lindeboom & France Portrait, 2007. "Conjugal Bereavement Effects on Health and Mortality at Advanced Ages," Tinbergen Institute Discussion Papers 07-009/3, Tinbergen Institute. [Downloadable!]
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  6. Jeffrey R. Brown & Amy Finkelstein, 2004. "Supply or Demand: Why is the Market for Long-Term Care Insurance So Small?," NBER Working Papers 10782, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  7. Karakaya, Güngör, 2009. "Long-term care: regional disparities in Belgium," MPRA Paper 13394, University Library of Munich, Germany. [Downloadable!]
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  8. Olivia S Mitchell & John Piggott & Michael Sherris & Shaun Yow, 2006. "Financial Innovation for an Ageing World," RBA Annual Conference Volume, in: Christopher Kent & Anna Park & Daniel Rees (ed.), Demography and Financial Markets Reserve Bank of Australia. [Downloadable!]
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  9. Romeu Gordo, Laura, 2006. "Compression of morbidity and the labor supply of older people," IAB Discussion Paper 200609, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany]. [Downloadable!]
  10. Darius N. Lakdawalla & Robert F. Schoeni, 2003. "Is nursing home demand affected by the decline in age difference between spouses?," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 8(10), pages 279-304, May. [Downloadable!]
  11. Jeffrey R. Brown & Amy Finkelstein, 2004. "The Interaction of Public and Private Insurance: Medicaid and the Long-Term Care Insurance Market," NBER Working Papers 10989, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  12. Darius Lakdawalla & Thomas Philipson, 2001. "Public Financing and the Market for Long-Term Care," Forum for Health Economics & Policy, Berkeley Electronic Press, vol. 4(1), pages 1023-1023. [Downloadable!] (restricted)
  13. Craig William Perry & Harvey S. Rosen, 2001. "The Self-Employed are Less Likely to Have Health Insurance Than Wage Earners. So What?," NBER Working Papers 8316, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  14. Rinaldo Brau & Matteo Lippi Bruni, 2006. "Eliciting the Demand for Long Term Care Coverage: A Discrete Choice Modelling Analysis," Working Papers 2006.71, Fondazione Eni Enrico Mattei. [Downloadable!]
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  15. David M. Cutler & Louise Sheiner, 1998. "Demographics and Medical Care Spending: Standard and Non-Standard Effects," NBER Working Papers 6866, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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