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Who Will Pay for Long-Term Care in the UK? Projections Linking Macro- and Micro-Simulation Models

Author

Listed:
  • Ruth Hancock
  • Adelina Comas-Herrera
  • Raphael Wittenberg
  • Linda Pickard

Abstract

The long-term care funding system continues to attract much debate in the UK. We produce projections of state and private long-term care expenditure and analyse the distributional impact of state-financed care, through innovative linking of macro- and micro-simulation models. Variant assumptions about life expectancy, dependency and care costs are examined and the impact of universal state-financed (‘free’) personal care, based on need but not ability to pay, is investigated. We find that future long-term care expenditure is subject to considerable uncertainty and is particularly sensitive to assumed future trends in real input costs. On a central set of assumptions, free personal care would, by 2051, increase public spending on long-term care from 1.1 per cent of GDP to 1.3 per cent, or more if it generated an increase in demand. Among the care-home population aged 85 or over, the immediate beneficiaries of free personal care would be those with relatively high incomes.

Suggested Citation

  • Ruth Hancock & Adelina Comas-Herrera & Raphael Wittenberg & Linda Pickard, 2003. "Who Will Pay for Long-Term Care in the UK? Projections Linking Macro- and Micro-Simulation Models," Fiscal Studies, Institute for Fiscal Studies, vol. 24(4), pages 387-426, December.
    • Handle: RePEc:ifs:fistud:v:24:y:2003:i:4:p:387-426
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    Citations

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    Cited by:

    1. Karlsson, Martin & Mayhew, Les & Rickayzen, Ben, 2007. "Long term care financing in four OECD countries: Fiscal burden and distributive effects," Health Policy, Elsevier, vol. 80(1), pages 107-134, January.
    2. Hancock, Ruth & Malley, Juliette & Wittenberg, Raphael & Morciano, Marcello & Pickard, Linda & King, Derek & Comas-Herrera, Adelina, 2013. "The role of care home fees in the public costs and distributional effects of potential reforms to care home funding for older people in England," Health Economics, Policy and Law, Cambridge University Press, vol. 8(1), pages 47-73, January.
    3. Geyer, Johannes & Haan, Peter & Korfhage, Thorben, 2015. "Indirect fiscal effects of long-term care insurance," Ruhr Economic Papers 584, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    4. Del Bono, Emilia & Sala, Emanuela & Hancock, Ruth & Parisi, Lavinia & Gunnell, Caroline, 2007. "Gender, older people and social exclusion: a gendered review and secondary analysis of the data," ISER Working Paper Series 2007-13, Institute for Social and Economic Research.
    5. Rinaldo Brau & Matteo Lippi Bruni, 2008. "Eliciting the demand for long‐term care coverage: a discrete choice modelling analysis," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 411-433, March.
    6. Guogui Huang & Fei Guo & Zhiming Cheng & Massimiliano Tani & Gong Chen, 2023. "Projections of Future Demand and Costs of Aged Care Services in China," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(4), pages 1-30, August.
    7. Rinaldo Brau & M. Lippi Bruni & Am Pinna, 2004. "Public vs private demand for covering long term care expenditures," Working Paper CRENoS 200408, Centre for North South Economic Research, University of Cagliari and Sassari, Sardinia.
    8. Carmichael, F. & Charles, S. & Hulme, C., 2010. "Who will care? Employment participation and willingness to supply informal care," Journal of Health Economics, Elsevier, vol. 29(1), pages 182-190, January.
    9. Rinaldo Brau & Matteo Lippi Bruni & Anna Maria Pinna, 2010. "Public versus private demand for covering long-term care expenditures," Applied Economics, Taylor & Francis Journals, vol. 42(28), pages 3651-3668.
    10. Evelien Eggink & Isolde Woittiez & Michiel Ras, 2016. "Forecasting the use of elderly care: a static micro-simulation model," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(6), pages 681-691, July.
    11. Davis, Peter & Lay-Yee, Roy & Pearson, Janet, 2010. "Using micro-simulation to create a synthesised data set and test policy options: The case of health service effects under demographic ageing," Health Policy, Elsevier, vol. 97(2-3), pages 267-274, October.
    12. Eggink, Evelien & Ras, Michiel & Woittiez, Isolde, 2017. "Dutch long-term care use in an ageing population," The Journal of the Economics of Ageing, Elsevier, vol. 9(C), pages 63-70.

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