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The economics of long-term care: a survey

Author

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  • CREMER, Helmuth

    (Toulouse School of Economics (IDEI, GREMAQ and Iuf), France)

  • PESTIEAU, Pierre

    (Université catholique de Louvain, CORE, B-1348 Louvain-la-Neuve, Belgium; CREPP, Université de Liège, Belgium; IDEI, Toulouse School of Economics, France)

  • PONTHIERE, Grégory

    (Ecole Normale Supérieure, Paris - Paris School of Economics)

Abstract

This paper surveys recent theoretical economic research on long term care (LTC). LTC differs from health care: it is about nursing; it is mostly provided by unpaid caregivers (mainly spouses and children), whereas both the market and the State play a modest role. The future of LTC appears to be gloomy: sustained population ageing and recent societal trends (e.g., children's mobility, changes in family values) generate a mounting demand on the State and on the market to provide alternatives to the family. In this paper, we review these causes, and the extent to which we can expect them to fade away in the future. We then turn to the design of a sustainable public LTC scheme integrating both the market and the family.

Suggested Citation

  • CREMER, Helmuth & PESTIEAU, Pierre & PONTHIERE, Grégory, 2012. "The economics of long-term care: a survey," LIDAM Discussion Papers CORE 2012030, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  • Handle: RePEc:cor:louvco:2012030
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    as
    1. VALLETTA, Giacomo, 2012. "Health, fairness and taxation," LIDAM Discussion Papers CORE 2012016, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    2. Sumit Agarwal & John C. Driscoll & Xavier Gabaix & David I. Laibson, 2007. "The age of reason: financial decisions over the lifecycle," Working Paper Series WP-07-05, Federal Reserve Bank of Chicago.
    3. Ramos, Xavier & Van de gaer, Dirk, 2012. "Empirical Approaches to Inequality of Opportunity: Principles, Measures, and Evidence," IZA Discussion Papers 6672, Institute of Labor Economics (IZA).
    4. Alain Jousten & Barbara Lipszyc & Maurice Marchand & Pierre Pestieau, 2005. "Long-term Care Insurance and Optimal Taxation for Altruistic Children," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 61(1), pages 1-18, March.
    5. Liliana Pezzin & Robert Pollak & Barbara Schone, 2009. "Long-term care of the disabled elderly: do children increase caregiving by spouses?," Review of Economics of the Household, Springer, vol. 7(3), pages 323-339, September.
    6. Sloan, Frank A & Norton, Edward C, 1997. "Adverse Selection, Bequests, Crowding Out, and Private Demand for Insurance: Evidence from the Long-Term Care Insurance Market," Journal of Risk and Uncertainty, Springer, vol. 15(3), pages 201-219, December.
    7. Hoerger, Thomas J & Picone, Gabriel A & Sloan, Frank A, 1996. "Public Subsidies, Private Provision of Care and Living Arrangements of the Elderly," The Review of Economics and Statistics, MIT Press, vol. 78(3), pages 428-440, August.
    8. Meier, Volker, 1999. "Why the Young Do Not Buy Long-Term Care Insurance," Journal of Risk and Uncertainty, Springer, vol. 18(1), pages 83-98, April.
    9. Kopczuk Wojciech & Slemrod Joel, 2005. "Denial of Death and Economic Behavior," The B.E. Journal of Theoretical Economics, De Gruyter, vol. 5(1), pages 1-26, August.
    10. Canta Chiara & Pestieau Pierre, 2013. "Long-Term Care Insurance and Family Norms," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 14(2), pages 401-428, April.
    11. Pierre Pestieau & Gregory Ponthière, 2012. "Long-Term Care Insurance Puzzle," Palgrave Macmillan Books, in: Joan Costa-Font & Christophe Courbage (ed.), Financing Long-Term Care in Europe, chapter 3, pages 41-52, Palgrave Macmillan.
    12. Duranton, Gilles & Martin, Philippe & Mayer, Thierry & Mayneris, Florian, 2010. "The Economics of Clusters: Lessons from the French Experience," OUP Catalogue, Oxford University Press, number 9780199592203.
    13. Cremer, Helmuth & Roeder, Kerstin, 2013. "Long-term care policy, myopia and redistribution," Journal of Public Economics, Elsevier, vol. 108(C), pages 33-43.
    14. Darius Lakdawalla & Tomas Philipson, 2002. "The Rise in Old-Age Longevity and the Market for Long-Term Care," American Economic Review, American Economic Association, vol. 92(1), pages 295-306, March.
    15. Amy Finkelstein & Erzo F. P. Luttmer & Matthew J. Notowidigdo, 2013. "What Good Is Wealth Without Health? The Effect Of Health On The Marginal Utility Of Consumption," Journal of the European Economic Association, European Economic Association, vol. 11, pages 221-258, January.
    16. HAEDO, Christian & MOUCHART, Michel, 2012. "A stochastic independence approach for different measures of concentration and specialization," LIDAM Discussion Papers CORE 2012025, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    17. Helmuth Cremer & Pierre Pestieau, 2014. "Social long-term care insurance and redistribution," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 21(6), pages 955-974, December.
    18. Fleurbaey,Marc & Maniquet,François, 2011. "A Theory of Fairness and Social Welfare," Cambridge Books, Cambridge University Press, number 9780521887427.
    19. Jeffrey R. Brown & Amy Finkelstein, 2009. "The Private Market for Long‐Term Care Insurance in the United States: A Review of the Evidence," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 76(1), pages 5-29, March.
    20. Hiedemann, Bridget & Stern, Steven, 1999. "Strategic play among family members when making long-term care decisions," Journal of Economic Behavior & Organization, Elsevier, vol. 40(1), pages 29-57, September.
    21. Nuscheler, Robert & Roeder, Kerstin, 2013. "The political economy of long-term care," European Economic Review, Elsevier, vol. 62(C), pages 154-173.
    22. BAUWENS, Luc & STORTI, Giuseppe, 2012. "Computationally efficient inference procedures for vast dimensional realized covariance models," LIDAM Discussion Papers CORE 2012028, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    23. Pierre Pestieau & Motohiro Sato, 2008. "Long‐Term Care: the State, the Market and the Family," Economica, London School of Economics and Political Science, vol. 75(299), pages 435-454, August.
    24. Bridget Hiedemann & Michelle Sovinsky & Steven Stern, 2018. "Will You Still Want Me Tomorrow?: The Dynamics of Families’ Long-Term Care Arrangements," Journal of Human Resources, University of Wisconsin Press, vol. 53(3), pages 663-716.
    25. Pilar García‐Gómez & Erik Schokkaert & Tom Van Ourti & Teresa Bago d'Uva, 2015. "Inequity in the Face of Death," Health Economics, John Wiley & Sons, Ltd., vol. 24(10), pages 1348-1367, October.
    26. Sloan, Frank A & Picone, Gabriel & Hoerger, Thomas J, 1997. "The Supply of Children's Time to Disabled Elderly Parents," Economic Inquiry, Western Economic Association International, vol. 35(2), pages 295-308, April.
    27. Bernheim, B Douglas & Shleifer, Andrei & Summers, Lawrence H, 1986. "The Strategic Bequest Motive," Journal of Labor Economics, University of Chicago Press, vol. 4(3), pages 151-182, July.
    28. John Cawley & David C. Grabowski & Richard A. Hirth, 2004. "Factor Substitution and Unobserved Factor Quality in Nursing Homes," NBER Working Papers 10465, National Bureau of Economic Research, Inc.
    29. Bisin, Alberto & Verdier, Thierry, 2001. "The Economics of Cultural Transmission and the Dynamics of Preferences," Journal of Economic Theory, Elsevier, vol. 97(2), pages 298-319, April.
    30. Liliana E. Pezzin & Robert A. Pollak & Barbara S. Schone, 2007. "Efficiency in Family Bargaining: Living Arrangements and Caregiving Decisions of Adult Children and Disabled Elderly Parents," CESifo Economic Studies, CESifo, vol. 53(1), pages 69-96, March.
    31. Ponthiere Gregory, 2013. "Long-Term Care, Altruism and Socialization," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 14(2), pages 429-471, October.
    32. Valletta, G., 2012. "Health, fairness and taxation," Research Memorandum 017, Maastricht University, Maastricht Research School of Economics of Technology and Organization (METEOR).
    33. Jeffrey R. Brown & Amy Finkelstein, 2011. "Insuring Long-Term Care in the United States," Journal of Economic Perspectives, American Economic Association, vol. 25(4), pages 119-142, Fall.
    34. Amy Finkelstein & Kathleen McGarry, 2006. "Multiple Dimensions of Private Information: Evidence from the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 96(4), pages 938-958, September.
    35. repec:adr:anecst:y:2006:i:83-84:p:06 is not listed on IDEAS
    36. Gaertner,Wulf & Schokkaert,Erik, 2011. "Empirical Social Choice," Cambridge Books, Cambridge University Press, number 9781107013940, October.
    37. Jean-Charles Rochet, 1991. "Incentives, Redistribution and Social Insurance," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 16(2), pages 143-165, December.
    38. Éric Bonsang & Stéphane Adam & Sophie Germain & Sergio Perelman, 2007. "Retraite, activités non professionnelles et vieillissement cognitif. Une exploration à partir des données de Share," Économie et Statistique, Programme National Persée, vol. 403(1), pages 83-96.
    39. Xavier Ramos & Dirk Van de gaer, 2012. "Empirical approaches to inequality of opportunity: Principles, measures, and evidence," Working Papers 259, ECINEQ, Society for the Study of Economic Inequality.
    40. Oecd, 2006. "Projecting OECD Health and Long-Term Care Expenditures: What Are the Main Drivers?," OECD Economics Department Working Papers 477, OECD Publishing.
    41. Louis Eeckhoudt & Olivier Mahul & John Moran, 2003. "Fixed‐Reimbursement Insurance: Basic Properties and Comparative Statics," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 70(2), pages 207-218, June.
    42. Duée, Michel & Rebillard, Cyril & Pennec, Sophie, 2005. "Les personnes dépendantes en France : Evolution et prise en charge [Old-age disability in France: Long-term evolution, private caregiving and public expenditure]," MPRA Paper 69877, University Library of Munich, Germany.
    43. Jeffrey R. Brown, 2007. "Rational and Behavioral Perspectives on the Role of Annuities in Retirement Planning," NBER Working Papers 13537, National Bureau of Economic Research, Inc.
    44. Louis R. Eeckhoudt & Olivier Mahul & John Moran, 2003. "Fixed-reimbursement insurance : basic properties and comparative statics," Post-Print hal-01952092, HAL.
    45. Amy Finkelstein & Kathleen McGarry & Amir Sufi, 2005. "Dynamic Inefficiencies in Insurance Markets: Evidence from Long-Term Care Insurance," American Economic Review, American Economic Association, vol. 95(2), pages 224-228, May.
    46. Sloan, Frank A. & Thomas J. Hoerger & Gabriel Picone, 1996. "Effects of Strategic Behavior and Public Subsidies on Families' Savings and Long-Term Care Decisions," Working Papers 96-01, Duke University, Department of Economics.
    47. PESTIEAU, Pierre & SATO, Motohiro, 2006. "Long term care: the state and the family," LIDAM Reprints CORE 1933, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    48. Pauly, Mark V, 1990. "The Rational Nonpurchase of Long-term-Care Insurance," Journal of Political Economy, University of Chicago Press, vol. 98(1), pages 153-168, February.
    49. Pierre Pestieau & Motohiro Sato, 2006. "Long term care: the state and the family," Annals of Economics and Statistics, GENES, issue 83-84, pages 151-166.
    50. David M. Cutler, 1993. "Why Doesn't the Market Fully Insure Long-Term Care?," NBER Working Papers 4301, National Bureau of Economic Research, Inc.
    51. Jeffrey Brown & Amy Finkelstein, 2011. "Insuring Long Term Care In the US," NBER Working Papers 17451, National Bureau of Economic Research, Inc.
    52. Frank A. Sloan & Jingshu Wang & Harold H. Zhang, 2002. "Upstream Intergenerational Transfers," Southern Economic Journal, John Wiley & Sons, vol. 69(2), pages 363-380, October.
    53. Grabowski, David C. & Gruber, Jonathan, 2007. "Moral hazard in nursing home use," Journal of Health Economics, Elsevier, vol. 26(3), pages 560-577, May.
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    More about this item

    Keywords

    long term care; social insurance; dependence; family solidarity;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination

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