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Long-Term Care in Latin America and the Caribbean? Theory and Policy Considerations

Listed author(s):
  • Martín Caruso
  • Sebastian Galiani
  • Pablo Ibarrarán

This paper discusses theoretical and practical issues related to long-term care (LTC) services in Latin America. Demand for these services will rise as the region undergoes a swift demographic transition from its currently young population to a rapidly aging one, especially since the region’s aging cohorts are more prone to experience a decline in their functional and physical abilities than elderly people elsewhere in the world. We argue that private insurance markets are ill-equipped to provide coverage to meet the need for LTC, while the amount of personal savings required to afford self-insurance would be prohibitively high. We study how developed economies have dealt with the issue of LTC and pay special attention to the most salient features of their LTC programs. We then direct the discussion to Latin America, where LTC may not be an immediate priority, but governments are likely to encourage the development of LTC programs as demand for them steadily grows. In particular, policymakers are probably going to focus initially on LTC programs for the poor and vulnerable, for whom affordability of LTC is a greater problem. We therefore study how basic elements of policy design affect cost-effectiveness of LTC programs by means of a formal model. Our study shows that pro-poor programs are more cost effective when people have the option to receive cash subsidies, and the availability of in-kind and in-cash choices reduces program costs overall.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 23797.

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Date of creation: Sep 2017
Handle: RePEc:nbr:nberwo:23797
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  1. Goda, Gopi Shah, 2011. "The impact of state tax subsidies for private long-term care insurance on coverage and Medicaid expenditures," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 744-757, August.
  2. McKnight, Robin, 2006. "Home care reimbursement, long-term care utilization, and health outcomes," Journal of Public Economics, Elsevier, vol. 90(1-2), pages 293-323, January.
  3. Courtemanche, Charles & He, Daifeng, 2009. "Tax incentives and the decision to purchase long-term care insurance," Journal of Public Economics, Elsevier, vol. 93(1-2), pages 296-310, February.
  4. Arntz, Melanie & Sacchetto, Ralf & Spermann, Alexander & Steffes, Susanne & Widmaier, Sarah, 2006. "The German social long-term care insurance - structure and reform options," ZEW Discussion Papers 06-74, ZEW - Zentrum für Europäische Wirtschaftsforschung / Center for European Economic Research.
  5. Canta, Chiara & Cremer, Helmuth & Gahvari, Firouz, 2016. "Maybe "honor thy father and thy mother": uncertainfamily aid and the design of social long term care insurance," TSE Working Papers 16-685, Toulouse School of Economics (TSE).
  6. Van Houtven, Courtney Harold & Norton, Edward C., 2004. "Informal care and health care use of older adults," Journal of Health Economics, Elsevier, vol. 23(6), pages 1159-1180, November.
  7. Kim, Hyuncheol Bryant & Lim, Wilfredo, 2015. "Long-term care insurance, informal care, and medical expenditures," Journal of Public Economics, Elsevier, vol. 125(C), pages 128-142.
  8. Bonsang, Eric, 2009. "Does informal care from children to their elderly parents substitute for formal care in Europe?," Journal of Health Economics, Elsevier, vol. 28(1), pages 143-154, January.
  9. Barr, Nicholas & Diamond, Peter, 2008. "Reforming Pensions: Principles and Policy Choices," OUP Catalogue, Oxford University Press, number 9780195311303.
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