Financing Long-Term Care: Options for Policy
The nation is ill-prepared to finance the quantum jump in long-term care spending that is on its way as the baby boom ages. By default rather than by design, Medicaid has become the main source of funds for long- term care. But reliance on Medicaid has fostered the institutionalization of the disabled elderly, has given rise to a two- tier care system, and has yielded the bizarre outcome of use of limited welfare funds by middle- and even high-income Americans who have succeeded in sheltering assets from Medicaid's spend-down requirements. Insurance would be a greatly better answer to the nation's long-term care needs. But the market will remain small and underdeveloped as long as Americans can make easy claim on Medicaid. The paper puts forth a plan for universal long-term care insurance, supported by income-scaled tax credits, to replace Medicaid in its current role. That would make for "honest government"—one that not only does not fund inheritance protection but also genuinely protects those with greatest need.
|Date of creation:||09 Oct 2000|
|Date of revision:|
|Note:||Type of Document - Adobe Acrobat PDF; prepared on IBM PC; to print on PostScript; pages: 34; figures: included|
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- Victor R. Fuchs, 1996. "Individual and Social Responsibility: Child Care, Education, Medical Care, and Long-Term Care in America," NBER Books, National Bureau of Economic Research, Inc, number fuch96-1.
- David M. Cutler, 1993. "Why Doesn't the Market Fully Insure Long-Term Care?," NBER Working Papers 4301, National Bureau of Economic Research, Inc.
- David M. Cutler & Louise Sheiner, 1994.
"Policy Options for Long-Term Care,"
in: Studies in the Economics of Aging, pages 395-442
National Bureau of Economic Research, Inc.
- 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 201-19, December.
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