Stumbling over iron rice bowls: the quest for integrated continuing care for the elderly

Chappell and Hollander "offer an evidence-based policy prescription to meet the challenges …[of] an aging society." The fallacies of apocalyptic demography are briskly dismissed; their message is that decades of solid evidence support the critical importance of an integrated system of continuing care for the chronically ill elderly, both health services and home support. But the paper loses focus with discussions of "ageism", the compression of morbidity, and healthy communities. The authors might have explored why (as they argue) public policy has retreated from their prescription in recent decades. That prescription would require either a re-allocation of resources (incomes) away from politically well-entrenched interests, or simply more money. Neither appears currently promising.