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Paying for long-term care

C L Estes1, T Bodenheimer

  • 1Department of Social and Behavioral Sciences, University of California, San Francisco, School of Nursing 94143-0612.

The Western Journal of Medicine
|January 1, 1994
PubMed
Summary
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Long-term care insurance in the U.S. is insufficient. A social insurance program is the only viable solution for universal, affordable, and equitable long-term care coverage, as private options are unaffordable for most elderly individuals.

Area of Science:

  • Health Policy
  • Social Insurance
  • Gerontology

Background:

  • Long-term care insurance in the United States is widely recognized as inadequate.
  • Significant debate exists regarding whether private or public sectors should provide this insurance.
  • Current private insurance models face affordability challenges, particularly for the elderly population.

Purpose of the Study:

  • To analyze the challenges of private long-term care insurance.
  • To evaluate the potential of public-private partnerships.
  • To determine the most effective model for universal long-term care coverage.

Main Methods:

  • Analysis of the experience-rating principle in private insurance.
  • Assessment of the affordability of private long-term care insurance for the elderly.

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  • Evaluation of public-private partnership models for long-term care.

    • Main Results:

    • Private long-term care insurance premiums are unaffordable for approximately 80% of the elderly due to high-risk pricing.
    • Public-private partnerships are unlikely to resolve the coverage dilemma.
    • A social insurance program is identified as the optimal solution.

    Conclusions:

    • The current private insurance market fails to provide adequate and affordable long-term care coverage.
    • Government subsidies within a private framework are insufficient to ensure equitable access.
    • A publicly administered social insurance program is essential for achieving universal, affordable, and equitable long-term care coverage.