[Realization and financing of different models of home care]

In the long term perspectives for home care are characterized by four challenges: First, home care services can be rationalized only below average. If professionals in the home care services shall take part nevertheless in the general development of wages in the economy, it is necessary that a rising part of domestic income will be spent for these services. Second, in the families tensions between the desire for self-realization of the middle generations and expectations of home care patients that the next generation shall take over caring responsibilities, will increase, which will lead to a rising demand for professional home care services. Third, the rising proportion of single households will also lead to a rising demand for professional services, because people living alone need more services than people living within families. Fourth, the future demographic development will not only lead to a rising number of people in need of home care but also to declining number of younger people. This will cause not only problems for financing of welfare state programs for people in need of home care but will also lead to a scarcity of nursing professionals. Against this background the new "Social Long Term Care Insurance," which will come into effect in Germany by 1995 has to be examined for its economic justifiability, for its distributional justice and for the effectiveness of its benefits. The new insurance program can strengthen home care; however in terms of economic justifiability and distributional justice it is not without risks.