Individual Decision Making in the Non-Purchase of Long-Term Care Insurance

Curry, Leslie; Robison, Julie; Shugrue, Noreen; Keenan, Patricia S.; Kapp, Marshall B.

doi:10.1093/geront/gnp041

Cited by 28 publications

(21 citation statements)

References 28 publications

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“…Although this was a cross-sectional study, several couples articulated an intention to purchase LTCI or self-insure at a time when their personal financial situations allowed. Similar to research on general couple decision-making (Adams 2004;Cramer 2001), study findings suggested that financial LTC planning may not be as static as previous research has suggested (Curry et al 2009;Cramer and Jensen 2006;MetLife Mature Market Institute 2009). Couples may choose to change their financial LTC intentions as well as behaviors as they get older and the risk of LTC becomes more eminent.…”

Section: Financial Ltc Planning Outcomessupporting

confidence: 75%

“…Most of these studies have focused on understanding behaviors in regards to LTCI as one financing alternative (AARP 2009;AHIP 2007;Curry et al 2009;Cramer and Jensen 2006;Mellor 2000;MetLife Mature Market Institute 2009;Schaber and Stum 2007;Swamy 2004). Some studies have explored intentions as well as behaviors and found that the majority of individuals who did not purchase LTCI intended to buy LTCI in the future (AHIP 2007;Swamy 2004).…”

Section: Financial Ltc Planning Behaviorsmentioning

confidence: 99%

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Couples Managing the Risk of Financing Long-Term Care

Barnett

Stum

2012

J Fam Econ Iss

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This study examined the complexity of financial long-term care (LTC) decision outcomes among married couples. Supporting the theory of planned behavior, couples reported a range of consensus patterns with their financial LTC intentions and behaviors. Five newly articulated typologies of couples emerged from consensus patterns revealing that couples reported a range of financial LTC intentions and behaviors. More couples reported consensus with their financial LTC behaviors compared to intentions; financial LTC decision outcomes reflected a dynamic and on-going process; and couples were not always in agreement on their financial LTC decision outcomes. Findings reinforce the importance of family practitioners going beyond working with individuals to understanding couple-level planning for financing LTC.

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Section: Financial Ltc Planning Outcomessupporting

confidence: 75%

Section: Financial Ltc Planning Behaviorsmentioning

confidence: 99%

Couples Managing the Risk of Financing Long-Term Care

Barnett

Stum

2012

J Fam Econ Iss

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“…Asymmetric information results in adverse selection 139, 141, 142, 143. In addition, consumer irrationality in the forms of myopia, underestimation of one's risk of needing LTSS, narrow framing, and bounded rationality further contribute to the low uptake of LTCI 1, 144, 145, 146, 147, 148. In regard to bounded rationality, many Americans are unaware that LTCI exists, that they are eligible for coverage, or that their existing health care insurance plans do not cover LTSS 144, 149.…”

Section: Ltss Financing Ideas From Singaporementioning

confidence: 99%

Financing Long‐Term Services and Supports: Ideas From Singapore

Graham

Bilger

2017

Milbank Quarterly

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Policy Points: In Singapore, long‐term services and supports (LTSS) are financed through a mix of public and private sources comprising tiered means‐tested public subsidies and government grants to care providers, charitable donations, voluntary long‐term care insurance, and other private resources.Singapore's high take‐up rate of voluntary long‐term care insurance is explained by plans offering partial coverage, medical underwriting, early automatic enrollment, direct debit of insurance premiums, and defined cash benefits.Singapore's experience in long‐term care financing is relevant to the US debate, as it provides policy ideas that may be transferable to the American context.We recommend maximizing the population's total contribution to voluntary long‐term care insurance by striking the right balance between coverage adequacy and take‐up rate while targeting subsidies to low‐income individuals. ContextFinancing long‐term services and supports (LTSS) for the elderly is a pressing issue in the United States with reforms of long‐term care insurance (LTCI) presently being explored. Singapore, with 65% of residents aged 40 to 83 covered by basic LTCI, including 22% with supplementary LTCI plans, has the highest voluntary LTCI rate in the world. This article contributes to the discourse by presenting the case of LTSS financing in Singapore.MethodsWe first reviewed Singapore's LTSS policies through a comprehensive search of academic papers, governmental reports, parliamentary debate transcripts, print media, and official websites of LTSS providers. We then estimated the LTSS financing mix, conducted an in‐depth analysis of the main policies, and illustrated the financial protection they procure for the elderly using realistic hypothetical scenarios.FindingsThe main principles governing Singapore's LTSS policies are shared responsibility for long‐term care financing, targeted assistance for the poor, centralized governance and administration, separation from other income and housing policies, and limited intergenerational cross‐subsidizing. We estimate the financing mix to consist of out‐of‐pocket spending (40%), government spending (42%), long‐term care insurance (9%), and charitable donations (9%). Assuming a monthly LTSS bill of US$1,545 to US$2,575, between 11% and 19% of LTSS expense is offset by LTCI for severely disabled individuals with basic coverage. Overall, 63% of care recipients are eligible for public subsidies that amount to 20% to 80% of their expenses.ConclusionsThe high take‐up of voluntary LTCI in Singapore is explained by the high prevalence of plans offering partial coverage, medical underwriting, early automatic enrollment, direct debit of insurance premiums, and defined cash benefits. We recommend setting the coverage of voluntary long‐term care insurance plans at levels that maximize the population's total contribution by striking the right balance between coverage adequacy and take‐up rate while targeting subsidies to low‐income individuals.

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“…We know from prior research that individuals' decisions regarding planning and paying for LTC are based not only on financial incentives, but also on behavioral factors, as well as family structures (Curry et al, 2009). We also know that there is much more to LTC planning than purchasing LTC insurance or financial planning alone.…”

Section: Discussionmentioning

confidence: 99%

“…It is clear from prior research that both behavioral and psychosocial factors play a large role in these decisions as well (Curry, Robison, Shugrue, Keenan, & Kapp, 2009). We look to existing models to guide our understanding.…”

Section: Introductionmentioning

confidence: 99%

Are Baby Boomers Who Care for Their Older Parents Planning for Their Own Future Long-Term Care Needs?

Finkelstein

Reid

Kleppinger

et al. 2012

Journal of Aging & Social Policy

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A rapidly expanding number of baby boomers provide care to aging parents. This study examines associations between caregiver status and outcomes related to awareness and anticipation of future long-term care (LTC) needs using 2007 Connecticut Long-Term Care Needs Assessment survey data. Baby boomers who were adult child caregivers (n = 353) vs. baby boomers who were not (n = 1242) were more likely to anticipate some future LTC needs and to have considered certain financing strategies. Although baby boomer adult child caregivers more readily anticipate some future LTC needs, they are not taking specific actions. It is important to address the need for public education directed towards those who are currently (or have recently completed) caring for aging parents.

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Individual Decision Making in the Non-Purchase of Long-Term Care Insurance

Cited by 28 publications

References 28 publications

Couples Managing the Risk of Financing Long-Term Care

Couples Managing the Risk of Financing Long-Term Care

Financing Long‐Term Services and Supports: Ideas From Singapore

Are Baby Boomers Who Care for Their Older Parents Planning for Their Own Future Long-Term Care Needs?

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