Long-Term Care over an Uncertain Future: What Can Current Retirees Expect?

Kemper, Peter; Komisar, Harriet; Alecxih, Lisa

doi:10.5034/inquiryjrnl_42.4.335

Cited by 126 publications

(81 citation statements)

References 37 publications

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“…These moves also run counter to the growing recognition that everyone faces the risk of financially catastrophic LTC expenses (8,11,34). A growing number of citizens have seen firsthand the high costs of caring for elderly people who have seriously debilitating conditions, so there is strong support to maintain social insurance for LTC expenses.…”

Section: Lessons and Policy Implicationsmentioning

confidence: 84%

“…Local control of community services contributes to LTC differences within and across countries; it has enabled regions to reduce services provided or focus services only on the elderly with the greatest needs when an economic downturn occurs (2,45). Despite formal LTC programs existing in many OECD countries, a substantial majority (60-70%) of people who need LTC receive it informally from relatives or friends in all the countries (18,33,34,59).…”

Section: Types Of Services Provided To the Elderly Who Need Assistancementioning

confidence: 99%

“…Mounting evidence indicates that everyone faces the risk of needing costly assistance. Several studies have found that close to 70% of people need some type of assistance after age 65, and-significantly-16% need more than $100,000 (in 2005 dollars) of care in their lifetime after age 65 (11,34).…”

Section: Introductionmentioning

confidence: 99%

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Searching for a Balance of Responsibilities: OECD Countries' Changing Elderly Assistance Policies

Swartz

2013

Annu. Rev. Public Health

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The rapid aging of OECD country populations and the now five-yearlong financial crisis in Europe are causing many OECD countries to reconfigure their assistance programs for the elderly, particularly their long-term care (LTC) policies. Debates about intergenerational responsibilities are evident in recently published research papers that examine how countries are revising programs for the elderly. Building financial sustainability into program reforms has suddenly become a priority. Until just recently, reform efforts focused on creating efficiencies and better quality of services. What emerges from the recent literature is a strong sense that the OECD countries are responding to the financial crisis and the rapid aging of populations in very similar ways. Given the countries' different histories of how they provide assistance to their elderly citizens, the convergence of policy responses is not something we might have foreseen. The United States could learn much from the OECD countries' choices.

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Section: Lessons and Policy Implicationsmentioning

confidence: 84%

Section: Types Of Services Provided To the Elderly Who Need Assistancementioning

confidence: 99%

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Searching for a Balance of Responsibilities: OECD Countries' Changing Elderly Assistance Policies

Swartz

2013

Annu. Rev. Public Health

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“…A sizable minority will face substantial financial liabilities or will place large burdens on their families for informal care. 1 Yet only slightly more than half of nonbuyers consider themselves to be at risk for needing significant long-term care services, and most believe that they will not be liable for the costs of care (that is, the government or other health insurance would pay). 4 At the same time, nonbuyers generally overestimate premium costs and underestimate longterm care costs, reinforcing barriers to purchase.…”

Section: Why Don't More Middle-class Americans Pur-chase Long-term Camentioning

confidence: 99%

The Complementarity Of Public And Private Long-Term Care Coverage

Stevenson

Cohen²,

Tell³

et al. 2010

Health Affairs

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Discussions about long-term care financing often get mired in the false dichotomy that long-term care should be primarily either a public or a private responsibility. Our starting premise is that public and private long-term care coverage can best serve complementary roles. Therefore, public policy should focus on supporting both mechanisms to achieve efficient and equitable outcomes. The current state of the private long-term care insurance market, and the possible reasons for its modest size, provide a starting point for exploring how public policy might interface more productively with it, in the context of both existing and potential programs, such as the proposed Community Living Assistance Services and Supports (CLASS) Act. Discussions about how best to finance long-term services and supports can become contentious, especially when the role of private long-term care insurance is considered. Proponents and critics alike point to the current modest role of private insurance in financing long-term care. They argue, respectively, that public policies impede development of a more robust private market, and that private policies are unaffordable to most Americans and are thus unlikely to play a substantial role in providing risk protection to individuals and their families.Often characterizing these debates is the false dichotomy that long-term care should be primarily either a public or a private responsibility and, by extension, that public policies should prioritize either development of the private insurance market or expanded public coverage for longterm services and supports. Insufficient discussion is focused on strategies to improve a combined approach where both public and private coverage play sizable roles.We begin from the premise that public and private coverage for long-term care can serve complementary roles. This makes the key public policy question not which approach to make central, but instead how to align incentives across public and private financing sources to create a rational, more sustainable system. Characterizing the current long-term care insurance market, and exploring the potential reasons for its modest size, can help inform discussion of how public policy might interface with this market more productively-especially in the context of Medicaid and other public programs. Why Insurance?A good starting point in discussing how to finance long-term care needs in the United States is to emphasize the insurability of appropriate services and supports. Most of us will need supportive services as we age. However, there will be tremendous variation across individuals in how extensive these needs will be, and in how much will be spent for them. Upon turning age sixtyfive, for instance, 42 percent of Americans can expect to spend nothing on long-term care during their lifetimes, while 16 percent can expect to spend more than $100,000. 1Although this distribution of financial risk implies an appropriate role for insurance as an

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“…In most countries, a major share of such care is provided informally, meaning that it is not reflected in social statistics (Bettio & Verashchagina 2010, Kemper et al 2005). Yet even though informal caregivers work mostly without payment, care provision can still come at a certain cost: in particular, it is timeconsuming, mentally stressful, and physically exhausting, which can negatively affect the caregiver's career and health.…”

Section: Introductionmentioning

confidence: 99%

Impacts of Informal Caregiving on Caregiver Employment, Health, and Family

2015

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. www.econstor.eu Terms of use: Documents in D I S C U S S I O N P A P E R S E R I E S ABSTRACTImpacts of Informal Caregiving on Caregiver Employment, Health, and Family *As the aging population increases, the demand for informal caregiving is becoming an ever more important concern for researchers and policy-makers alike. To shed light on the implications of informal caregiving, this paper reviews current research on its impact on three areas of caregivers' lives: employment, health, and family. Because the literature is inherently interdisciplinary, the research designs, sampling procedures, and statistical methods used are heterogeneous. Nevertheless, we are still able to draw several conclusions: first, despite the prevalence of informal caregiving and its primary association with lower levels of employment, the affected labor force is seemingly small. Second, such caregiving tends to lower the quality of the caregiver's psychological health, which also has a negative impact on physical health outcomes. Third, the implications for family life remain under investigated. The research findings also differ strongly among subgroups, although they do suggest that female, spousal, and intense caregivers tend to be the most affected by caregiving.JEL Classification: E26, J14, J46

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Long-Term Care over an Uncertain Future: What Can Current Retirees Expect?

Cited by 126 publications

References 37 publications

Searching for a Balance of Responsibilities: OECD Countries' Changing Elderly Assistance Policies

Searching for a Balance of Responsibilities: OECD Countries' Changing Elderly Assistance Policies

The Complementarity Of Public And Private Long-Term Care Coverage

Impacts of Informal Caregiving on Caregiver Employment, Health, and Family

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