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

Abstract

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.

Social Insurance Accounting for a Notional Defined Contribution Scheme Combining Retirement and Long-Term Care Benefits

“…In OECD countries, there are significant concerns about the sustainability of financing LTC services and other assistance for the elderly [52]. This is not surprising given that an increased demand for LTC services (and an increase in associated costs) is forecast in various countries including the UK, Germany, Spain, Italy, Japan, Canada, Chile, the US and China, to name just a few [51,53].…”

Tendencias en las políticas de atención a la dependencia de ancianos y sus reformas

“…La mayor parte de los países estudiados financian sus sistemas públicos con impuestos generales (nacionales, regionales o locales) 4,15 22 .…”

“…Las medidas tuvieron como objetivo aumentar la capacidad recaudatoria, aunque también reducir el gasto y mejorar la eficiencia en su uso 15,19,23 .…”

“…Las tendencias que han marcado los últimos años han sido un balance a favor de la atención domiciliaria por sobre la atención residencial y la incorporación de prestaciones económicas en la mayoría de modelos 14,15,19,21,23 .…”

“…No obstante, no se puede obviar el posible incentivo de las administraciones para contener el gasto público, ya que el costo de una plaza en residencia puede duplicar el de la atención domiciliaria 15 . De hecho, existe evidencia acerca de una proporción mayor de atención domiciliaria en gobiernos locales con bajos ingresos que en localidades de altos ingresos 30 .…”