title: Paying for long-term care.
abstract: Everyone agrees that insurance for long-term care is inadequate in the United States. Disagreement exists, however, on whether such insurance should be provided through the private or public sector. Private insurance generally uses the experience-rating principle that persons with higher risk of illness are charged higher premiums. For private insurance for long-term care, this principle creates a dilemma. Most policies will be purchased by the elderly; yet, because the elderly have a high risk of needing long-term care, only about 20% of them can afford the cost of premiums. A public-private partnership by which the government partially subsidizes private long-term-care insurance is unlikely to resolve this dilemma. Only a social insurance program for long-term care can provide universal, affordable, and equitable coverage.
authors.affiliation: Department of Social and Behavioral Sciences, University of California, San Francisco, School of Nursing 94143-0612.
authors.forename: C L
authors.initials: CL
authors.lastname: Estes
authors.forename: T
authors.initials: T
authors.lastname: Bodenheimer
mesh_terms: D018166:Health Care Reform; D006801:Humans; D007348:Insurance, Health; D008134:Long-Term Care / Q000191:economics*; D014481:United States