Can social insurance for long-term care work? The experience of Germany.
In 1994 Germany enacted a universal-coverage social insurance program for long-term care to largely replace its means-tested system. The program has achieved many of its stated policy goals: shifting the financial burden of long-term care off the states and municipalities; expanding home and community-based services; lessening dependence on means-tested welfare; and increasing support of informal caregivers. Many of these goals were reached without exploding caseloads or uncontrolled expenditures. We examine the German long-term insurance program, focusing on issues of financing, eligibility and assessment, benefits, availability of services, and quality assurance.
Cuellar
A E
AE
Wiener
J M
JM
D019090:Case Management; D004608:Eligibility Determination; D005380:Financing, Government; D005858:Germany; D006297:Health Services Accessibility; D007353:Insurance, Long-Term Care / Q000191:economics* / Q000639:trends; D011787:Quality of Health Care; D019472:Universal Health Insurance / Q000191:economics / Q000331:legislation & jurisprudence* / Q000639:trends