title: Lessons from public long-term care insurance in Germany and Japan.
abstract: The U.S. Congress is considering the Community Living Assistance Services and Supports (CLASS) Act, a voluntary insurance program that would help pay for long-term services and supports to disabled Americans. In Germany and Japan, social insurance programs are universal, support family caregivers, and allow individuals considerable flexibility in securing the services they require. We explored differences between Germany and Japan in program goals, eligibility process, scope, size, and sustainability for possible applications in the United States. Moreover, when we compared public spending on long-term care, we found that spending in the United States is actually higher than in Germany even now, prior to enactment of the CLASS Act, and is only slightly lower than in Japan.
authors.affiliation: Emeritus, University of Michigan in Ann Arbor, USA. jccamp@umich.edu
authors.forename: John Creighton
authors.initials: JC
authors.lastname: Campbell
authors.forename: Naoki
authors.initials: N
authors.lastname: Ikegami
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Gibson
mesh_terms: D000368:Aged; D040561:Assisted Living Facilities; D003153:Community Health Services; D003191:Comprehensive Health Care / Q000379:methods; D004608:Eligibility Determination; D005858:Germany; D005102:Health Expenditures; D006302:Health Services Research; D006299:Health Services for the Aged; D006801:Humans; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D007353:Insurance, Long-Term Care / Q000191:economics / Q000331:legislation & jurisprudence*; D007564:Japan; D017146:Models, Organizational; D012943:Social Security / Q000458:organization & administration