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. 1994 Jan;160(1):64–69.

Paying for long-term care.

C L Estes 1, T Bodenheimer 1
PMCID: PMC1022265  PMID: 8128712

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.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bodenheimer T., Grumbach K. Financing universal health insurance: taxes, premiums, and the lessons of social insurance. J Health Polit Policy Law. 1992 Fall;17(3):439–462. doi: 10.1215/03616878-17-3-439. [DOI] [PubMed] [Google Scholar]
  2. Burner S. T., Waldo D. R., McKusick D. R. National health expenditures projections through 2030. Health Care Financ Rev. 1992 Fall;14(1):1–29. [PMC free article] [PubMed] [Google Scholar]
  3. Cohen M. A., Kumar N., Wallack S. S. New perspectives on the affordability of long-term care insurance and potential market size. Gerontologist. 1993 Feb;33(1):105–113. doi: 10.1093/geront/33.1.105. [DOI] [PubMed] [Google Scholar]
  4. Cohen M. A., Kumar N., Wallack S. S. Who buys long-term care insurance? Health Aff (Millwood) 1992 Spring;11(1):208–223. doi: 10.1377/hlthaff.11.1.208. [DOI] [PubMed] [Google Scholar]
  5. Guralnik J. M., Yanagishita M., Schneider E. L. Projecting the older population of the United States: lessons from the past and prospects for the future. Milbank Q. 1988;66(2):283–308. [PubMed] [Google Scholar]
  6. Harrington C., Cassel C., Estes C. L., Woolhandler S., Himmelstein D. U. A national long-term care program for the United States. A caring vision. The Working Group on Long-term Care Program Design, Physicians for a National Health Program. JAMA. 1991 Dec 4;266(21):3023–3029. [PubMed] [Google Scholar]
  7. Jennings M. C., Porter M. The changing elderly market. Top Health Care Financ. 1991 Summer;17(4):1–8. [PubMed] [Google Scholar]
  8. Kolb D. S., Veysey P. J., Gocke J. L. Private long-term care insurance: will it work? Top Health Care Financ. 1991 Summer;17(4):9–21. [PubMed] [Google Scholar]
  9. Lazenby H. C., Letsch S. W. National health expenditures, 1989. Health Care Financ Rev. 1990 Winter;12(2):1–26. [PMC free article] [PubMed] [Google Scholar]
  10. Lee P. R., Soffel D., Luft H. S. Costs and coverage. Pressures toward health care reform. West J Med. 1992 Nov;157(5):576–583. [PMC free article] [PubMed] [Google Scholar]
  11. Liu K., Manton K. G., Liu B. M. Morbidity, disability, and long-term care of the elderly: implications for insurance financing. Milbank Q. 1990;68(3):445–492. [PubMed] [Google Scholar]
  12. Liu K., Perozek M., Manton K. Catastrophic acute and long-term care costs: risks faced by disabled elderly persons. Gerontologist. 1993 Jun;33(3):299–307. doi: 10.1093/geront/33.3.299. [DOI] [PubMed] [Google Scholar]
  13. McCall N., Knickman J., Bauer E. J. Public/private partnerships: a new approach to long-term care. Health Aff (Millwood) 1991 Spring;10(1):164–176. doi: 10.1377/hlthaff.10.1.164. [DOI] [PubMed] [Google Scholar]
  14. Merrill J. C., Somers S. A. Long-term care: the great debate on the wrong issue. Inquiry. 1989 Fall;26(3):317–320. [PubMed] [Google Scholar]
  15. Schroeder S. A., Cantor J. C. On squeezing balloons. Cost control fails again. N Engl J Med. 1991 Oct 10;325(15):1099–1100. doi: 10.1056/NEJM199110103251510. [DOI] [PubMed] [Google Scholar]
  16. Smith M. D., Altman D. E., Leitman R., Moloney T. W., Taylor H. Taking the public's pulse on health system reform. Health Aff (Millwood) 1992 Summer;11(2):125–133. doi: 10.1377/hlthaff.11.2.125. [DOI] [PubMed] [Google Scholar]
  17. Somers A. R. Insurance for long-term care. Some definitions, problems, and guidelines for action. N Engl J Med. 1987 Jul 2;317(1):23–29. doi: 10.1056/NEJM198707023170105. [DOI] [PubMed] [Google Scholar]
  18. Stone D. A. The struggle for the soul of health insurance. J Health Polit Policy Law. 1993 Summer;18(2):287–317. doi: 10.1215/03616878-18-2-287. [DOI] [PubMed] [Google Scholar]
  19. Wiener J. M., Hanley R. J., Illston L. H. Financing long-term care: how much public? How much private? J Health Polit Policy Law. 1992 Fall;17(3):425–434. doi: 10.1215/03616878-17-3-425. [DOI] [PubMed] [Google Scholar]
  20. Wiener J. M., Hanley R. J. The Connecticut model for financing long-term care: a limited partnership. J Am Geriatr Soc. 1992 Oct;40(10):1069–1072. doi: 10.1111/j.1532-5415.1992.tb04488.x. [DOI] [PubMed] [Google Scholar]
  21. Woolhandler S., Himmelstein D. U. The deteriorating administrative efficiency of the U.S. health care system. N Engl J Med. 1991 May 2;324(18):1253–1258. doi: 10.1056/NEJM199105023241805. [DOI] [PubMed] [Google Scholar]

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