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Long-term Care Financing in the United States: Sources and Institutions

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  • Richard G. Frank

Abstract

This paper reviews the financing of long-term services and supports (LTSS) in the United States. I characterize existing payment arrangements as incomplete insurance. The paper organizes existing literature on U.S. financing of LTSS and uses it to analyze the economic, policy and behavioral forces that underpin the observed equilibrium. I assess several sources of market failure and consider policy directions that are viable within the U.S. political environment.

Suggested Citation

  • Richard G. Frank, 2012. "Long-term Care Financing in the United States: Sources and Institutions," Applied Economic Perspectives and Policy, Agricultural and Applied Economics Association, vol. 34(2), pages 333-345.
    • Handle: RePEc:oup:apecpp:v:34:y:2012:i:2:p:333-345.
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    File URL: http://hdl.handle.net/10.1093/aepp/pps016
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    Cited by:

    1. Justina Klimaviciute & Pierre Pestieau & Jérôme Schoenmaeckers, 2019. "Family altruism and long-term care insurance," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 44(2), pages 216-230, April.
    2. Bergquist, Savannah & Costa-Font, Joan & Swartz, Katherine, 2018. "Long-term care partnerships: Are they fit for purpose?," The Journal of the Economics of Ageing, Elsevier, vol. 12(C), pages 151-158.
    3. Joan COSTA‐FONT & Christophe Courbage & Katherine Swartz, 2015. "Financing Long‐Term Care: Ex Ante, Ex Post or Both?," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 45-57, March.
    4. M. Martin Boyer & Franca Glenzer, 2021. "Pensions, annuities, and long-term care insurance: on the impact of risk screening," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 46(2), pages 133-174, September.
    5. William Lim & Gaurav Khemka & David Pitt & Bridget Browne, 2019. "A method for calculating the implied no-recovery three-state transition matrix using observable population mortality incidence and disability prevalence rates among the elderly," Journal of Population Research, Springer, vol. 36(3), pages 245-282, September.
    6. Justina Klimaviciute & Pierre Pestieau, 2020. "Insurance with a deductible: a way out of the long term care insurance puzzle," Journal of Economics, Springer, vol. 130(3), pages 297-307, August.
    7. PESTIEAU, Pierre & PONTHIERE, Gregory, 2016. "The Public Economics of Long Term Care," LIDAM Discussion Papers CORE 2016008, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    8. Costa-Font, Joan & Frank, Richard G. & Swartz, Katherine, 2019. "Access to long term care after a wealth shock: Evidence from the housing bubble and burst," The Journal of the Economics of Ageing, Elsevier, vol. 13(C), pages 103-110.
    9. Fuino, Michel & Wagner, Joël, 2020. "Duration of long-term care: Socio-economic factors, type of care interactions and evolution," Insurance: Mathematics and Economics, Elsevier, vol. 90(C), pages 151-168.
    10. Norton, E.C., 2016. "Health and Long-Term Care," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 951-989, Elsevier.
    11. Costa-Font, Joan & Jiménez-Martín, Sergi & Vilaplana-Prieto, Cristina, 2022. "Do Public Caregiving Subsidies and Supports affect the Provision of Care and Transfers?," Journal of Health Economics, Elsevier, vol. 84(C).
    12. He, Alex Jingwei & Qian, Jiwei & Chan, Wai-sum & Chou, Kee-lee, 2021. "Preferences for private long-term care insurance products in a super-ageing society: A discrete choice experiment in Hong Kong," Social Science & Medicine, Elsevier, vol. 270(C).
    13. Cremer, Helmuth & Lozachmeur, Jean-Marie & Pestieau, Pierre, 2016. "The design of long term care insurance contracts," Journal of Health Economics, Elsevier, vol. 50(C), pages 330-339.
    14. Akaichi, Faical & Costa-Font, Joan & Frank, Richard, 2020. "Uninsured by Choice? A choice experiment on long term care insurance," Journal of Economic Behavior & Organization, Elsevier, vol. 173(C), pages 422-434.
    15. Martin Boyer & Franca Glenzer, 2016. "Pensions, annuities, and long-term care insurance: On the impact of risk screening," Cahiers de recherche 1603, Chaire de recherche Industrielle Alliance sur les enjeux économiques des changements démographiques.
    16. Christophe Courbage & Guillem Montoliu-Montes & Joël Wagner, 2023. "On children’s motives to influence parents’ long-term care insurance purchase: evidence from Switzerland," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 102-129, January.

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