As millions of baby boomers retire and age in the coming years, more American families will confront difficult choices about the long-term care of their loved ones. The swelling ranks of the disabled and elderly who need such care—including home care, adult day care, or a nursing home stay—are faced with a strained, inequitable and expensive system. How will American society and policy adapt to this demographic transition? In Universal Coverage of Long-Term Care in the United States, editors Nancy Folbre and Douglas Wolf and an expert group of care researchers assess the current U.S. long-term care policies and exercise what can be learned from other countries facing similar care demands.
After the high-profile suspension of the Obama Administration’s public long-term insurance program in 2011, Robert Hudson and Howard Gleckman provide concrete suggestions for lowering the cost and improving the quality of long-term care coverage in America. In a deeply personal and empirically rigorous analysis, family care expert Carol Levine draws crucial lessons from her experience as a caregiver for her ailing husband. She sheds light on the often fraught interactions that occur between the formal care system and family caregivers and analyzes how public policy can best support long-term family care. The volume next examines recent reforms in other developed countries and finds valuable lessons for American policy-makers. Contributors David Bell and Alison Bowes discuss the provision of personal care services in Scotland, which have been publicly financed since 2002. Their analysis shows that the new program reduced costs improved efficiency and allowed more recipients to receive care. The volume assesses the political and institutional prospects for moving towards a truly universal long-term care system in the United States. Robyn Stone provides a sobering overview of the formal, paid long-term care workforce in America, which is in crisis due to increasing demand and a shortage of qualified workers. Economist Leonard Burman focuses on public finances of the long-term care system, which will come under increasing strain as more Americans rely on Medicaid to pay for their long-term care. In the volume’s concluding chapter, Folbre and Wolf summarize criticisms of existing long-term care policies and outline particular reforms that can move the United States toward a universal system of long-term care insurance.
Universal Coverage of Long-Term Care in the United States provides an essential resource on how to improve the long-term care sector in America and helps advance the national debate on this pressing topic. This volume is available for free download on the Foundation’s website, as are the volume’s individual chapters.