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Financing Long-Term Care
Abstract
The availability and delivery of long-term care services in the United States have been hindered by major organizational and financial problems. The American College of Physicians has previously identified and addressed some of the organizational problems that impede access to long-term care. In this issues paper, we provide background information on and analysis of the costs and the methods currently used to finance such care in the United States. The Canadian National Health Care System is also described for comparison. We then analyze such alternative financing mechanisms as private individual insurance (beyond Medigap), employment-based long-term care insurance, self-insurance, vouchers, financing through Medicare, home equity conversions, and prepaid capitated case management plans. The advantages and disadvantages of each of these methods are presented.
- activities of daily living
- aged
- capital financing
- health insurance for aged and disabled, title 18
- health maintenance organizations
- home care services
- insurance, health
- insurance, long-term care
- long-term care
- medical assistance, title 19
- nursing homes
- United States Veterans Administration
- Canadian National Health Care System
- home equity
- life-care communities
- Medicaid
- Medicare
- Medigap
- self-insurance
- activities of daily living
- aged
- capital financing
- health insurance for aged and disabled, title 18
- health maintenance organizations
- home care services
- insurance, health
- insurance, long-term care
- long-term care
- medical assistance, title 19
- nursing homes
- United States Veterans Administration
- Canadian National Health Care System
- home equity
- life-care communities
- Medicaid
- Medicare
- Medigap
- self-insurance
Article and Author Information
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↵* This paper was drafted by Jack A. Ginsburg, and developed for the Health and Public Policy Committee by the Health Care Financing Subcommittee: John M. Eisenberg, M.D., Chairman; Robert H. Brook, M.D.; Bruce Samms, MD.; Arthur Feinberg, M.D.; H. Denman Scott, M.D.; and Paul S. Entmacher, M.D. Members of the Health and Public Policy Committee for the 1987-1988 term are Richard G. Farmer, M.D., Chairman; John M. Eisenberg, M.D.; Paul F. Griner, M.D.; Joseph E. Johnson III, M.D.; Michael A. Nevins, M.D.; Donald L. Feinstein, M.D.; Charles E. Lewis, M.D.; Malcolm L. Peterson, M.D. [deceased November 1987]; C. S. Lewis, Jr., M.D.; Steven A. Schroeder, M.D.; and Quentin D. Young, M.D. Ex officio members are Edwin P. Maynard, M.D. and Lawrence Scherr, M.D. This paper was adopted by the Board of Regents on 14 November 1987.
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▸From the American College of Physicians; Philadelphia, Pennsylvania.
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▸Requests for reprints should be addressed to Jack. A. Ginsburg; American College of Physicians, 655 Fifteenth Street, N.W., Suite 425; Washington, D.C. 20005.
- © 1988 American College of Physicians
