Public Long-Term Care Insurance
Enacting public long-term care insurance would dramatically change the role of the U.S. government in long-term care financing.* Although most Western European countries and Canada cover long-term care along with acute care under their national health insurance or national health service, the United States makes a sharp distinction between the two kinds of care. 1 Acute care is covered by social insurance under the medicare program, and long-term care is primarily covered by medicaid, a means-tested welfare program.
The rationale for public long-term care insurance is that the use of long-term care is a normal, insurable risk of growing old, but that the private insurance market is unable to provide adequate coverage at a price affordable by most of the elderly. Covering long-term care under a universal public program avoids two problems inherent in the current private insurance market: those people likely to need long-term care insurance may buy it disproportionately, and insurance companies tend____________________