Insuring Long-Term Care in the United States

摘要

Long-term care expenditures constitute one of the largest uninsured financial risks facing the elderly in the United States and thus play a central role in determining the retirement security of elderly Americans. Long-term care is a broad umbrella term for a wide range of supportive and health services for individuals whose physical and/or mental impairments do not allow them to independently perform basic functions of daily living. Such care currently accounts for almost 9 percent of total health expenditures in the United States (Centers for Medicare and Medicaid Services, 2010), and these expenditures are expected to grow substantially over the coming decades as the population ages (OECD, 2011b). However, much of this risk is uninsured. About one-third of these expenditures are paid for out of pocket, about 60 percent are paid for by the public sector, in particular, by Medicaid, which is the primary public insurance program for long-term care; only about 4 percent are paid for by private insurance (CBO, 2004).