Financing long-term care for older people in England

During a decade of debate on how best to fund long-term

care, British analysts have focused more on policy developments

in other countries than ever before. Discussing

criteria for appraising options, the paper argues that the

objectives of the financing system must be considered in

the light of the objectives for the long-term care system

as a whole. The types of funding mechanisms discussed

are private insurance, including private/public partnerships,

tax-funded and social insurance models. The

differences between tax-funded and social insurance models

are discussed. Social insurance with hypothecation of funds

is no longer part of the current debate, which now focuses

on the three types of options whose properties are

described in the paper: free personal care (adopted in

Scotland), the retention of means-tested arrangements in

some form, and a partnership model as recommended in

the Wanless report. The paper agrees with the Wanless

report that all three have strengths and weaknesses.

Decision-makers have a window of opportunity to make

reforms before the baby-boomers reach late old age.