Long-term care social insurance: How to avoid big losses?

Summary Long-term care (LTC) needs are expected to rapidly increase in the next decades, and at the same time, the main provider of LTC, namely the family, is stalling. This calls for more involvement of the state that today covers <20% of these needs and most often in an inconsistent way. Besides the need to help the dependent poor, there is a mounting concern in the middle class that a number of dependent people are incurring costs that could force them to sell all their assets. In this paper, we study the design of a social insurance program that meets this concern. Following Arrow (Am Econ Rev 53:941–973, 1963), we suggest a policy that is characterized by complete insurance above a deductible amount.