Subsidized, Mandatory Long-Term Care Insurance

Lawrence A Frolik (Professor of Law, University of Pittsburgh School of Law)spoke at the Notre Dame Journal of Law, Ethics & Public Policy symposium entitled “Long-Term Care for America's Elderly: Who Is Responsible, and How Will It Be Achieved?”. His remarks have been edited for publication in An Essay on the Need for Subsidized, Mandatory Long-Term Care Insurance, 21 Notre Dame J.L. Ethics & Pub. Pol'y 517 (2007).

Here are the concluding paragraphs:

The advantages of mandatory long-term care insurance are obvious. It would create a pool of funds from which to pay for much of the future long-term care costs. It would create national savings to meet a national expense. How much it would pay for each individual would depend upon the amount of the benefits, and that in turn would depend upon how high were the premiums. The rich, the middle class, and the poor would all benefit. The rich, who might be able to pay for their long-term care, would receive benefits that would increase the size of their estates or permit them to purchase better care. The middle class would be better able to preserve assets for their heirs and provide for a more comfortable life for a community spouse. In contrast to Medicaid, which only pays for nursing homes, mandated long-term care insurance benefits would also pay for assisted living and possibly home health care, thus providing the poor with funds to purchase long-term care in a variety of settings, and often at a lower price. And if the premiums of those with limited income were subsidized, they would have received even greater  value from the insurance. Those of any economic class, who died after only modest or even no long-term care expenses, would have received the value of the insurance coverage in the same way that fire insurance has value even if the house never has a fire. In short, all economic segments of society would benefit from mandatory long-term care insurance.

The costs of long-term care must be borne by someone. Why not by all of us through an insurance arrangement? By collective action, we can meet the need of the individual to pay for long-term care and thus reduce by a bit our being “exposed to every risk and hardship.”