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Chapter 15: Barriers to Opportunities for Private Long-term Care Insurance in England: What Can We Learn from Other Countries?
15 Barriers to and opportunities for private long-term care insurance in England: what can we learn from other countries? Adelina Comas-Herrera, Rebecca Butterfield, José-Luis Fernández, Raphael Wittenberg and Joshua M. Wiener 1. INTRODUCTION An ageing population, together with the rising cost of services, means that long-term care expenditures will increase greatly over the next several decades. Wittenberg et al. (2008) project that the numbers of disabled older people in England will more than double between 2005 and 2041, rising from around 2.40 million to around 4.95 million. They project that public expenditure on social care and disability benefits will need to rise from around 1.2 per cent of GDP in 2005 to around 2.0 per cent of GDP in 2041 to keep pace with demographic pressures and expected real rises in the unit costs of care. This raises serious questions about how this is to be funded. In light of increasing fiscal constraints, policy makers are particularly keen on mechanisms for incentivising private contributions to the care system, for instance by increasing use of the private long-term care insurance market. In spite of their advantages in terms of the pooling of risks of needing long-term care, there have been substantial difficulties in the development of private long-term care insurance products in England. In many countries, especially where the public long-term care system plays only a residual or ‘safety-net’ role, individual and family resources pay for a substantial proportion of long-term care costs, often out of pocket at the...
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