As millions of baby boomers retire and age in the coming years, more American families will confront difficult choices about the long-term care of their loved ones. The swelling ranks of the disabled and elderly who need such care—including home care, adult day care, or a nursing home stay—are faced with a strained, inequitable and expensive system. How will American society and policy adapt to this demographic transition? In Universal Coverage of Long-Term Care in the United States, editors Nancy Folbre and Douglas Wolf and an expert group of care researchers assess the current U.S. long-term care policies and exercise what can be learned from other countries facing similar care demands. After the high-profile suspension of the Obama Administration’s public long-term insurance program in 2011, Robert Hudson and Howard Gleckman provide concrete suggestions for lowering the cost and improving the quality of long-term care coverage in America. In a deeply personal and empirically rigorous analysis, family care expert Carol Levine draws crucial lessons from her experience as a caregiver for her ailing husband. She sheds light on the often fraught interactions that occur between the formal care system and family caregivers and analyzes how public policy can best support long-term family care. The volume next examines recent reforms in other developed countries and finds valuable lessons for American policy-makers. Contributors David Bell and Alison Bowes discuss the provision of personal care services in Scotland, which have been publicly financed since 2002. Their analysis shows that the new program reduced costs improved efficiency and allowed more recipients to receive care. The volume assesses the political and institutional prospects for moving towards a truly universal long-term care system in the United States. Robyn Stone provides a sobering overview of the formal, paid long-term care workforce in America, which is in crisis due to increasing demand and a shortage of qualified workers. Economist Leonard Burman focuses on public finances of the long-term care system, which will come under increasing strain as more Americans rely on Medicaid to pay for their long-term care. In the volume’s concluding chapter, Folbre and Wolf summarize criticisms of existing long-term care policies and outline particular reforms that can move the United States toward a universal system of long-term care insurance. Universal Coverage of Long-Term Care in the United States provides an essential resource on how to improve the long-term care sector in America and helps advance the national debate on this pressing topic. This volume is available for free download on the Foundation’s website, as are the volume’s individual chapters.

'Beyond Survival' breaks new ground in the ongoing debate about health finance and financial protection from the costs of health care. The evidence and discussion support the need to consider financial protection, in addition to health status, as a policy objective when setting priorities for health systems. This book reviews the Latin American experience with health reform in the last 20 years and the fundamentals of health system financing, using new evidence to show the magnitude and mechanisms that determine the impoverishing effects of health events (diseases, accidents, and those of the life cycle). It provides options for policy makers on how to protect, and help household to protect themselves,against this impoverishment. The authors use empirical evidence from six case studies commissioned for this report, on Argentina, Chile, Colombia, Ecuador, Honduras, and Mexico. This book provides policy makers with a solid conceptual basis for decisions on the contents of mandatory health insurance benefit packages, choices of financing mechanisms, and the roles of public policy in this field. 'Beyond Survival' provides an in-depth analysis of, and organizational alternatives for, risk pooling and health insurance for financial protection. It analyzes the urgent need to extend risk pooling to the informal sector, the challenges for current social insurance arrangements, and options for policy makers to effectively extend risk pooling to the informal sector.

This volume represents the most important work to date on one of the pressing policy issues of the moment: the privatization of social security. Although social security is facing enormous fiscal pressure in the face of an aging population, there has been relatively little published on the fundamentals of essential reform through privatization. Privatizing Social Security fills this void by studying the methods and problems involved in shifting from the current system to one based on mandatory saving in individual accounts. "Timely and important. . . . [Privatizing Social Security] presents a forceful case for a radical shift from the existing unfunded, pay-as-you-go single national program to a mandatory funded program with individual savings accounts. . . . An extensive analysis of how a privatized plan would work in the United States is supplemented with the experiences of five other countries that have privatized plans." —Library Journal "[A] high-powered collection of essays by top experts in the field."—Timothy Taylor, Public Interest

Demographics is a vital field of study for understanding social and economic change and it has attracted attention in recent years as concerns have grown over the aging populations of developed nations. Demographic studies help make sense of key aspects of the economy, offering insight into trends in fertility, mortality, immigration, and labor force participation, as well as age, gender, and race specific trends in health and disability. Demography and the Economy explores the connections between demography and economics, paying special attention to what demographic trends can reveal about the sustainability of traditional social security programs and the larger implications for economic growth. The volume brings together some of the leading scholars working at the border between the two disciplines, and it provides an eclectic overview of both fields. Contributors also offer deeper analysis of a variety of issues such as the impact of greater wealth on choices about marriage and childbearing and the effects of aging populations on housing prices, Social Security, and Medicare.

"This white paper focusses on the policy interventions made to help people manage risk, uncertainty and the losses from events whose impacts are channeled primarily through the labor market. The objectives of the white paper are: to scrutinize the relevance and effects of prevailing risk-sharing policies in low- and middle-income countries; take account of how global drivers of disruption shape and diversify how people work; in light of this diversity, propose alternative risk-sharing policies, or ways to augment and improve current policies to be more relevant and responsive to peoples' needs; and map a reasonable transition path from the current to an alternative policy approach that substantially extends protection to a greater portion of working people and their families. This white paper is a contribution to the broader, global discussion of the changing nature of work and how policy can shape its implications for the wellbeing of people. We use the term risk-sharing policies broadly in reference to the set of institutions, regulations and interventions that societies put in place to help households manage shocks to their livelihoods. These policies include formal rules and structures that regulate market interactions (worker protections and other labor market institutions) that help people pool risks (social assistance and social insurance), to save and insure affordably and effectively (mandatory and incentivized individual savings and other financial instruments) and to recover from losses in the wake of livelihood shocks ('active' reemployment measures). Effective risk-sharing policies are foundational to building equity, resilience and opportunity, the strategic objectives of the World Bank's Social Protection and Jobs Global Practice. Given failures of factor markets and the market for risk in particular the rationale for policy intervention to augment the options that people have to manage shocks to their livelihoods is well-understood and accepted. By helping to prevent vulnerable people from falling into poverty --and people in the poorest households from falling deeper into poverty-- effective risk-sharing interventions dramatically reduce poverty. Households and communities with access to effective risk-sharing instruments can better maintain and continue to invest in these vital assets, first and foremost, their human capital, and in doing so can reduce the likelihood that poverty and vulnerability will be transmitted from one generation to the next. Risk-sharing policies foster enterprise and development by ensuring that people can take appropriate risks required to grasp opportunities and secure their stake in a growing economy."--

Addressing the challenge of covering heath care expenses—while minimizing economic risks. Moral hazard—the tendency to change behavior when the cost of that behavior will be borne by others—is a particularly tricky question when considering health care. Kenneth J. Arrow’s seminal 1963 paper on this topic (included in this volume) was one of the first to explore the implication of moral hazard for health care, and Amy Finkelstein—recognized as one of the world’s foremost experts on the topic—here examines this issue in the context of contemporary American health care policy. Drawing on research from both the original RAND Health Insurance Experiment and her own research, including a 2008 Health Insurance Experiment in Oregon, Finkelstein presents compelling evidence that health insurance does indeed affect medical spending and encourages policy solutions that acknowledge and account for this. The volume also features commentaries and insights from other renowned economists, including an introduction by Joseph P. Newhouse that provides context for the discussion, a commentary from Jonathan Gruber that considers provider-side moral hazard, and reflections from Joseph E. Stiglitz and Kenneth J. Arrow. “Reads like a fireside chat among a group of distinguished, articulate health economists.” —Choice