Grimaldi P L
Health Prog. 1987 Nov;68(9):33-40.
Most Americans have little or no private health insurance for chronic illness or disability, largely because of forces restricting the development of a market for long-term care insurance. Properly structured incentives could alter this situation and help defuse a financial time bomb confronting the nation. Spending for long-term care has grown dramatically in the last 20 years and is expected to continue escalating. The question is who will pay for it. Considerable room exists to increase private insurance's proportion of long-term care expenses, which are now largely paid by the patient out-of-pocket or by Medicaid. The current market, however, is under-developed because demand is thin and private third-party insurers are reluctant to write policies. But the potential demand is substantial because of the increasing elderly population. To develop a long-term care insurance market, tax incentives should be offered, the elderly need to be educated about the limited coverage provided by Medicare, and beneficiaries need to be made aware that relying on Medicaid's safety net could lead to impoverishment.
大多数美国人几乎没有或完全没有针对慢性病或残疾的私人医疗保险，这主要是由于一些因素限制了长期护理保险市场的发展。合理构建的激励措施可以改变这种状况，并有助于化解美国面临的一颗金融定时炸弹。在过去20年里，长期护理支出急剧增长，预计还会持续攀升。问题是谁来为此买单。提高私人保险在长期护理费用中所占比例的空间很大，目前长期护理费用主要由患者自掏腰包或由医疗补助计划支付。然而，当前市场发育不足，因为需求低迷，私人第三方保险公司不愿承保。但由于老年人口不断增加，潜在需求巨大。为了发展长期护理保险市场，应提供税收激励措施，需要让老年人了解医疗保险提供的有限覆盖范围，还需要让受益人意识到依赖医疗补助计划的安全网可能导致贫困。
