McCormack J J
Health Prog. 1988 Jan-Feb;69(1):52-5.
Private insurance may be the most viable approach to financing long-term care for middle- and upper-income elderly, but many issues must be considered. Should public policy favor service-oriented or indemnity plans? Should states require companies to offer a minimum plan benefit to sell policies? Should companies try to design integrated plans that presume future Medicaid eligibility for some private-plan enrollees? Should states and private businesses require professional quality review, utilization control, and cost management features? One policy direction would encourage local management of insured individuals' long-term care, but such a strategy should be tested for structural, technical, administrative, and financial feasibility. A local management structure for long-term care insurance would have four functions: expenditure control, utilization control, quality control, and service development.
对于中高收入老年人的长期护理融资而言，私人保险或许是最可行的办法，但必须考虑诸多问题。公共政策应倾向于服务型计划还是赔偿型计划？各州是否应要求保险公司提供最低计划福利才能销售保单？保险公司是否应尝试设计综合计划，假定一些私人计划参保人未来有资格享受医疗补助？各州和私营企业是否应要求具备专业质量审查、使用控制和成本管理功能？一种政策方向是鼓励对参保个人的长期护理进行地方管理，但这种策略应在结构、技术、行政和财务可行性方面进行测试。长期护理保险的地方管理结构将有四项功能：支出控制、使用控制、质量控制和服务发展。
