Cover image for Public and private responsibilities in long-term care : finding the balance
Public and private responsibilities in long-term care : finding the balance
Walker, Leslie C., 1962-
Publication Information:
Baltimore : Johns Hopkins University Press, [1998]

Physical Description:
xv, 206 pages ; 24 cm
Format :


Call Number
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Item Holds
RA644.6 .P8 1998 Adult Non-Fiction Central Closed Stacks

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Massive reforms affecting the financing of long-term care are taking place at both federal and state levels. As a result, the debate over public versus private responsibilities for providing that care has become increasingly important in the formation of public policy. In this book, a distinguished group of contributors examines competing perspectives regarding individual and societal obligations to provide and finance long-term care for our older citizens. The authors argue that the traditional juxtaposition of public and private responsibilities in long-term care may no longer be germane in framing policy discussions around long-term care financing. The chapters are grouped into four sections: an introduction and overview, the theoretical context of public and private roles, a review of current policies and programs for financing long-term care, and concluding policy recommendations. Integrating theory, practice, and policy, the book will be valuable to professionals in gerontology, health policy and finance, and public policy. Contributors: Robert H. Binstock, Elizabeth H. Bradley, Brian Burwell, Norman Daniels, Kevin J. Mahoney, Hunter L. McKay, Mark R. Meiners, Mark Schlesinger, Lori Simon-Rusinowitz, Kathleen C. J. Treat, Leslie C. Walker, Terrie Wetle, Joshua M. Wiener, and Donna L. Yee.

Author Notes

Robert H. Binstock, Ph.D., is professor of aging, health, and society at Case Western Reserve University
Elizabeth H. Bradley, Ph.D., is assistant professor in the Department of Epidemiology and Public Health at the Yale University School of Medicine
Brian Burwell is vice president for Medicaid Policy Research at the MEDSTAT Group, Cambridge, Massachusetts
Norman Daniels, Ph.D., is the Goldthwaite Professor and professor of medical ethics at Tufts Medical School
Kevin J. Mahoney, Ph.D., is a faculty member at the University of Maryland Center on Aging
Hunter L. McKay is deputy director of the national program office for four Robert Wood Johnson Foundation programs
Mark R. Meiners, Ph.D., is associate professor and associate director for the University of Maryland Center on Aging in College Park. He is the originator of the Robert Wood Johnson Foundation Partnership for Long-Term Care
Mark Schlesinger, Ph.D., is associate professor of public health, head of the Division of Health Policy and Administration, and fellow of the Institution for Social and Policy Studies, Yale University. He is also a visiting associate professor at the Institute for Health, Health Care Policy, and Aging Research at Rutgers University
Lori Simon-Rusinowitz is deputy director of the Cash and Counseling Demonstration and Evaluation Project at the University of Maryland Center on Aging
Kathleen C. J. Treat is coordinator of the service credit program at the Center on Aging at the University of Maryland
Leslie C. Walker, M.P.H., is director of the Braceland Center for Mental Health and Aging at the Institute of Living/Hartford Hospital. She holds a dual appointment as assistant professor in medicine and in community medicine and health care at the University of Connecticut School of Medicine
Terrie Wetle, Ph.D., is deputy director of the National Institute on Aging of the National Institutes of Health
Joshua M. Wiener, Ph.D., is a principal research associate at the Urban Institute, where he specializes in research on Medicaid and on long-term care
Donna L. Yee, Ph.D., the director of policy and research at the National Asian Pacific Center on Aging, conducts numerous studies in the area of long-term care

Reviews 1

Choice Review

Individual authors address concerns growing out of the demographic revolution resulting in increasing numbers of elders needing health care and the costs this phenomenon will incur. They believe that a need exists to redefine the traditional juxtaposition of public versus private responsibilities for providing needed care for America's elders. A review of the current financing mechanisms is provided, and analyses of the need for new elder care initiatives are presented from the perspectives of political science, economics, sociology, and philosophy. Welfare economics are explored, and the responsibilities of the public and of individuals to provide long-term care are reviewed. Medicaid estate planning is described and analyzed, with several program initiatives viewed as politically feasible presented and analyzed. A useful and valuable exploration of current economic and philosophical issues in the provision of elder care in the US. All levels. J. E. Allen University of North Carolina at Chapel Hill

Table of Contents

Robert H. BinstockMark SchlesingerElizabeth H. BradleyDonna L. YeeNorman DanielsMark R. MeinersJoshua M. WienerKevin J. Mahoney and Lori Simon-Rusinowitz and Mark R. Meiners and Hunter L. McKay and Kathleen C. J. TreatLeslie C. Walker and Brian BurwellLeslie C. Walker and Elizabeth H. Bradley
List of Contributorsp. vii
Prefacep. xi
Introduction: The Financing and Organization of Long-Term Carep. 1
Part I Public and Private Roles in Long-Term Care: A Theoretical Context
Chapter 1 Deceptive Dichotomies: Political Reasoning and Government Involvement in Long-Term Carep. 25
Chapter 2 Self-interested Behavior and Social Welfare: Perspectives from Economic Theoryp. 62
Chapter 3 Community Perceptions of Public and Private Responsibility in the Context of Cultural Diversityp. 77
Chapter 4 Justice and Prudential Deliberation in Long-Term Carep. 93
Part II The Public-Private Dilemma in Long-Term Care: Policy Responses
Chapter 5 Public-Private Partnerships in Long-Term Carep. 115
Chapter 6 Jump Starting the Market: Public Subsidies for Private Long-Term Care Insurancep. 134
Chapter 7 Empowering the Community: Public Initiatives in Consumer-directed Servicesp. 150
Chapter 8 Access to Public Resources: Regulating Asset Transfers for Long-Term Carep. 165
Conclusion: Integrating Theory and Practice in Long-Term Carep. 181
Indexp. 197