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Welfare Reform on the Web (October 2011): Care of the elderly - overseas

Embedded incentives in the funding arrangements for residential aged care in Australia

S.D. Hamilton and F.M. Menezes

Economic Papers, vol.30, 2011, p. 326-340

This article explores the market for Australian residential aged care services. It begins with a description of existing arrangements, showing how the Australian government intervenes in the market in a number of ways. The interventions are complex and are likely to interact with one another to influence market outcomes. The paper then goes on to describe the incentives embedded in these arrangements, exploring incentives offered to providers, residents and the government in the light of the policy framework. Providers are likely to have an incentive to discriminate against high-care residents in favour of low-care residents. As a result, since high-care residents have few viable alternatives, many are forced into public hospital beds, which has placed pressure on the health system.

Insurance crowding out and long-term care partnerships

J. Costa-Font

CESifo DICE Report, 2/2011, p. 52-53

Private insurance for long-term care of elderly dependent individuals is underdeveloped compared to insurance for health and longevity risks, especially in Europe. This is puzzling because the costs associated with long term care are high but it is a relatively low probability, and hence should meet the required insurability conditions. This article presents an explanation for the anomaly, based on the interaction between family, government and markets. There appears to be some form of crowding out, especially from public insurance and from the existence of strong family ties.

Partner or perish? Exploring inter-organisational partnerships in the multicultural community aged care sector

H. Radermacher and others

Health and Social Care in the Community, vol. 19, 2011, p. 550-560

The numbers of older people from culturally and linguistically diverse backgrounds in Australia are increasing, and there is evidence that mainstream services are not fully addressing their needs. The Australian government has responded by promoting partnerships between mainstream aged care services and community groups to enable the delivery of more culturally appropriate care. This paper reports on a qualitative study aimed at exploring the experiences of existing partnerships between mainstream organisations and small community groups who deliver services to older people from culturally diverse backgrounds. In particular, the study sought to identify the key factors that facilitate and hinder the formation, maintenance and effectiveness of partnerships within the ethnic and multicultural community aged care sector.

Sharing the burden: understanding the roles of public and private insurance in financing aged care

L.L. Hixon

Economic Papers, vol. 30, 2011, p. 316-325

It is estimated that the share of the Australian government budget committed to the care of older adults will increase from 3% in 2009/10 to 6.6% in 2049/50. Given that government's commitment to limiting overall annual growth in public spending, it is likely that it will seek to shift responsibility for financing care of older adults from the state to the individual. This article explores the relative roles that the public and private sectors will play in the future financing of aged care. It considers how to build on the existing aged care funding scheme and how the Commonwealth might introduce some form of insurance.

Social protection of older people in Finland from the eighteenth to the twenty-first centuries: messages for current policy and practice from an historical analysis

P. Topo

British Journal of Social Work, vol. 41, 2011, p. 876-893

This study seeks to describe how social protection for the elderly evolved in Finland and to review the influence of historical developments on current policy. The paper traces two interconnected themes in particular. One is the shifting levels of paternalism that show that, over the period studied, there has been a shift from strong to weak paternalism, and from the duties to the rights of people in their old age. Recent developments, however, have the potential to leave the most vulnerable old people to fend for themselves in a complex care system. The second theme traced concerns the evolution of service provision from early annual auctions of destitute older people to the household agreeing to care for them most cheaply, through state provision to increased privatisation and commissioning of services. Recent statistics show that eligibility criteria have been raised for access at a higher price to services that may have deteriorated.

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