Universal Coverage of Long-Term Care in the United States

Can We Get There from Here?
Douglas Wolf
Nancy Folbre
Paperback or Ebook
340 pages
September, 2012

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Douglas Wolf
In this overview of the volume, Wolf outlines recent developments in long-term care policy and how research can help lead to a truly universal long-term care system in America.
Long-Term Care and Long-Term Family Caregivers: Outdated Assumptions, Future Opportunities
Carol Levine
Blending insights from her personal life and policy analysis, Carol Levine asks: How can public policy best support long-term family care?
The Rise and Fall of the Class Act: What Lessons Can We Learn?
Howard Gleckman
In an engaging history of the CLASS Act, Howard Gleckman examines why the landmark legislation failed and if it can be improved.
The CLASS Promise in the Context of American Long-Term Care Policy
Robert Hudson
Robert Hudson looks at the history of long-term care policy in America and why the issue has remained only marginally acknowledged or addressed.
Free Personal Care in Scotland, (Almost) 10 Years On
David Bell and Alison Bowes
After reviewing recent policy shifts in the United Kingdom, David Bell and Alison Bowes describe the costs and benefits of the provision of free personal care in Scotland.
Population Aging and Long-Term Care: The Scandinavian Case
Svein Olav Daatland
Svein Olav Daatland analyzes the Scandinavian approach to long-term care, with a particular emphasis on the Norwegian model.
Lessons on Long-Term Care from Germany and Japan
Mary Jo Gibson
Germany and Japan have both implemented mandatory social insurance programs to help provide long-term care. Mary Jo Gibson provides an in-depth analysis, along with possible lessons for American policymakers.
The Long-Term Care Workforce: From Accidental to Valued Profession
Robyn Stone
In her overview of the formal, paid long-term care workforce, Robyn I. Stone discusses current challenges and potential solutions to increase supply and quality.
The Perverse Public and Private Finances of Long-Term Care
Leonard Burman
How do Americans pay for long-term care? Leonard Burman explains the long-term care financing system, which he calls "dysfunctional."
It Takes Two to Tango: A Perspective on Public and Private Coverage for Long-Term Care
David Stevenson, Marc A. Cohen, Brian Burwell, and Eileen J. Tell
David Stevenson, Marc A. Cohen, Brian Burwell and Eileen J. Tell look at the private long-term care insurance market and ask: Why don’t more Americans purchase such insurance?
Long-Term Care Coverage for All: Getting There from Here
Nancy Folbre and Douglas Wolf
Editors Nancy Folbre and Douglas Wolf conclude the volume by discussing potential pathways to more comprehensive long-term care insurance.

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 support—including home care, adult day care, or a nursing home stay—must often interact 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 acclaimed group of care researchers offers a much-needed assessment of current U.S. long-term care policies, the problems facing more comprehensive reform, and 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, this volume, the Foundation’s first free e-book, includes concrete suggestions for moving policy toward a more affordable and universal long-term care coverage in America.


David Bell is a Professor of Economics in the Stirling Management School at the University of Stirling, Stirling, Scotland.

Alison Bowes is a Professor in the School of Applied Social Science at the University of Stirling, Stirling, Scotland.

Leonard Burman is the Daniel P. Moynihan Professor of Public Affairs in the Maxwell School of Citizenship and Public Affairs of Syracuse University, Syracuse, New York.

Brian Burwell is Vice President for Community Living Systems at Thomson Reuters, Cambridge, Massachusetts.

Marc A. Cohen is Chief Research and Development Officer of LifePlans, Inc., in Waltham, Massachusetts.

Svein Olav Daatland is Senior Researcher at NOVA/Norwegian Social Research, in Oslo, Norway.

Nancy Folbre is a Professor of Economics at the University of Massachusetts at Amherst.

Mary Jo Gibson, formerly a Strategic Policy Adviser at AARP's Public Policy Institute, is a long-term care consultant.

Howard Gleckman is a Resident Fellow at The Urban Institute, where he is affiliated with both the Tax Policy Center and the Program on Retirement Policy. 

Robert Hudson is Professor and Chair of Social Welfare Policy in Boston University’s School of Social Work.

Carol Levine is Director of the Families and Health Project at the United Hospital Fund, New York City.

David Stevenson is an Associate Professor of Health Policy in the Department of Health Care Policy at Harvard Medical School.

Robyn Stone is Executive Director of the Center for Applied Research and Senior Vice President of LeadingAge in Washington, D.C.

Eileen J. Tell is Senior Vice President of Univita (formerly the Long Term Care Group, Inc.), in Natick, Massachusetts.

Douglas Wolf is the Gerald B. Cramer Professor of Aging Studies and Director of the Center for Aging and Policy Studies at Syracuse

Universal Long Term Care Fact Sheet

Author Interviews

Robyn I. Stone discusses the long-term care workforce in America, its challenges and potential reforms for improvement. Read the Interview

Carol Levine discusses her personal experience as a family caregiver, and how policy must change to better support friends and family who offer unpaid care. Read the Interview

Douglas Wolf offers an overview of Universal Coverage and outlines possible reforms to improve the provision of long-term care in America. Read the Interview


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