Top PDF Long-Term Care Financing In The United States

Long-Term Care Financing In The United States

Long-Term Care Financing In The United States

In the United States, people who need long-term care (LTC) face a system with large gaps in care, which they must rely on friends and family to fill. Medicaid finances the majority of paid LTC, but people must exhaust their resources to qualify. Medicare and private health insurance do not cover LTC, and the private market for long-term care insurance is failing. Unpaid family and friends provide most long-term services, but the value of their services is rarely reflected in debates about LTC financing and delivery. Beyond the value of the services, this system has costs to the economy, as spouses and adult children reduce paid work to care for their loved ones. As the population ages and families are less able to shoulder the burden of LTC, the current system may be unable to meet the growing need without an alternative, sustainable financing mechanism.
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Home equity release for long term care financing: an improved market structure and pricing approach

Home equity release for long term care financing: an improved market structure and pricing approach

In this paper, we propose a specific structure for HER loans that involves a securitization and a new form of loan to be offered to homeowners, at an adjustable rate based on the regional house price index (HPI). The use of HPI based mortgages to alleviate basis risk was first proposed by Shiller and Weiss (2000). Our proposal involves the establishment of a centralized system that supports efficient sharing of risks and a transparent method for pricing HER loans. These objectives are achieved by independently pricing the NNEG consisting of basis and longevity risk, while offering HPI linked securities backed by physical homes. It is important to note that both elements work together more effectively than in isolation. For instance, the United States has a mechanism for providing NNEG insurance via an agency, but this has not been sufficient to increase the take up of loans due to limitations of pricing the long term fixed rate contracts.
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Long term effects of economic fluctuations on health and cognition in Europe and the United States

Long term effects of economic fluctuations on health and cognition in Europe and the United States

36 and 1980s. For this purpose, they linked individual-level data on earnings as well as employment histories to death records from the Social Security Administration (SSA). Their results showed that male workers who were working with the same company for a comparatively long time and who lost their job suffered from a significant increase in subsequent mortality rates. In the years immediately after the displacement, the mortality hazard increased by 50 to 100 per cent, but then dropped to 10 to 15 per cent over time. Over a follow-up of 25 years, this would equal in a shortening of life expectancy of around 1 to 1.5 years. No significant effect of job loss on mortality was found for workers who were near the retirement age. Schröder (2013) used information on self-reported job loss from eleven European countries and found that the displaced men are more likely to suffer from depression and memory loss compared to those workers who retained their jobs years after the displacement. Thereby, displaced women experienced increased risks of poor self-rated health status as well as chronic conditions. Strully (2009), using data from the U.S. Panel Study of Income Dynamics (PSID) found significant adverse health- effects of involuntary job loss, which did not differ between white- or blue-collar workers.
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Long-Term Trend Analysis of Precipitation and Air Temperature for Kentucky, United States

Long-Term Trend Analysis of Precipitation and Air Temperature for Kentucky, United States

Abstract: Variation in quantities such as precipitation and temperature is often assessed by detecting and characterizing trends in available meteorological data. The objective of this study was to determine the long-term trends in annual precipitation and mean annual air temperature for the state of Kentucky. Non-parametric statistical tests were applied to homogenized and (as needed) pre-whitened annual series of precipitation and mean air temperature during 1950–2010. Significant trends in annual precipitation were detected (both positive, averaging 4.1 mm/year) for only two of the 60 precipitation-homogenous weather stations (Calloway and Carlisle counties in rural western Kentucky). Only three of the 42 temperature-homogenous stations demonstrated trends (all positive, averaging 0.01 ˝ C/year) in mean annual temperature: Calloway County, Allen County in
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Response of Long-Term Interest Rates to Overnight Interest Rates in the United States

Response of Long-Term Interest Rates to Overnight Interest Rates in the United States

In this study, income was proxied by GDP in billions of dollars. Because GDP is the most essential economic barometer, it represents a wide range of economic activity assessment and indicates the pathway of overall aggregate economic activity. In view of this, an increase in nominal GDP results in an increase in spending. Similarly, this means demand for money also must increase to meet spending needs. Should the money supply not increase to meet the demand for money, the result will be high interest rates. Researchers indicated that the continuous decrease in U.S. GDP growth has affected the long-term interest rates (Gale & Orszag, 2004). Saher and Herbert (2010) find that GDP is positively associated with long-term interest rate.
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FHA FINANCING FOR LONG TERM CARE AHLA Long Term Care and the Law February 27-29, 2012 Phoenix, AZ Andrea C. Barach

FHA FINANCING FOR LONG TERM CARE AHLA Long Term Care and the Law February 27-29, 2012 Phoenix, AZ Andrea C. Barach

The elderly and frail residents of nursing homes are particularly vulnerable to injury or death in the event of a fire, since they are unable to exit the building without assistance. In 2003 there were two tragic nursing home fires. One was in Nashville, Tennessee and the other in Hartford, Connecticut. Together, 31 people lost their lives. Neither building was protected with automatic fire sprinklers, and both fires occurred at night, when staffing was lowest. The Center for Medicare & Medicaid Services (CMS) responded first with an interim final rule 25 that required battery operated smoke detectors in resident sleeping rooms and public areas, unless there was a hard-wired smoke detector system or sprinkler system in place. Thereafter, in 2008 it adopted a final rule 26 that all existing nursing homes must be fully protected with fire safety sprinklers in accordance with the 1999 edition of NFPA 13 27 by August 13, 2013 and established a five year transitional period. CMS staff cited data from NFPA in a 2004 GAO report that there is an 82% reduction in the chance of death occurring in a sprinklered building over one without sprinklers. In addition, they noted that there has never been a multiple death fire in a long term facility that was protected with an automatic fire sprinkler system.
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Term Limits in the United States

Term Limits in the United States

Similarly, much of the corruption in Congress is due to the career politicians. According to Babbin, the more time a person stays in office, the more likely they will become corrupted because their experience brings a sense of power and seniority (30). Also, with that, the more likely the members will try to use their position to gain favors and bribes from lobbyists and groups that want to speak with them (Babbin 28). The members believe that they can use their position because those groups want to have some influence on the lawmaking process by meeting with them. The members figure that the groups will be more willing to take unethical measures, such as bribes, to promote their agenda. The corruptive power of staying in office can be seen in how the Republican Party’s viewpoint on term limits shifts in 1997. Previously, the Democratic Party had control of Congress, so the Republicans supported term limits more strongly, but when they won control in 1997, their support for term limits diminished because they wanted to stay in office as long as they could (Babbin 30). Their change in opinion symbolizes that the power associated with a position in Congress corrupts the politicians because they become greedy and used to their new power and do not want to give it up. Overall, the supporters of term limits view it as a limit of corruption by being an automatic barrier to the corrupting forces political power has on people.
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Dynamics of Fiscal Financing in the United States

Dynamics of Fiscal Financing in the United States

Present-value multipliers change dramatically when only capital and labor taxes react to stabilize debt, as table 6 reports. First, it is commonplace for long-run multipliers to have a different sign from short-run multipliers [see also Judd (1985), Sims (1998), Leeper and Yang (2008), Uhlig (2009)]. Higher government spending stimulates output for a couple of years, but as taxes rise, output falls and the long-run present-value multiplier is sharply negative. Lower capital taxes only weakly raise output in the short run; after a couple of years output reverses and is below steady state until eventually returning back to steady state. Because there is a brief time (25 quarters in the table) where output has already increased above steady state and capital tax revenue are still above steady state, multiplier is positive. Eventually, though, capital taxes must adjust to the lower level of debt and drop below steady state. At this point, capital tax revenues drop below steady state and the very long run the present value multiplier is strongly negative. Second, as the output multiplier of −3.70 demonstrates (second panel of table 6), capital tax multipliers can be very large indeed in the long run. 12
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Financing Affordable Housing in the United States

Financing Affordable Housing in the United States

Under concerns about the growing budget demands of the Sec- tion 236 and BMIR programs, the Nixon administration imposed a moratorium on subsidized housing production in January 1973. Ultimately, while these earlier interest subsidy programs were scuttled, the private development interests succeeded in pushing for a new program, the Section 8 Housing Assistance Payments Program created by the 1974 Housing Act. The theory of the Section 8 program was that by providing private owners with 15- year rental subsidy contracts, the owners could get conventional private financing. In practice, most owners had to use federally insured mortgage loans, supported by guaranteed sales to the secondary mortgage market. The program was a popular one, resulting in increased demands for budget authority (annual contract for rental assistance times the term of the contract). The Section 8 production programs (for new construction and substantial rehabilitation), in turn, were curtailed beginning in 1981, when the new administration was making a concerted effort to reduce social spending and, in particular, the substan- tial budget authority required for the production programs. The production component of Section 8 also had been shown to be more expensive, for the housing provided, than the existing housing component (Wallace et al. 1981), which provided port- able tenant subsidies with relatively short-term commitments to the subsidized households (and to the administering agencies, generally public housing agencies).
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Long-term Recovery from Recent Disasters in Japan and the United States

Long-term Recovery from Recent Disasters in Japan and the United States

Life recovery starts with the identification of the disaster victims. In Japan, local governments in the impacted area issue a “damage certificate” to disaster victims by household, recording the extent of each victim’s housing damage. After the Kobe earthquake, a total of 500,000 certificates were issued. These certificates, in turn, were used by both public and private organizations to determine victim’s eligibility for individual assistance programs. However, about 30% of those victims who received certificates after the Kobe earthquake were dissatisfied with the results of assessment. This caused long and severe disputes for more than three years. Based on the lessons learned from the Kobe earthquake, Mr. Horie’s paper presents (1) a standardized procedure for building damage assessment and (2) an inspector training system. This system has been adopted as the official building damage assessment system for issuing damage certificates to victims of the 2004 Niigata-ken Chuetsu earthquake, the 2007 Noto-Peninsula earthquake, and the 2007 Niigata-ken Chuetsu Oki earthquake.
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The Thin Blue Line: Long Term Care as an Indicator of Equity in Welfare States

The Thin Blue Line: Long Term Care as an Indicator of Equity in Welfare States

Staffing levels are related to the very high illness and injury rates in long-term care. Care providers in these facilities experienced higher rates of injury and illness than in any other industrial sector, and research in British Columbia has shown that workload is an important determi- nant of these injuries (Cohen et al.). The workplaces with the lowest staff level have the highest injury rates. Equally important, variation across provinces and institutions suggest that such illness and injury rates are far from inevitable (Yassi et al.). In our 2003 survey (Armstrong, Jansen, et al.), a stunning 97 percent reported being ill or injured as a result of work in the last five years. Being sick does not necessarily mean staying home. In our 2007 study (Armstrong, Arm- strong and Daly), 42 percent said they had gone to work two to five times in the last year even when they were sick or injured, while another 18 percent said they had done so more than five times. The respondents made it clear why they thought the illness and injury rates are so high. “We are on the run off our feet to get our work done. Therefore, we’ve had an increase of work-related injuries, more off sick with stress.”
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Long-Term Care: An Overview

Long-Term Care: An Overview

expenditures made up about 12 percent of U.S. personal health care spending in 2002 (Feldman et al., 2005). State and local gov- ernments spent even more (see Figure 4), with a quarter of Medicaid dollars going toward nursing homes and HCBS. Consequently, states have experimented with three broad strategies to control their LTC costs: 1) substituting private or federal dollars for state dollars, 2) shifting the cost control burden to providers by controlling nursing home bed supply or cutting provider payment rates, and 3) attempting to reform the health care delivery system through some combination of integrating acute and LTC services and/or increasing the availability of HCBS alternatives to institutional care.
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Health Care Expenditure and Financing in the United Kingdom

Health Care Expenditure and Financing in the United Kingdom

13.10 It is observed that 85% of total health care expenditure was taken up by the NHS, of which, 75% covered hospital and community services, 23% covered family health services and the remaining for other services. Since hospital services have taken up a large proportion of NHS expenditure, the NHS remains predominantly a service for curative care. Of the hospital and community services, nearly half of the expenditure went to acute hospital services. Most of these services are consumed by elderly people. It is expected that with an aging population, there will be greater demand on health care services, especially long-term care and community care services. Of the family health services, over half of the expenditure was on drugs and prescription expenses. This implies that an increase in prices of drugs and related expenses would have great impact on the expenditure of family health services. According to Allsop (1996), 41 prescription charges had risen sharply: between 1979 and 1994, there had been an increase from under £1 per item prescribed to almost £5.
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An Examination of Public Health Financing in the United States

An Examination of Public Health Financing in the United States

often the first state-level budget cut. One interviewee explained that health departments in their state have tried to “make the argument that public health direct services make money in the long run,” but the state often decides that short-term needs trump long-term benefits. As a result, a number of case study participants have seen funding cuts across the board for public health, which leaves health departments to determine how those cuts will impact their state’s public health system—for example, if reductions should be made across all public health programs or to specific programs. Some states have made this decision by prioritizing public health programs. Other case study participants said that the state has made cuts to specific programs, citing infectious disease laboratories and immunization programs as examples. Often, program-specific cuts are made at the state level, passed on to the state health department and, subsequently, onto LHDs. However, multiple case study participants report that they attempt to not pass along budget cuts to LHDs. One decentralized case study participant said that instead, the state health department makes cuts from the operational side by streamlining operations, rather than eliminating services at the local level. The participant noted that this approach may result in drastic state personnel reductions, however, which may impact the quality of public health programs. A participant from another case study state health department explained: “We [the state health department] try to tighten our purse strings as much as we can, but that’s really difficult to a certain degree after a while….You want [the money] out to communities so they can do their work, but you also need infrastructure at the state.” In one case study state, the state health department has had to prioritize work and consider potential programs to eliminate.
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LARIBA (Islamic) Mortgage Financing in the United States

LARIBA (Islamic) Mortgage Financing in the United States

Approximately 66% of the residential properties in the United States are owner occupied. They represent about US$7 trillion in value. Mortgage payments are the biggest monthly liability of a typical American household. A typical homebuyer borrows up to 85 to 90% of the purchase price of a home for a 30-year term. Because of the mobility of the US employment market and the continued needs of American families to move to larger and more modern homes in more attractive suburbs and neighborhoods, many of these mortgages are closed long before the end of the 30-year term. California Home Financing Association statistics on the characteristics of homebuyers and sellers in California in 1996 indicate that the average number of years of ownership of a particular home is approximately 8 years. As the homeowner moves to another home, he/she closes the old mortgage, pays off the loan, and applies for a new home mortgage. As interest rates have continued to decline in the past two years many homeowners have refinanced their homes more than once.
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15 Cheapest/ Expensive States for Long-Term Care Costs: 2015

15 Cheapest/ Expensive States for Long-Term Care Costs: 2015

For the 11th year, Genworth’s Cost of Care Survey, conducted by CareScout, uses data that span more than 14,800 LTC providers from 440 regions across the country, covering all 50 states and Washington, D.C. Also included are potential cost growth rates, as well as a look at how expenses in each category have risen over the past 5 years.

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Willingness to Pay For Long-Term Health Care Financing in Côte d’Ivoire

Willingness to Pay For Long-Term Health Care Financing in Côte d’Ivoire

Millions of Africans suffer severe economic consequences due to the need to pay for out-of-pocket health care, which in turn aggravates inequities and impedes sustainable social and economic development, and millions more do not even seek the care they need due to the high costs of accessing and using it, thereby contributing to avoidable morbidity and premature mortality(AfDB, 2014).Ensuring the financial accessibility of the African populations against the risk of disease is now more than necessary. To this end, powerful interests must be called into question and the political and economic priorities of the states must also be reshaped. Offering low-cost health insurance to low-income households is one innovative method through which to finance health care provision and to avoid catastrophic out-of-pocket health expenditures(Gustafsson-Wright et al., 2009).Indeed, since 1992, the Ivorian government, with the support of the French Cooperation, institutionalized community financing of health care through the creation of community-based “Formation Sanitaire Urbaine” (FSU) (Ortiz et Dogaud, 1998). The Yearbook of Health Statistics 2008 (edited in 2010) of the Ministry of Health and Public Hygiene listed 86 community health care financing systems, 74 of which were based in Abidjan and the other 12 were dispersed in the deep country.
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Policy Options for Financing Long-Term Care in the U.S.

Policy Options for Financing Long-Term Care in the U.S.

Policymakers in U.S. states differ in how they designed their LTC programs, reflecting different emphases and fiscal realities. Hawaii’s program reflects a strong cultural tradition of family caregiving for elders; policymakers chose to provide a small universal benefit that targeted working families and would help caregivers maintain their employment. Maine’s ballot measure was geared toward allowing elderly people and disabled people to stay in their homes; it would have involved no means testing or cost sharing, although details of the range and scope of benefits were left to a Trust Fund Board to be named later. Washington state made some strategic fiscal decisions about eligibility and scope of benefits, choosing to provide a modest, flexible benefit that could be applied across settings and could be used to pay a family caregiver. The plan was not universal; employees had to pay into for a certain number of years to be eligible, and it excluded current retirees and children with disabilities.
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An Innovative Proposal for the Health Care Financing System of the United States

An Innovative Proposal for the Health Care Financing System of the United States

Under the FHIRS proposal, to cover subsidy, tax credits, and loss of income from tax-free insurance, Congress would establish a budget. FHIRS would have several options including altering the benefits packages, increasing copayments, and/or reducing the upper limits of tax-advantaged fees to stay within that budget without Congressional interfer- ence. The first priority of the FHIRS would be to protect basic health financing for the entire popula- tion. A high percentage of medical costs result from often heroic and unproven treatment of basically terminal illnesses, followed by a limited poor quality
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Policy dilemmas in financing long-term care in Europe

Policy dilemmas in financing long-term care in Europe

Another set of mechanisms for funding LTC is of the ex post type. They are activated after the onset of old-age dependency, comprising family bailout, the use of housing equity for financing LTC (‘reverse mortgages’), and the subsidization of informal and formal LTC. Again, intergenerational moral hazard looms large. At a time when the younger generation has to struggle to make ends meet, fairness does not dictate participation in a family bailout. As to reverse mortgages, they are viable only in highly developed capital markets and given reasonably stable housing prices – conditions not satisfied notably in southern European OECD countries. Moreover, reverse mortgages permit potential recipients of LTC services to continue living independently. This serves to preserve their non-housing wealth in which children as heirs may be especially interested. Therefore, their incentives work both ways: on the one hand, providing some informal care keeps the parent in her home; on the other hand, non-housing wealth is protected by the insurance provided by the reverse mortgage.
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