In 2007, 17 percent of the Austrian population was age 65 or old, and the older population will increase markedly over the decades to come. Today, life expectancy at age 50 is 29 years for men, and almost 34 years for women, half of which will be troubled by health problems and functional limitations. As a result, the number of Austrians receiving LTC will increase by at least 41 percent between 2008 and 2030, and, spending on long-term care would claim 1.96 percent of the country's GDP in 2030, which compares to 1.3 percent in 2008. This paper provides an overview of Austria's tax-based LTC system, including its principles of subsidiarity and solidarity, and details of the system, including universal cash benefits for care clients, complex policies regarding funding of social care services, and policies supporting family caregivers.

England provides long term care services as a part of the social care. Approximately 1.7 million people use social care services organized by the 150 local councils in 2005. At 1.2 million, older people constitute by far the largest user group for social care. Of those, 1.0 million older people used publicly "brokered" community-based services that include domiciliary care (i.e., support to people in their own homes) and day care (services and activities available in other settings). Local authorities spent £ 8.0 billion on personal social care services in 2004/5, 1.6 billion of which was recouped from users through means-tested charges. A further 3.7 billion was paid out to individuals on non-means-tested benefits to help toward the costs of care. The amount of public support for dependent people varies significantly depending on the wealth and geographical location of individuals. This paper first follows the evolution of the English policy of social services since 1980's, then introduces the current debates on community care policy, and finally explains the market structure of the community care market in England.

This paper describes social long-term care insurance (SLTCI) in Germany. Following a short review of the history of long-term care organization and preceding laws in Germany, the implementation of SLTCI as a separate and self-sustaining pillar within the system of social insurances in Germany is presented, with detailed descriptions of eligibility criteria, service provision, and financing. Since SLTCI is a universal, contribution-financed insurance, the aging of society and corresponding shifts in the number of persons in need of care and the number of persons potentially providing informal care are challenges for its sustainability. Recently suggested reform options are discussed at the end of the paper, showing possible pathways to a sufficient provision of care services in the future.

In the 10 years since its introduction in Japan, long-term care insurance has already become an indispensable part of the Japanese social insurance system for most families. Partly for this reason, economists have actively researched how that insurance has changed the way our families and institutions care for the elderly and the economic consequences of those changes. The purpose of this paper is to provide an overview of their findings of effects in four major areas, namely, on family caregivers' burdens, on labor supply, on the service quality of providers, and on social hospitalization. At the same time, we pay close attention to the quality of the data used and to the estimation methods. Through our analyses, we hope to identify the issues that are still waiting for further research.

The Netherlands was the first country to introduce a universal mandatory social health insurance scheme to cover a broad range of long-term care (LTC) services in a variety of care settings. Compared with spending in most other OECD countries, both total and public expenditure on long-term care is high, particularly since the Dutch population is relatively young. On the other hand, coverage of LTC services is relatively comprehensive. In this paper we examine the past experiences, current deficiencies, and future prospects of LTC financing in the Netherlands. We discuss whether the proposed reforms offer a perspective on a sustainable system of comprehensive LTC insurance.

A historical overview shows how ancient are the roots of the Swedish welfare state. Expenses for older people―pensions, housing allowances, institutional and community care―kept growing in the postwar years but stagnated in the 1990s. Since that decade, cutbacks in some services have led to more care and support from families and the streamlining of services, but also more efficient targeting. Diversification and rationing of services have meant that older people are still served reasonably well, usually through the joint efforts of family and state. To give perspective to the findings, historical and demographic aspects are considered.