Long-term care and the family

Universidad Carlos III de Madrid - Departamento de Economía (ECO-UC3M)

Family has traditionally played an important role in providing care to the elderly everywhere in the World. However, ageing societies and the increase in female labour-force participation are putting pressure on governments to take a more active role in senior population care. When policymakers consider reform scenarios, it is of utmost importance that they take into account the magnitude of the response of informal caregiving.

Researchers Daniel Barczyk (McGill University, Montreal) and Matthias Kredler (ECO-UC3M, Madrid).

For example, if a country with high expenditures on nursing homes (as the U.S.) were to introduce free nursing-home care, one would expect a sizeable number of elderly, who were previously taken care of informally at home, to move to nursing homes. So, if one takes into account the response of families to economic incentives, what are the implications for policy makers?

Regarding this, researchers Daniel Barczyk (McGill University, Montreal) and Matthias Kredler (ECO-UC3M, Madrid) built a model in which parents and children interact strategically in the care decision and used it to study how long-term care (LTC) would fare in the U.S. context.

Their findings indicate that informal care responds strongly to even relatively small subsidies. This is in line with the large differences in how care is provided across rich countries, as documented in the follow-up article: “Southern European countries and the U.S.”. For instance, countries that provide low subsidies to formal care rely on family caregivers to a much larger extent than central and northern European countries. The latter provide much more generous funding, some of them spending up to 4% of GDP on formal long-term care services.

Results of this research suggest that informal-care subsidies may reduce reliance on formal care.

The model predicts that an informal-care subsidy substantially reduces reliance on Medicaid (the U.S. government programme that pays for formal care), while the reduction of tax revenues caused by the reduction in caregivers’ labour supply is modest.

So, the informal-care subsidy turns out to be welfare-improving, as it keeps the elderly at home with the family (which they appreciate). In addition, this is relatively cheap as the increase in government spending on the subsidy is largely compensated by the savings from a reduced Medicaid programme. These results add to the social and economic considerations to be taken into account regarding policymaking in this field.


Image credits: Images were kindly provided by ECO-UC3M.

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