by National Academy of Social Insurance

Social Insurance is a Critical Base for Achieving Universality and Efficiency

Hundreds of long-term care (LTC) experts gathered in Washington, D.C. today at The SCAN Foundation briefing to discuss private and public options for delivering and financing long-term care to the 12 million Americans who currently need it and the 27 million people expected to need it by 2050.

The discussion comes at a critical time. Congress recently approved the formation of a bipartisan commission on long-term care, tasked with making recommendations on meeting the nation’s needs for affordable long-term care services and support. Direct spending in the United States for long-term care services was $211 billion in 2011, with Medicaid picking up more than 62 percent of the tab. 

“Americans today are not prepared to finance their future care needs, and have few choices to adequately plan for this very likely time in their life,” said Bruce Chernof, M.D., president & CEO of The SCAN Foundation. “Whether in the private market, public sector, or a hybrid of the two, we as a nation need affordable and accessible options so that Americans with functional needs can get quality care that enables them to live with dignity, choice, and independence.”

As part of the briefing, Lee Goldberg, Vice President for Health Policy at the National Academy of Social Insurance (NASI) presented a new paper, entitled Social Insurance: A Critical Base for Financing Long-Term Services and Supports. Goldberg and his co-author Larry Atkins, President of NASI, make the case that the United States needs a universal system to help people plan ahead for the risks of aging and disability. “Since social insurance is both universal and contributory, it is the most efficient and flexible way to ensure that people allocate additional resources in advance of their needing LTC,” said Goldberg. 

The paper is part of The SCAN Foundation’s policy brief series, Shaping Affordable Pathways for Aging with Dignity. It provides an updated body of intellectual capital on LTC financing options and approaches to facilitate a much needed national policy dialogue. These papers build on various policy concepts developed over the last two decades, and account for recent health policy changes that are reshaping the current LTC financing discussion. For more information, visit The SCAN Foundation’s website at Below is a full list of the briefs in the series: 

  1. Shaping Affordable Pathways for Aging with Dignity: Current Issues and Potential Solutions for Addressing America's Long-Term Care Financing Crisis, by Gretchen E. Alkema
  2. Overview of Current Long-Term Care Financing Options, by Eileen J. Tell
  3. Size of the Employer and Self-Employed Markets Without Access to Long-Term Care Coverage Options, by Jeremy Pincus, Katherine Wallace-Hodel, and Katey Brown
  4. Medicaid Spend Down: Implications for Long-Term Services and Supports and Aging Policy, by Joshua M. Wiener, Wayne L. Anderson, Galina Khatutsky, Yevgeniya Kaganova, and Janet O’Keeffe (RTI International) and Anne Tumlinson, Eric Hammelman, and Elana Stair (Avalere Health)
  5. RTI International: Medicaid Spend Down: New Estimates and Implications for Long-Term Services and Supports Financing Reform, by Joshua M. Wiener, Wayne L.Anderson, Galina Khatutsky, Yevgeniya Kaganova, Janet O’Keeffe
  6. Avalere: Insuring Americans for Long-Term Services and Supports: Challenges and Limitations of Voluntary Insurance, by Anne Tumlinson, Eric Hammelman, Elana Stair, Joshua M. Wiener
  7. Social Insurance: A Critical Base for Financing Long-Term Services and Supports, by Lee Goldberg and G. Lawrence Atkins
  8. Making Progress: Expanding Risk Protection for Long-Term Services and Supports through Private Long-Term Care Insurance, by Richard G. Frank, Marc Cohen, and Neale Mahoney

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