By Ke Yanghua, Research Department of Social Development, DRC

Research Report, No.131, 2019 (Total 5631) 2019-8-8

Abstract: The United States has no independent long-term care guarantee system, whereas it established the medicaid project early in 1965 as the primary funding source of different types of long-term care fee for low-income people and the elderly. In the initial phase after the establishment of the system, medicaid projects took a preferential stance and only covered costs of nursing homes. As a result, social capital, nursing staff and consumers all swarmed around nursing institutions, which induced huge financial pressure to medicaid projects. The US long-term care system initiated rebalance reforms and took comprehensive measures to shift the focus of care expenditure and service from institutions to communities and homes in the 1980s. By 2013, the expenditure of long-term community and home care of the medicaid project exceeded that of institutional care. China is developing social pension service system in the form of at-home and community-based services and supplemented by relevant institutions. While drawing on US experience, China needs to strike a balance between homes, communities and institutions on elderly care services.

Key words: long-term care, rebalance, institutional care, at-home and community-based services, the United States