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Edward C. Norton, PhD; Joseph P. Newhouse, PhD

JAMA. 1994;271(19):1520-1524.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

CONTROVERSY surrounds the place of long-term care insurance as part of national health system reform and the nature of such insurance if it is to be part of the reform. Some groups, most notably those representing older adults, believe that the current financing system, which relies heavily on the Medicaid program, must be altered. Others would not modify present arrangements, at least in the short run.

Under current law, individuals are eligible for nursing home benefits through Medicaid if they have few assets other than housing equity. The following proposals would markedly change these arrangements:

• The Pepper Commission1 recommends a universal insurance system for those sufficiently disabled, but limits benefits to an initial period of 3 months. After 3 months, nursing home residents would pay for everything, unless they are poor enough to qualify for coverage similar to the current Medicaid program.
  
• Analysts at the Brookings Institution² advocate expanding the
  

Author Affiliations
From the Research Triangle Institute, Research Triangle Park, NC (Dr Norton), and the Department of Health Care Policy, Harvard Medical School, the Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass, and the Kennedy School of Government, Harvard University, Cambridge, Mass (Dr Newhouse).

Footnotes
Reprint requests to Research Triangle Institute, 3040 Cornwallis Rd, Hobbs Building, PO Box 12194, Research Triangle Park, NC 27709-2194 (Dr Norton).

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