Description: While there are many issues in healthcare, the single most significant issue is cost, both in terms of the cost today and in terms of the growth in cost over the past several decades. We need to increase the ability of all citizens to purchase healthcare services or health insurance that in turn purchases healthcare services, and decrease the growth in the cost of healthcare.

Description: This paper proposes, for long-term care, a new funding model in which social insurance and private insurance will pay for the bulk of the costs, supplemented by personal payment. If these sources fail, public welfare will serve as a safety net.

Description: Abstract for “Home Equity and At-Need Annuities—A Dynamic Long-Term Care Funding Duo.” This paper describes the prevalence of the still uninsured long-term care financial risk, and how the at-need annuity/home equity combination can address long term care needs.

Description: This is the abstract for the paper, The Need for Coordinated Care for Depression, and the Need for Creative Innovation by Stephen P. Melek, FSA.

Description: Abstract for the 2008 ERM Monograph paper, “Creating Value through Integrated ERM for Health Care Insurers in Europe”.

Description: Presented at the Living to 100 Symposium, January 2011. The Community Living Assistance Services and Supports 'CLASS' Act’s designers and promoters envision the program as a noble plan to relieve the financial strain on Medicaid long-term care and enable disabled and elderly Americans to purchase more home care and suffer less nursing home institutionalization. This paper explains why CLASS, like private long-term care insurance, is doomed to failure unless and until the crowd-out effect of easy access to Medicaid LTC benefits is addressed.

Description: This essay highlights that the healthcare of the future should offer unversal coverage, preserve competitiveness, research cost and quality and offer free or low cost preventative services.

Description: Considerable attention has been given in the recent past to the likely economic and social impact of Australia’s ageing population. One particular aspect which continues to be the subject of increased commentary and conjecture, is the need and subsequent costs for Long Term Care LTC. In this paper, a multiple state projection model based on a framework by Rickayzen and Walsh 2002 is constructed in order to project the number of people in Australia who are likely to require LTC.

Description: Presented at the Living to 100 Symposium, January 2011. This paper examines the relationship between the earliest stages of dementia—mild cognitive impairment—and mortality. Using data from long-term care insurance applicants, and linking this to the Social Security Master Death File, the authors focus on the classification results of two cognitive screens used at various times in the underwriting process. Applying the Cox Proportional Hazards Model as well as relative mortality ratio analysis, the authors show that the proportion of individuals classified as cognitively impaired have significantly higher relative mortality compared to those classified as cognitively intact.

Description: This research paper assesses the adequacy of the combination of elder care and support programs in six developed countries. The programs considered are social security (retirement income), health care and long-term care, and four family compositions are considered to make the assessment. The paper discusses the difficulties of defining adequacy. The fuzzy set methodology of Ragin (2000) is used to label the level of adequacy of the combined programs. This is the first time this methodology has been applied to this problem. The paper contributes to research in the social sciences by combining quantitative and qualitative results. It finds that the combined programs are: often inadequate in England and the United States; not adequate or inadequate in Canada; and mainly adequate in France, Germany and Sweden. Three policy recommendations, which would increase the likelihood of benefit adequacy, are made.