Description: A call for essays issued by the SOA Health and Long Term Care Sections on the visions for the future of the U.S. health care system.

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: Chapter 4 review the evolution of the health care system in Canada, and how an aging population will create cost-escalation pressures on the health care system. The chapter does not address issues concerning the efficiency and efficacy of the present health care system. From Economic Security for an Aging Canadian Population, M-RS99-2.

Description: The paper focuses on value creation for European health insurance companies through the practical application of integrated ERM frameworks.

Description: Employer and payers need to actively seek change in the system of mental health care deliveryoperational, clinical, and financial change. From Financing Chronic Care Monograph, M-HB05-1.

Description: Author’s response to discussant comments for the 2009 Housing Wealth monograph paper, “Home Equity and At-Need Annuities—A Dynamic Long-Term Care Funding Duo”. The 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: 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.

Description: An essay suggesting one solution in theory would be to create a system similar to Medicare Advantage for the entire American population.

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.