Financing Long-Term Care in Southwest Europe: Italy, Portugal and Spain

The progressive ageing of the European population and the transformation of family care giving arrangements bring to the fore the question of how best to Finance long-term care (LTC). Particularly important is the specific financial organization of LTC systems when both social and demographic constraints compete with economic motivations to rationalize public insurance schemes. LTC provides support for old age dependants that need some health care, but primarily social care. However, Southern European countries are facing the paradox of health care being a top policy priority as in almost all European countries, whilst social care is nearly privatized or has been heavily decentralized to local authorities, and subject to means- as well as needs-testing (Costa-Font and Font-Vilalta, 2006; Gil, 2009; CostaFont, 2010a; Santana, 2010). Private financing is primarily dominated by intra-household interactions and self Financing. The role of private financing alternatives is developing in some countries such as Spain, but is still far from taking off.