关键词:
homecare
health care delivery policy
aging network
Older Americans Act
social insurance
long term care insurance
atención domiciliaria
póliza de atención médica
red de envejecimiento
Ley de estadounidenses de edad avanzada
seguro social
seguro de atención a largo plazo
家庭护理
医疗交付政策
老龄化网络
《美国老年人法案》
社会保险
长期护理保险
摘要:
With nearly twice as many elderly Americans living with disabilities expected within a dozen years, public policy must update and revise the social arrangements that support caregiving, disability, and old age. Needs that already often go unmet will mount, growing from quietly suffered indignities to broadly felt breakdowns. Inequities faced by young and old will compound this shared strain. Creating long-term care financing arrangements, accessible housing stock, and resilient macroeconomics for an aging population will require long lead times and therefore prompt convergence and enactment of policies and programs to address these needs. For example, while academic and independent policy institutions have recommended public catastrophic long-term care social insurance and private insurance market reforms, delay in enacting these modest policies keep the US on a default course to underfunded but cripplingly expensive safety net obligations, any gaps in which will impoverish elders and their families. The US has not even developed a serious dialogue on disability adapted and affordable housing or on the macroeconomics facts that demand investment in highly productive young adults. Equity, efficiency, and capacity of social services, caregiving, and medical care also require redesign over the next few years. Community arrangements shape much of the experience of declining health in old age. The US urgently needs to enable a number of communities (counties, cities, and rural regions) to move ahead aggressively to redefine excellence and affordability in eldercare, making exemplars that the rest of the nation could emulate. Some critical issues do not yet have the language for public discourse, being treated as taboo subjects. We outline four of these and call for data and reflection. We all deserve to come to old age confident that we have the needed supports, so that we can enjoy the last of life with comfort and meaningfulness, without impoverishing the next generati