POOLING PUBLIC AND PRIVATE FUNDS IN THE PATIENTS INTEREST - THE CASE FOR LONG-TERM-CARE INSURANCE

Although the extent of medical care in France may be thought adequate, the same does not apply to the social medicine sector. The Assurance- maladie paid 87.7% of hospital health expenditure in 1994, whereas dir ect funding of home assistance amounted to only 9%. In contrast, a rec ent Leges study (Bungener M. et al. Le bilan economique et financier d u secteur medico social, Universite de Paris IX, Leges, Janvier 1994) [1] estimated that home assistance costs represent 41-50% of medical-s ocial expenditure. When people are unable to manage because of the hig h costs of their invalidity, the social security system comes to their assistance, although only under Draconian conditions involving compul sory ''family support commitments'' and the state's claim on the inher itance of the beneficiary (total costs for hospital admission and boar ding and the dual limits of 1000F liabilities and 250,000F net assets for home assistance). The elderly well appreciate the severity of this problem and are deeply distressed by the thought of dependency. Many, however, live under the illusion that the social security system or, to a lesser extent, the mutual funds will come to their assistance, al though the problems involved lie partly outside their remits. We there fore need to design new systems to allow the elderly to finance their costs should they become dependant. Copyright (C) 1996 Published by El sevier Science Ltd.