walkitout (walkitout) wrote,
walkitout
walkitout

_Long Term Care for the Elderly_, Robyn Stone

Published by the Urban Institute, this thin paperback doesn't exist in the kindle store so I bought it in paper. Here is the author's description of it:

http://www.leadingage.org/Article.aspx?id=2772

which indicates it started as work for Milbank. Milbank + Urban Institute = It Has To Be Good.

Does it fulfill this promise? Yes. There is _no_ narrative structure to it. A story format speeds me through a book, so while it is about 150 pages long, it took me more time to read it (spent reading and elapsed since page one due to interruptions) than equivalent narrative reading material ten times its length. This is not a complaint, but instead an observation.

I picked it up for two reasons. (1) I was trying to get an answer to what the labor participation rate of the future will be when people aren't discussing it in an election year context and (2) I occasionally read about long-term care issues because it seems like a good idea to be informed on this topic. It served both purposes well.

Stone rallies historical trend lines, demographic projections, immigration information, evolving customer/client preferences, legal and regulatory issues and a host of other domains to her cause. The organization of the book is straightforward, with the core built around descriptions of who needs care, who pays for care and who actually provides the care. Along with this core, she describes efforts to ascertain and improve quality and project future needs. She uses quantitative and qualitative research with sensitivity, and while she is appreciative of many of the newer approaches to care (Green Houses, etc.), she refrains from advocacy.

It's a good book. You should seriously think about getting it from a library and reading it. It won't necessarily help you find a good assisted living facility or continuing care facility for an aging parent, but it will give you an excellent base for understanding current public debates on programs like Medicaid, Medicare and on financial products such as long term care insurance as well.

Not unexpectedly, Stone leans pretty heavily in favor of programs which spread risk/benefit across our entire society, and has a strong preference for more systematic approaches over the ad hockery so characteristic of American public policy. Because her descriptions of the current options and trends is so comprehensive, however, it is quite possible to pick out potential ad hoc solutions for the next few decades. If you've never heard of adult day care or realized that adult day care services can provide a point to organize health and social services, well, let's just say you probably will know that, sometime in the next few decades.
Tags: book review, economics, health, non-fiction, our future economy today
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