Progressivity in the Wealth Changes Experienced by Users of Formal Long-Term Care

With ageing populations in many Western populations, concerns have arisen about equity in the provision of long-term care (LTC). This study describes equity-relevant LTC policies and investigates how the proportional changes in wealth that users of formal LTC experience vary along the wealth distribution in Austria, Flanders, Germany and the Netherlands. It is found that users of formal LTC face significant negative wealth changes in Austria and the Netherlands: a progressive pattern appears in Austria, a regressive pattern in the Netherlands. Formal LTC users suffer no significant wealth changes in Germany, nor do the wealthier users in Flanders; a group of formal LTC users at the bottom of the wealth distribution in Flanders sees wealth increase. Several policy implications are deduced from the findings: informal care-giving ought to be encouraged and (co-)payments for formal LTC should be made means-tested – without setting minima. Furthermore, it is advised that the cumulative effect of various LTC policies is coordinated.