Mixed blessings: long-term care benefits in Germany

This chapter opens with the movement to long-term care benefits in Germany in 1994 with a two-tiered system of employment-related, contribution-based long-term care insurance (LTCI) and a last resort of tax-funded social assistance. The goals were to reduce the financial burden on the states and municipalities, lessen poverty for care clients, increase long-term care services, expand home- and community-based services and support informal caring, and to prevent or delay institutionalisation. The chapter looks at the methods in which the benefit design in the German system affects employment, and examines the social long-term care insurance scheme. A main characteristic is the choice of cash benefits and benefits in-kind, distinguishing the German LTCI from the long-term care systems in most other countries. The mixed-benefit design of the system considers the institutional framework, funding, beneficiaries and eligibility criteria, the benefits and the special features of the German system, which are an [...]