By Susan Tester
This obtainable textbook compares ways that uncomplicated parts of group care are funded, organised and supplied by means of governmental and non-governmental corporations, permitting practitioners and policy-makers to profit from the studies in their opposite numbers in Europe and North the US.
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Extra info for Community Care for Older People: A Comparative Perspective
The Netherlands, which tends towards the 'univer:salist statedominated' pension regime, has a national insurance system with basic flat rate pensions for all residents. Supplementary occupational pension schemes are compulsory in many industries, voluntary in others. The social insurance system provides compulsory health insurance for people below a fixed income limit; those not covered take up voluntary health Insurance. The UK's pension system is atypical because it has elements of both the 'universalistic' and the 'residualist'.
The local authority was given responsibilities for planning, coordination and regulation of the system, and a new funding system was introduced to limit state financial support for residential care. The reformed system was intended to make services more responsive to individual assessed needs and increase choice, and, in effect, to encourage 'substitution' of community for institutional care and informal for formal types of provision (Davies, 1991: 2). The United States of America is a prime example of the 'liberal' or 'residual' welfare state, relying on the market and family, with meanstested assistance as a last resort.
The Federal government attempted to expand Medicare to cover longterm care through the Medicare Catastrophic Coverage Act 1988, to be financed through income tax. Pressure from higher income older people led to the repeal of the act. The Pepper Commission (1990) report on long-term care reform proposed expanded funding for nursing home care and home health care. Further legislation to expand Medicare to help 22 Community Care for Older People cover long-term care costs in the community and in nursing homes was introduced in 1990 (Waxman, 1990).