Bias pervades America's long-term care (LTC) service delivery and financing system.
The system is biased in favor of nursing home care--which Medicaid pays for but which most people would rather avoid. It is biased against home- and community-based care--which Medicaid is much less likely to pay for, but which most aging Americans prefer when they require LTC.
Perhaps most importantly, LTC in the United States is biased toward public financing (Medicaid and Medicare) and against private financing alternatives such as long-term care insurance (LTCi) and home equity conversion.
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