"The United States does not have a comprehensive long-term care system. Arguably, it has no system at all. Medicare does not cover long-term care services. Private long-term care insurance remains expensive and not available to everyone. Americans rely primarily upon the unpaid contributions of family members and friends, who provide the vast majority of LTC services received by people of all ages who need help with basic daily activities. Medicaid, a safety net program and payer of last resort designed for people with low incomes and few assets, is the primary public financing system for LTC, with benefits varying from state to state. European perspectives on LTC are a largely untapped resource for examining ways to improve the financing and delivery of LTC in the U.S. Virtually all European countries have had far higher proportions of people age 80 and older than the U.S. has had for some time. Some of these countries have implemented LTC programs that hold important lessons for the U.S. and can serve as “natural laboratories” for tracking the impact of LTC policy changes over time. This paper concentrates on describing the LTC systems in the Netherlands, Norway and, to a lesser extent, the United Kingdom and France"

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