Co-payments for long-term care (LTC) can impose a substantial financial burden on the elderly. How this burden is distributed across income groups depends on the design of the co-payment. We estimate the lifecycle dynamics of LTC using Dutch administrative data. These estimates are inputs in a stochastic lifecycle decision model. Using the model, we analyze the welfare effects of the Dutch income- and wealth-dependent co-payment system and compare it to alternative systems. We find that the Dutch co-payment system redistributes income to low-income groups, who use the most care over their life but contribute the least co-payments, from high-income groups, who pay the most. Moreover, the Dutch system protects the middle-income groups relatively well against financial risk: although alternative co-payment systems hardly affect these groups average payments, they induce welfare losses of 2% to 4% due to an increased risk of very high co-payments.

中文翻译：

---

长期护理共付额的风险保护和再分配效应

长期护理（LTC）的共同支付可能会给老年人带来沉重的经济负担。这种负担如何在不同收入群体之间分配取决于共同支付的设计。我们使用荷兰行政数据估计 LTC 的生命周期动态。这些估计是随机生命周期决策模型中的输入。使用该模型，我们分析了荷兰收入和财富依赖的共同支付系统的福利效应，并将其与替代系统进行比较。我们发现，荷兰的共同支付制度将收入重新分配给低收入群体，这些群体在生活中使用最多的照顾但共同支付的费用最少，而高收入群体支付的费用最多。此外，荷兰的制度相对较好地保护了中等收入群体免受金融风险：