The study of optimal long-term care (LTC) social insurance is generally carried out under the utilitarian social criterion, which penalizes individuals who have a lower capacity to convert resources into well-being, such as dependent elderly individuals or prematurely dead individuals. This paper revisits the design of optimal LTC insurance while adopting two egalitarian social criteria—ex ante and ex post egalitarianism—which give priority to the worst-off either in expected or in realized terms. Using a lifecycle model with risk about the duration of life and risk about old-age dependence, it is shown that the optimal second-best insurance under the ex ante egalitarian criterion involves, in comparison to utilitarianism, higher LTC and pension benefits and higher tax rates on savings and on labor earnings. In comparison to ex ante egalitarianism, ex post egalitarianism involves lower LTC and pension benefits, a higher tax on savings and a lower tax rate on labor earnings, in order to increase consumption of the young, who include persons who will turn out to be short-lived.

最佳长期护理（LTC）社会保险的研究通常是在功利社会标准下进行的，该标准惩罚了那些将资源转化为幸福的能力较低的人，例如受抚养的老年人或过早死亡的人。本文在采用两种均等社会标准（事前和事后均等主义）的同时，重新审视了最佳LTC保险的设计，这两个标准在预期或已实现条件下均优先考虑最糟糕的情况。使用具有生命周期风险和老年依赖风险的生命周期模型，可以证明，与功利主义相比，事前平均主义准则下最优的次优保险涉及更高的LTC和养老金福利以及更高的税收储蓄率和劳动收入率。与事前平均主义相比，