Service provision.
The services covered by the LTCI program
are divided into institutional and community-based care (which
may be either delivered to the home or provided in institutions to
persons who live in the community). Both categories have hitherto
been covered under both social services and health insurance, an
exceedingly complicated situation that should be simplified in the
long run by unified financing under the new LTCI program. Transitional
problems will be difficult, particularly in dealing with current
recipients who might be disadvantaged by the new system.
Institutional care. It is estimated that 705,000 persons will be covered
by LTCI, in three types of facilities: nursing homes (43 percent
of beds), previously under social services; and two types previously
covered by health insurance—health facilities for the elderly (29
percent of beds) and designated long-term-care beds in hospitals
(28 percent of beds), which are mostly upgraded from ordinary
hospital beds by providing somewhat more floor space per bed.18 The intention is eventually to merge the three types, which makes
sense given that neither the characteristics of the residents nor the
actual care they get differs very much. Incidentally, only a portion of