Long-term care can be defined as a broad range of paid and unpaid services for people who are mentally or physically disabled or whose chronic illness makes them in need of medical care or staff for long periods of time. “It is estimated that there are more than twelve million Americans of all ages whose mix of severe disability and chronic disease places them at high risk for functional decline, hospitalization, or nursing home placement.” (Benjamin) Different populations require long-term care services, and the needs of these populations vary. In addition to older adults, many long-term care users are younger people with physical disabilities; people with developmental disabilities; and people with chronic diseases such as diabetes, emphysema and AIDS. The growing need for these services is creating significant budgetary concerns for federal and state governments, as well as putting a strain on family finances. Combined Medicare and Medicaid expenditures have grown significantly. Approximately 40% of long-term care costs are covered by the federal/state Medicaid program. (Feder, Komisar, and Niefeld) Although the Medicare program represents only a small share of total spending, its share is growing. Despite increased government spending, direct payments continue to represent a large source of financing for long-term care. As a result, for many people with chronic care needs, long-term care remains a catastrophic cost. At the same time, long-term care has become a topic of attention in the United States for several reasons. The clearest reason for its appearance is that people are living longer than in the past. Population increases after the World Wars, the “baby boom” era, along with a higher average...... middle of paper......n is expanded social insurance. This is seen as an alternative to public support for private insurance. Medicare could be expanded to include long-term care, giving everyone, regardless of income, some insurance protection should they suffer harm. This may sound good, but it's not feasible. Despite the nation's underlying prosperity and wealth, our willingness to redistribute resources to reflect an aging population seems highly unlikely. In conclusion, better support for economically disadvantaged people must be a priority in future policy. Private long-term care insurance must be available to all, whether tax-subsidized or supported by the federal government; long-term care coverage must be equitably distributed. We now expect people to become completely impoverished before we provide them with long-term care, and this system seems overly harsh.