Caring for Our Own: Why There Is No Political Demand for New American Social Welfare Rights. By Sandra R. Levitsky. New York: Oxford University Press, 2014. Pp. xiv+210. $99.00 (cloth); $24.95 (paper)

Abstract

In my health policy course, the subtitle of the long-term care (LTC) unit is, “The Biggest Health Policy Problem You’ve Never Heard Of.” The aged population is growing (the high-need 85 years or older group most rapidly), yet families are smaller and geographically dispersed. The majority of women, the usual caregivers, are in the paid labor force. Yet public policy is wholly inadequate and unresponsive to growing need: Medicare doesn’t cover LTC; Medicaid covers it only for the truly impoverished; there is no paid leave for caregivers or tax credits to offset costs; and the availability of state-provided home care, respite care, and adult day care is widely variable and meager. Nor is the private sector much help: with its high cost and limited benefits, private LTC insurance is practically useless. Despite these glaring inadequacies, however, the political silence on care issues is near absolute.