Essays on Long-Term Care

In the last decades, life expectancy at birth has sharply risen in all European countries and North America. This increasing life expectancy is definitely accompanied by an improvement of the health state of elderly people. But an ageing population also leads to an increase in the number of dependent people. Dependence is defined as the partial or total impossibility for a person to perform without help some essential activities of daily living.
The first chapter shows that poor people are more likely to die and become dependent than the rich. The second chapter explores the motives of help between children and parents. Long-term care seems to be driven by moderate altruism or by family norm. The third chapter demonstrates the presence of strategic spend-down in the US allowing elderly people to benefit from the public aid even though they would have the financial means to buy this care on the market with their own resources. Finally, the fourth chapter establishes the determinants of the individual insurance purchase decision in a context where the individual's future health and income evolution is uncertain. We estimate that the less educated value less the long term care insurance than the educated.
A multitude of questions are still unresolved and the dependence, a state that all will face one day (with a grandparent, a parent, a sibling, a friend or oneself) is a field of exalting research.