Chiara Canta, Helmuth Cremer, and Firouz Gahvari, Maybe "honor thy father and thy mother": uncertainfamily aid and the design of social long term care insurance, IDEI Working Paper, n. 864, July 2016.


We study the role and design of private and public insurance programs when informal care is uncertain. Children's degree of altruism is represented by a parameter which is randomly distributed over some interval. The level of informal care on which dependent elderly can count is therefore random. Social insurance helps parents who receive a low level of care, but it comes at the cost of crowding out informal care. Crowding out occurs both at the intensive and the extensive margins. We consider two types of LTC policies. A topping up (TU ) scheme provides a transfer which is non exclusive and can be supplemented. An opting out (OO) scheme is exclusive and cannot be topped up. TU will involve crowding out both at the intensive and the extensive margins, whereas OO will crowd out solely at the extensive margin. However, OO is not necessarily the dominant policy as it may exacerbate crowding out at the extensive margin. Finally, we show that the distortions of both policies can be mitigated by using an appropriately designed mixed policy.


Long term care; uncertain altruism; private insurance; public insurance; topping up; opting out;

JEL codes

  • H2: Taxation, Subsidies, and Revenue
  • H5: National Government Expenditures and Related Policies

Research partnership

Scor Chair

Research theme

Longevity Risk, Long Term Care (Social) Insurance