Recently, analysts in the United States (US) have proposed adopting caregiver credits, or pension credits, provided to individuals for time spent out of the workforce while caring for dependent children and sick or elderly relatives. The primary objective of these credits, used in almost all public pension systems in the European Union, is to improve the adequacy of old-age benefits for women whose gaps in workforce participation typically lead to fewer years of contributions, lower lifetime average earnings, and consequently lower pensions. This article examines caregiver credits in the context of future reforms to the US Social Security system, with attention given to the adequacy of current spouse and survivor benefits and how changing marital patterns and family structures have increased the risk of old-age poverty among certain groups of women. It then analyzes caregiver credit programs in selected countries, with particular focus on design, administration, and cost.
Department of Economics and Centre for Health Economics and Policy Analysis, McMaster University, Kenneth Taylor Hall, Rm 426, 1280 Main Street West, Hamilton, ON, L8S 4M4, Canada. email@example.com
The recent growth of the home care sector combined with societal and demographic changes have given rise to concerns about the adequacy of the supply of family and friend caregivers. Potential caregivers face competing time pressures that pull them in the direction of the labour market on one hand, and towards unpaid caregiving duties on the other. This paper examines the influence of unpaid caregiving on the labour supply of a cohort of working-aged caregivers in Canada, with particular emphasis on caregiving intensity. Results suggest that caregivers are heterogeneous in both their caregiving inputs and associated labour market responses, thereby underscoring the importance of controlling for caregiving intensity when measuring labour supply. The negative influence of primary caregiving on labour supply appears to be at the level of labour force participation, rather than on hours of work or wages.
The objective of this study was to estimate the annual costs and consequences of unpaid caregiving by Canadians from a government perspective. We estimated these costs both at the individual and population levels for caregivers aged 45 and older. We conducted a cost-benefit analysis where we considered the costs of unpaid caregiving to be potential losses in income tax revenues and changes in social assistance payments and the potential benefit of reduced paid care expenditures. Our costing methods were based on multivariate analyses using the 2007 General Social Survey, a cross-sectional survey of 23,404 individuals. We determined the differential probability of employment, wages, and hours worked by caregivers of varying intensity versus non-caregivers. We also used multivariate analysis to determine how receiving different intensities of unpaid care impacted both the probability of receiving paid care and the weekly hours of paid care received. At the lowest intensities of caregiving, there was a net benefit to government from caregiving, at both the individual and population levels. At the population level, the net benefit to government was estimated to be $4.4 billion for caregivers providing less than five hours of weekly care. At the highest intensity of caregiving, there was a net cost to government of $641 million. Our overall findings were robust to a number of changes applied in our sensitivity analysis. We found that the factor with the greatest impact on cost was the probability of labour force participation. As the biggest cost driver appears to be the higher likelihood of intense caregivers dropping out of the labour force, government policies that enable intense caregivers to balance caregiving with employment may help to mitigate these losses.
Caregiving issues are important for industrialized societies that have been undergoing population aging. In this article we consider caregiving as a factor in the outlook for midlife and older women with respect to economic security and economic advancement. We use demographic and economic data from the United States, France, Sweden, and the United Kingdom, in particular to document the importance of continued labor force participation for older women to make ends meet in an era of high household costs of physician services, prescription drugs, and other health-related services, and uncertainties about pensions. Data on employment status, industry, and occupation of economically active women in comparison with men indicate the extent of both gender gaps and progress affecting women's resources. The research of Dr. Myrna Lewis was a stimulus to the present exploration. Our conclusion discusses the implications for women's welfare of policy initiatives relating to care of elderly disabled, including improving services to family caregivers, assuring social financing of formal care, raising local provisions to a national standard, and supporting women's return to the labor force after a period of caregiving. In the context of population aging and longevity, such initiatives are responsive to women's need for earned income to attain retirement security.
Implemented in 2004 by the Canadian government, the Compassionate Care Benefit (CCB) program aims to provide income assistance and job security to caregivers who decide to take temporary leave from their employment to care for a terminally ill family member at risk of dying. Reports have cited numerous challenges with respect to the benefit's successful uptake, including the major obstacle of a general lack of awareness regarding the program's existence. Based on this knowledge, the present analysis aims to consider local contexts and potential barriers through engagement with the knowledge-to-action (KTA) cycle. Using an innovative and spatially informed three-step mixed-method analysis, we identify: (1) who likely CCB-eligible family caregivers are; (2) where these individuals' households are located; and (3) how best to get information about the CCB to them. Melding the findings from the three analytic steps generates a tailored path from which an information dissemination strategy can be guided (the intended action). Results indicate that targeted dissemination efforts undertaken outside of urban cores are likely to be most efficient in reaching potential or current CCB-eligible family caregivers. This strategy should be implemented through multiple formats and venues via two information pathways: (1) from key professionals to family caregivers and (2) from the community to the general public. Through employing a spatial perspective, these findings engage and usefully contribute to the KTA cycle process. Future involvement in the cycle will entail translating these findings for use in a decision-making context in order to implement an intervention. This approach can also be applied to other health and social programs where lack of awareness exists or for targeted interventions that require identifying specific populations.
To estimate the value of informal care in Alzheimer's disease using contingent valuation.
A questionnaire was administered to 517 primary carers in four countries (UK, Spain, Sweden, and US). Dichotomous choice and bidding game methods were used to elicit their willingness to pay for a reduction in care burden by 1 h per day, or a total elimination of care needs. Further, the relationship between carer willingness to pay and carer and patient characteristics including disease severity and income was examined.
Carers spend on average about 7-9 h per day on giving care to their patient, of which 4-5 h constituted basic and instrumental ADL tasks. For a 1 h reduction in need for care per day, carers in the UK, Spain, Sweden, and US said that they were willing to pay pound105, pound121, pound59, and pound144 per month respectively. The willingness to pay was higher for carers with higher disposable income while the influence of other determinants varied across countries. About one-third of carers were not willing to pay anything for a reduction in care.
Carers' stated willingness to pay for reductions in care giving time is substantial and comparable to the prices currently paid for treatments that achieve this benefit. Its determinants seem more directly related to carer status than directly to patient status and may vary by region and by cultural and sociologic factors.