• Long-term care constitutes a component of age-determined expenditure. However, relative to pension costs, which – assuming demographic projections are reliable and current benefit structures are maintained – are relatively easy to assess, long-term care costs are not.
• One of the more pressing challenges facing Europe today and one that transcends short or medium term economic “crises” is the rapid increase in the number of very old people. In this respect there is a need to define what can be expected from the “European social model” and how that model might have to be refined.
• Despite, or even because of the challenges of the ageing of the population and the need to restore an environment conducive to restoring growth and jobs, it is important not to lose sight of the fact that it is necessary to ensure that people’s needs are covered adequately – indeed that the “rights” and the expectations that the European social model implies are satisfied.  In a climate of fiscal austerity, it is also important to recognise that attention be paid not merely to the quantity of public expenditure but also its quality.
• So far, rewards for investment in long-term care have not been easily measured or quantified. Long-term care provision has often been seen as a cost rather than part of the social capital and social cohesion maximizing objectives of the EU and of the Member States.
• Many countries have made efforts to reform LTC policies to boost long-term care provision and narrow the gap between needs and supply, whilst being economically and socially sustainable. In this context it is important to transcend a narrow fiscal approach and to locate the discussion about aspirations with the EU Treaty and related aspirations for the maintenance and improvement of social standards.
• There is often a lack of clarity about what constitutes care services, especially when these are paid for on the basis of ability to meet minimum standards of existence and when the boundaries between health- and social-determined need is fluid and often subjective.