• Article

Commentary: Cash and counseling in an international context

Health and long-term care policy in the United States is almost always carried out without knowledge of how other countries address similar problems. American public policy is the poorer for this ethnocentrism because other countries often have already implemented ideas which have only been proposed in the United States. To be sure, the cross-national differences in culture and the financing and organization of services do not allow for a simple transfer from one country to another, but the experiences of other countries can provide important insights.

While the Cash and Counseling demonstration was being developed and researched in the United States, similar approaches to consumer-directed long-term care were being implemented, generally in more radical forms, in other countries, including Austria, England, France, Germany, and the Netherlands (Tilly, Wiener, and Cuellar 2000; Wiener, Tilly, and Cuellar 2003; Lundsgaard 2005). The goal of this commentary is to put the American Cash and Counseling demonstration in context with similar initiatives in other countries, particularly the Netherlands, England, and Germany.


Wiener, J. (2007). Commentary: Cash and counseling in an international context. Health Services Research, 42(1, Part 2), 567-576. DOI: 10.1111/j.1475-6773.2006.00695.x