"7Dissertation Proposal The European Union member states have adopted one or two of the three categories ofgeneral social care systems that include: the state responsibility model, family care model,and the subsidiary model (Schulz, 2010). In Germany for instance, the main system thathas been used for years is the subsidiary model. It is not until 1994 that care-givingpredominately shifted to the family. However, to those that could not cover the care- givingcosts, they were eligible to apply for „means- tested benefits? that were offered by the socialassistance scheme. Years later, deliberations led to the introduction of the social securitysystem in Germany (Social Code Book, Part XI, Long-term care insurance) in 1995, thatcovers care for the whole population(Schulz, 2010). The members of the previous publichealth insurance systems became members of the social long-term care insurance (LTCI)by default, while those under the private health insurance were obligated to buy the privateLTCI that provided the same benefit packages.Some of the benefits of the LTCI adopted in Germany include; offering securityagainst needing- care risks, mitigating financial, mental and physical stress that may resultfrom the need for care, enabling care from home environment as well as improving securityfor unemployed careers to promote commitment (Schulz, 2010, Adequate socialprotection for long-term care needs in an ageing society, 2014 and Anon, 2017).For one to benefit from the package of LTCI, one had to be insured. However, benefitsare guaranteed depending on the extent to which one may need care which is providedirrespective of income, age or wealth. The level of assistance services that one may needtherefore depends on how long the person may need a care- giver to help him or her. Inthese case the eligibility is divide in four major categories: Care level 1, level 2, level 3 and 8Dissertation Proposal the hardship cases (Schulz, 2010). For care level one, one is entitled for hygienic andfeeding assistance as well as mobility through some activities, at least two activities. Leveltwo entitles one to at least two basic activities three times a day for two hours, while in carelevel three, one is entitled for at least two activities in a day for five hours. For the hardshipcases, the person is offered seven hours activities in a day with two of those hours at night.2.4 Long-term Care in England The entire health care services in England are provided free at the point of delivery.This is irrespective of the user?s financial means (Marmor, Freeman and Okma, 2009 andWelsh Office: NHS Wales: putting patients first, 2007). These financing comes entirelyfrom the general central taxation. However, the eligibility for care services is determinedby the local authority. Apart from testing the eligibility criterion, the local authorities alsofocus on budgetary arrangement and the assessments arrangement (Comas-Herrera et al.,2010). It is however stipulated under the national framework for eligibility criteria thatpeople with the same care needs are subjected to the same outcomes. However, it does notmean that people with similar needs be given services that are similar. Just like Germany,England has four bands eligibility framework allocated to individuals namely: low band,moderate, substantial and critical band (Comas-Herrera et al., 2010). The low band provides services to those that lack the ability to one or two personaldomestic routine. This band is recommended when education, learning or one or twoaspects of work cannot be sustained, when one or two social roles cannot be undertakenand when one or two social support relationships cannot be sustained. The moderate bandis granted to people when there is inability to conduct several personal domestic routines, 9Dissertation Proposal aspects of work, learning, education, several social support relationships as well as severalsocial responsibilities (Comas-Herrera et al., 2010). On the basis of financing, the government provides caring homes, day care services aswell as nursing homes. However, people are also encouraged to buy their own servicesthrough individual budgets and private funds as well as direct payments. Direct paymentsare organized by local authorities that follow assessment (Department of Health, 2008b). Itis estimated that in 2006 to 2007, the total number of service consumers of these type ofpayment was 1,231,000 elderly people.2.5 Long- term Care Alignment for Efficiency and AffordabilityTo warrant efficiency and affordability, there is need to developing a model thatprovides incentives for service consumers, service providers and insurers as well aspotential informal caregivers. Such incentives would help shape how each of the groupsmake decision as well as who gets affected by the use of the long-term care. However,these incentives have to be created by the government so that the outcomes are in line withthe society needs (Schut and van den Berg, 2010). The alignment of these incentives meansadopting a model that would protect the care- givers from embarking only on one sector beit form or informal sector and neglect the other.3.0 METHODOLOGYThis study will be a case study of England and will adopt the qualitative approachthat will take 8 weeks to collect, clean and analyze data. Data will be collected throughthe administration of questionnaires to the local authorities, nursing homes and "