The drivers of public expenditure on health and long term care : An integrated approach Public expenditures on health and long term care (hereafter LTC) are a matter of concern for governments in most OECD countries. These expenditures have recently accelerated and are putting pressure on public budgets adding to that arising from insufficiently reformed retirement schemes and other forms of social spending. The growth of public spending on health and long term care in OECD countries has been limited for some time via the implementation of cost containment policies. These policies acted essentially through wage moderation price controls and postponement of investment in the case of health care. A large share of long term care has been informally provided by families. However the scope for containing health and LTC expenditures along these lines is narrowing.