The article explores how public long term care insurance can be affected by family assistance and uncertainty. It suggests that full insurance may not be the best option due to tax distortions. The optimal tax for benefits is determined by factors like under-insurance, the impact of the tax on altruism, and wage differences. The study shows that the size of the tax is influenced by how much people are under-insured, how the tax affects the likelihood of altruism, and how wages vary.