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Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany

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  • Rhee, Jong Chul
  • Done, Nicolae
  • Anderson, Gerard F.

Abstract

Financing and provision of long-term care is an increasingly important concern for many middle-income countries experiencing rapid population aging. We examine three countries (South Korea, Japan, and Germany) that use social insurance to finance medical care and have developed long-term care insurance (LTCI) systems. These countries have adopted different approaches to LTCI design within the social insurance framework. We contrast their financing systems and draw lessons regarding revenue generation, benefits design, and eligibility. Based on this review, it seems important for middle-income countries to start developing LTCI schemes early, before aging becomes a significant problem and substantial revenues are needed. Early financing also ensures that the service delivery system has time to adapt because most middle-income countries lack the infrastructure for providing long-term care services. One approach is to start with a limited benefit package and strict eligibility rules and expanded the program as the country develops sufficient experience and more providers became available. All three countries use some form of cost-sharing to discourage service overuse, combined with subsidies for poor populations to maintain appropriate access. A major policy choice is between cash benefits or direct provision of services and the approach will have a large impact on the workforce participation of women.

Suggested Citation

  • Rhee, Jong Chul & Done, Nicolae & Anderson, Gerard F., 2015. "Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany," Health Policy, Elsevier, vol. 119(10), pages 1319-1329.
  • Handle: RePEc:eee:hepoli:v:119:y:2015:i:10:p:1319-1329
    DOI: 10.1016/j.healthpol.2015.06.001
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    References listed on IDEAS

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    1. Noguchi, Haruko & Shimizutani, Satoshi, 2007. "Nonprofit/for-profit status and earning differentials in the Japanese at-home elderly care industry: Evidence from micro-level data on home helpers and staff nurses," Journal of the Japanese and International Economies, Elsevier, vol. 21(1), pages 106-120, March.
    2. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517.
    3. Heinicke, Katrin & Thomsen, Stephan L., 2010. "The social long-term care insurance in Germany: origin, situation, threats, and perspectives," ZEW Discussion Papers 10-012, ZEW - Leibniz Centre for European Economic Research.
    4. Brown, Jeffrey R. & Finkelstein, Amy, 2007. "Why is the market for long-term care insurance so small?," Journal of Public Economics, Elsevier, vol. 91(10), pages 1967-1991, November.
    5. Melanie Arntz & Stephan L. Thomsen, 2010. "The Social Long-term Care Insurance: A Frail Pillar of the German Social Insurance System," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 8(2), pages 29-34, 07.
    6. Arntz, Melanie & Sacchetto, Ralf & Spermann, Alexander & Steffes, Susanne & Widmaier, Sarah, 2006. "The German social long-term care insurance - structure and reform options," ZEW Discussion Papers 06-074, ZEW - Leibniz Centre for European Economic Research.
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    Cited by:

    1. repec:pal:genrir:v:43:y:2018:i:2:d:10.1057_s10713-018-0027-x is not listed on IDEAS
    2. repec:kap:geneva:v:43:y:2018:i:2:d:10.1057_s10713-018-0027-x is not listed on IDEAS
    3. Nishimura, Y.; Oikawa, M.;, 2017. "Effects of Informal Elderly Care on Labor Supply: Exploitation of Government Intervention on the Supply Side of Elderly Care Market," Health, Econometrics and Data Group (HEDG) Working Papers 17/02, HEDG, c/o Department of Economics, University of York.

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