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Funding options for long-term care services in Latin America and the Caribbean☆

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  • Fabiani de Leva, Beatrice
  • Costa-Font, Joan
  • Aranco, Natalia
  • Stampini, Marco
  • Ibarrarán, Pablo

Abstract

Demographic and social changes in the Latin America and the Caribbean (LAC) region have called the traditional system of long-term care service provision into question, prompting many countries to prioritize long-term care reform on their social policy and fiscal agendas. A central policy issue under consideration involves assessing the demand and the costs of various long-term care options while evaluating its financial sustainability. To date, estimating the demand for care in Latin American countries is limited due to the underdeveloped and fragmented systems in place. This paper estimates the potential cost of various long-term care service packages that differ in the extent and type of government funding. Second, we investigate the financing sustainability of different coverage scenarios across seventeen countries in the LAC region. Finally, we assess the feasibility of alternative funding mechanisms and discuss the main benefits and drawbacks considering each country’s unique institutional constraints. Our estimates indicate that, while all seventeen LAC countries have the potential to implement a system funded through general taxation, a social insurance system is only feasible in a handful set of LAC countries.

Suggested Citation

  • Fabiani de Leva, Beatrice & Costa-Font, Joan & Aranco, Natalia & Stampini, Marco & Ibarrarán, Pablo, 2025. "Funding options for long-term care services in Latin America and the Caribbean☆," The Journal of the Economics of Ageing, Elsevier, vol. 30(C).
  • Handle: RePEc:eee:joecag:v:30:y:2025:i:c:s2212828x25000052
    DOI: 10.1016/j.jeoa.2025.100550
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    References listed on IDEAS

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    1. Joan Costa‐Font & Edward C. Norton & Luigi Siciliani & Joan Costa‐Font & Cristina Vilaplana‐Prieto, 2017. "Does the Expansion of Public Long‐Term Care Funding Affect Saving Behaviour?," Fiscal Studies, Institute for Fiscal Studies, vol. 38, pages 417-443, September.
    2. Bonsang, Eric & Costa-Font, Joan, 2020. "Behavioral regularities in old age planning," Journal of Economic Behavior & Organization, Elsevier, vol. 173(C), pages 297-300.
    3. Hanewald, Katja & Bateman, Hazel & Fang, Hanming & Wu, Shang, 2020. "Is there a demand for reverse mortgages in China? Evidence from two online surveys," Journal of Economic Behavior & Organization, Elsevier, vol. 169(C), pages 19-37.
    4. Costa-Font, Joan & Zigante, Valentina, 2020. "Building ‘implicit partnerships’? Financial long-term care entitlements in Europe," LSE Research Online Documents on Economics 106099, London School of Economics and Political Science, LSE Library.
    5. Joan Costa-Font & Raphael Wittenberg & Concepció Patxot & Adelina Comas-Herrera & Cristiano Gori & Alessandra di Maio & Linda Pickard & Alessandro Pozzi & Heinz Rothgang, 2008. "Projecting Long-Term Care Expenditure in Four European Union Member States: The Influence of Demographic Scenarios," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 86(2), pages 303-321, April.
    6. ., 2020. "Public spending within the new fiscal programme," Chapters, in: After Brexit, What Next?, chapter 8, pages 151-165, Edward Elgar Publishing.
    7. Costa-Font, Joan & Jimenez-Martin, Sergi & Vilaplana, Cristina, 2018. "Does long-term care subsidization reduce hospital admissions and utilization?," Journal of Health Economics, Elsevier, vol. 58(C), pages 43-66.
    8. Costa-Font, Joan & Vilaplana-Prieto, Cristina, 2025. "The hidden value of adult informal care in Europe," LSE Research Online Documents on Economics 126347, London School of Economics and Political Science, LSE Library.
    9. Shuji Tanaka, 2016. "A Proposal for Redesigning Social Security: Long-Term Care Pension," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 41(1), pages 98-117, January.
    10. Akaichi, Faical & Costa-Font, Joan & Frank, Richard, 2020. "Uninsured by Choice? A choice experiment on long term care insurance," Journal of Economic Behavior & Organization, Elsevier, vol. 173(C), pages 422-434.
    11. Kim, Hongsoo & Kwon, Soonman, 2021. "A decade of public long-term care insurance in South Korea: Policy lessons for aging countries," Health Policy, Elsevier, vol. 125(1), pages 22-26.
    12. Joan Costa‐Font & Cristina Vilaplana‐Prieto, 2025. "The Hidden Value of Adult Informal Care in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 34(4), pages 791-812, April.
    13. Christine de la Maisonneuve & Joaquim Oliveira Martins, 2013. "A Projection Method for Public Health and Long-Term Care Expenditures," OECD Economics Department Working Papers 1048, OECD Publishing.
    14. Joan Costa-Font & Valentina Zigante, 2020. "Building ‘implicit partnerships’? Financial long-term care entitlements in Europe," Policy Sciences, Springer;Society of Policy Sciences, vol. 53(4), pages 697-712, December.
    15. Raúl Pozo-Rubio & Román Mínguez-Salido & Isabel Pardo-García & Francisco Escribano-Sotos, 2019. "Catastrophic long-term care expenditure: associated socio-demographic and economic factors," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 691-701, July.
    16. Vidal-Melia, Carlos & Ventura-Marco, Manuel & Pla-Porcel, Javier, 2020. "An NDC approach to helping pensioners cope with the cost of long-term care," Journal of Pension Economics and Finance, Cambridge University Press, vol. 19(1), pages 80-108, January.
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    More about this item

    Keywords

    Long-term care; Population aging; Latin America and the Caribbean; Social insurance; Public finance; Tax financing;
    All these keywords.

    JEL classification:

    • H5 - Public Economics - - National Government Expenditures and Related Policies
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy
    • O54 - Economic Development, Innovation, Technological Change, and Growth - - Economywide Country Studies - - - Latin America; Caribbean

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