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Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany.
Health Policy 2015; 119(10):1319-29HP

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.

Authors+Show Affiliations

Chairman, Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Seoul, Korea; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 225N Collington Avenue, Baltimore, MD, 21231, USA.PhD Student in Health Economics and Policy, Department of Health Policy and Management Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. Electronic address: ndone1@jhu.edu.Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

26117093

Citation

Rhee, Jong Chul, et al. "Considering Long-term Care Insurance for Middle-income Countries: Comparing South Korea With Japan and Germany." Health Policy (Amsterdam, Netherlands), vol. 119, no. 10, 2015, pp. 1319-29.
Rhee JC, Done N, Anderson GF. Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany. Health Policy. 2015;119(10):1319-29.
Rhee, J. C., Done, N., & Anderson, G. F. (2015). Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany. Health Policy (Amsterdam, Netherlands), 119(10), pp. 1319-29. doi:10.1016/j.healthpol.2015.06.001.
Rhee JC, Done N, Anderson GF. Considering Long-term Care Insurance for Middle-income Countries: Comparing South Korea With Japan and Germany. Health Policy. 2015;119(10):1319-29. PubMed PMID: 26117093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Considering long-term care insurance for middle-income countries: comparing South Korea with Japan and Germany. AU - Rhee,Jong Chul, AU - Done,Nicolae, AU - Anderson,Gerard F, Y1 - 2015/06/11/ PY - 2015/03/04/received PY - 2015/05/19/revised PY - 2015/06/03/accepted PY - 2015/6/29/entrez PY - 2015/6/29/pubmed PY - 2017/1/11/medline KW - Financing KW - Germany KW - Japan KW - Long-term care insurance KW - South Korea SP - 1319 EP - 29 JF - Health policy (Amsterdam, Netherlands) JO - Health Policy VL - 119 IS - 10 N2 - 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. SN - 1872-6054 UR - https://www.unboundmedicine.com/medline/citation/26117093/Considering_long_term_care_insurance_for_middle_income_countries:_comparing_South_Korea_with_Japan_and_Germany_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8510(15)00161-X DB - PRIME DP - Unbound Medicine ER -