scholarly journals What Is Out There and What Can We Learn? International Evidence on Funding and Delivery of Long-Term Care

2021 ◽  
pp. 1-14
Author(s):  
Daniel Roland ◽  
Julien Forder ◽  
Karen Jones
Keyword(s):  
Social Insurance ◽  
Long Term Care ◽  
Social Care ◽  
Universal Coverage ◽  
Developed Countries ◽  
Safety Net ◽  
Term Care ◽  
Universal System ◽  
International Evidence

This article describes the social care funding and delivery arrangements of a varied selection of developed countries, focusing on long-term care of older people. International evidence and latest reforms can inform the debate as countries struggle economically. Some have opted for mandatory social insurance that provides universal coverage. A premium is paid and if the insured individual or relatives require support, they are entitled to it. Others opted for a similar universal system but with earmarked taxation, while others fund their social care entirely from general taxation. Many chose a safety-net system in which benefits are means-tested leaving wealthier individuals to secure private arrangements of care. Within the UK, the level of support varies as Scotland provides personal care free of charge, being more generous than England, Wales and Northern Ireland. There is no “one solution”, but understanding different options can help in the discussion of current and future reforms.

scholarly journals Financing Long-term Care: Lessons From Japan

2019 ◽  
Vol 8 (8) ◽  
pp. 462-466 ◽  
Author(s):  
Naoki Ikegami
Keyword(s):  
Social Services ◽  
Social Insurance ◽  
Ad Hoc ◽  
Long Term Care ◽  
Early Stage ◽  
Functional Decline ◽  
Eligibility Criteria ◽  
Term Care ◽  
Service Levels

Long-term care (LTC) must be carefully delineated when expenditures are compared across countries because how LTC services are defined and delivered differ in each country. LTC’s objectives are to compensate for functional decline and mitigate the care burden of the family. Governments have tended to focus on the poor but Germany opted to make LTC universally available in 1995/1996. The applicant’s level of dependence is assessed by the medical team of the social insurance plan. Japan basically followed this model but, unlike Germany where those eligible may opt for cash benefits, they are limited to services. Benefits are set more generously in Japan because, prior to its implementation in 2000, health insurance had covered long-stays in hospitals and there had been major expansions of social services. These service levels had to be maintained and be made universally available for all those meeting the eligibility criteria. As a result, efforts to contain costs after the implementation of the LTC Insurance have had only marginal effects. This indicates it would be more efficient and equitable to introduce public LTC Insurance at an early stage before benefits have expanded as a result of ad hoc policy decisions.

scholarly journals Social Insurance Accounting for a Notional Defined Contribution Scheme Combining Retirement and Long-Term Care Benefits.

2018 ◽  
Vol 10 (8) ◽  
pp. 2832 ◽  
Author(s):  
Carlos Vidal-Meliá ◽  
Manuel Ventura-Marco ◽  
Juan Manuel Pérez-Salamero González
Keyword(s):  
Social Insurance ◽  
Long Term Care ◽  
Balance Sheet ◽  
Defined Contribution ◽  
Term Care ◽  
Income Statement ◽  
Accounting Model ◽  
Notional Defined Contribution ◽  
Double Entry

This paper develops a social insurance accounting model for a notional defined contribution (NDC) scheme combining retirement and long-term care (LTC) contingencies. The procedure relies on standard double-entry bookkeeping and enables us to compile a “Swedish” type actuarial balance sheet (ABS) following a framework equivalent to an open group approach. This methodology is suitable for reporting the system’s solvency status and can show periodical changes in the system’s financial position by means of an income statement. The information underpinning the actuarial valuation is based on events and transactions that are verifiable at the valuation date, without considering expected future trends. The paper also contains an illustrative example to make it easier for policymakers to understand the main advantages and difficulties of our proposal. The policy conclusions stress the need to properly report social insurance benefits to enhance transparency and sustainability and to improve decision-making because it is in the public interest to do so.

Informal caregivers in Chile: the equity dimension of an invisible burden

2019 ◽  
Vol 34 (10) ◽  
pp. 792-799 ◽  
Author(s):  
Pablo Villalobos Dintrans
Keyword(s):  
Long Term Care ◽  
Population Aging ◽  
Large Fraction ◽  
Informal Caregivers ◽  
Developed Countries ◽  
Lower Income ◽  
Vicious Cycle ◽  
Care Needs ◽  
Term Care

Abstract Population aging is driving a process of increase in long-term care needs in Chile and many countries around the world. In this context, this article asks about the consequences of this increase in informal caregivers, emphasizing the inequity issues arising from these changes. Using the CASEN 2017 survey, caregivers are identified and matched to people with long-term care needs. Results show that most caregivers are women, and a large fraction of them are also elderly; this is similar to what has been found previously in developed countries. Caregivers have fewer opportunities than non-caregivers, which translates into lower income-generating ability and higher poverty. The nature of these tasks creates a vicious cycle in which people get trapped with increasing needs and fewer resources to meet them. Important differences arise between caregivers and the rest of the population. Even more concerning is that these disparities are avoidable to some extent, adding an equity dimension to the problem. This emphasizes the need for the generation of policies that will support caregivers and meet their needs.

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