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Social insurance for long-term care

Karagiannidou, Maria and Wittenberg, Raphael ORCID: 0000-0003-3096-2721 (2022) Social insurance for long-term care. Journal of Population Ageing, 15 (2). pp. 557-575. ISSN 1874-7884

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Identification Number: 10.1007/s12062-022-09366-6


The issue of how best to finance long-term care (LTC) is the subject of recent reforms, forthcoming reforms or continuing debate in various countries and remains as relevant and challenging as ever. LTC services are crucial to the wellbeing of large numbers of older adults who need help with everyday tasks. Demand for LTC for older adults is projected to rise across developed and developing countries as the number of older adults rises. Supply of care services is likely to remain constrained due to shortages of long-term care workforce and financial constraints in many countries, and the financial risks associated with LTC remain. Financing of LTC is a complicated issue which raises considerations of economic efficiency and incentives, equity including intergenerational equity, the balance of risk between public and private funding, and sustainability of public expenditures. The aim of this paper is to discuss analytically the case for social insurance as an equitable and efficient way to finance LTC. The paper considers social insurance systems, especially in Germany and Japan, in comparison with safety net tax funded systems such as in England and the USA and more generous tax funded systems such as in Sweden and Denmark. Social insurance has advantages and disadvantages compared with these other systems. It tends to be associated with greater clarity and acceptability since it involves collection of revenues ear marked for LTC and, at least in principle, a link between contributions and benefits on the basis of clear eligibility criteria.

Item Type: Article
Official URL:
Additional Information: © 2022 The Authors
Divisions: Personal Social Services Research Unit
Subjects: H Social Sciences > HV Social pathology. Social and public welfare. Criminology
H Social Sciences > HB Economic Theory
Date Deposited: 13 Apr 2022 16:30
Last Modified: 27 Jun 2022 08:12

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