Long-term Care Financing: Inserting Politics and Resource Allocation in the Debate; Comment on “Financing Long-term Care: Lessons From Japan”

Document Type: Commentary

Author

Department of Sociology and Social Research, University of Trento, Trento, Italy

Abstract

The ageing of the countries’ populations, and in particular the growing number of the very old, is increasing the need for long-term care (LTC). Not surprisingly, therefore, the financing of LTC systems has become a crucial topic across the Organisation for Economic Co-operation and Development (OECD). In the last three decades, various financing policies have been carried out in different countries and the related international debate has grown. The latter has so far focused mostly on the different alternatives to collect economic resources to pay for care. The international debate needs now to focus also on other issues, so far less discussed. One is the politics of LTC: the degree and nature of the political interest in LTC, that affects the size and profile of public financing. The other is resource allocation: how different services and benefits are distributed among people with different care needs, that determines if resources made available are optimized. If we do not pay more attention to these issues – inextricably connected to policies aimed to collect funds – our understanding of LTC financing will remain inevitably limited.

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  1. Gori C, Fernandez JL, Wittenberg R. Long-term care reforms in OECD countries: successes and failures. London: Policy Press; 2016.
  2. Ikegami N. Financing Long-term Care: Lessons From Japan. Int J Health Policy Manag. 2019;8(8):462-466. doi:10.15171/ijhpm.2019.35
  3. Costa-Font J, Courbage C, Swartz K. Financing long-term care: ex ante, ex post or both? Health Econ. 2015;24 Suppl 1:45-57. doi:10.1002/hec.3152
  4. Fernandez JL, Nadash P. The long-term care financing problem. In: Gori C, Fernandez JL, Wittenberg R, eds. Long-term care reforms in OECD countries: successes and failures. London: Policy Press; 2016:25-43.
  5. Szebehely M, Meagher G. Nordic eldercare–weak universalism becoming weaker? J Eur Soc Policy. 2018;28(3):294-308. doi:10.1177/0958928717735062
  6. Swartz K. Searching for a balance of responsibilities: OECD countries' changing elderly assistance policies. Annu Rev Public Health. 2013;34:397-412. doi:10.1146/annurev-publhealth-031912-114505
  7. Colombo F, Llena-Nozal A, Mercier J, Tjadens F. Help wanted? providing and paying for long-term care. Paris: OECD; 2011.
  8. Stoyanova A, Cantarero-Prieto D. Financing and policy for long-term care. In Oxford research encyclopedia of economics and finance. Oxford, UK: Oxford University Press; 2018.
  9. Norton E. Long-term care. In: Culyer AJ, Newhouse JP, eds. Handbook of health economics. Amsterdam: Elsevier; 2000:955-988.
  10. Muir T. Measuring social protection for long-term care. Paris: OECD; 2017.
  11. de la Maisonneuve C, Oliveira Martins J. The future of health and long-term care spending. OECD economic policy papers. Paris: OECD; 2014.
  12. OECD. Pensions at glance. Paris: OECD; 2014.
  13. Bonoli G, Natali D. The politics of the new welfare state. Oxford: Oxford University Press; 2012.
  14. Ranci C, Pavolini E. Reforms in long-term care policies in Europe. New York: Springer; 2013.
  15. Hieda T. Political institutions and elderly care policy. London: Palgrave; 2012.
  16. Maarse JAM, Jeurissen PP. The policy and politics of the 2015 long-term care reform in the Netherlands. Health Policy. 2016;120(3):241-245. doi:10.1016/j.healthpol.2016.01.014
  17. Nadash P, Doty P, von Schwanenflugel M. The German long-term care insurance program: evolution and recent developments. Gerontologist. 2018;58(3):588-597. doi:10.1093/geront/gnx018
  18. Gori C. Changing long-term care provision at the local level in times of austerity – a qualitative study. Ageing Soc. 2019;39(9):2059-2084. doi:10.1017/S0144686X18000430
  19. Brugavini A, Carrino L, Orso C, Pasini G. Vulnerability and long-term care in Europe: an economic perspective. London: Palgrave; 2017.
  20. León M, Ranci C, Rostgaard T. Pressures towards and within universalism: conceptualising change in care policy and discourse. In: León M, ed. The transformation of care in European societies. New York: Palgrave Macmillan; 2016:34-61.
  21. Campbell JC, Ikegami N, Gori C, et al. How different countries allocate long-term care resources to older users: a comparative snapshot. In: Gori C, Fernandez JL, Wittenberg R, eds. Long-term care reforms in OECD countries: successes and failures. London: Policy Press; 2016:47-76.
  22. Gori C, Barbabella F, Campbell C, et al. How different countries allocate long-term care resources to older users: changes over time. In: Gori C, Fernandez JL, Wittenberg R, eds. Long-term care reforms in OECD countries: successes and failures. London: Policy Press; 2016:77-116.
  23. Gianino MM, Lenzi J, Martorana M, et al. Trajectories of long-term care in 28 EU countries: evidence from a time series analysis. Eur J Public Health. 2017;27(6):948-954. doi:10.1093/eurpub/ckx177
  24. Gori C, Morciano M. Cash-for-care payments in Europe: changes in resource allocation. Soc Policy Adm. 2019;53(4):537-550. doi:10.1111/spol.12498