Financing Long-term Care: The Role of Culture and Social Norms; Comment on “Financing Long-term Care: Lessons From Japan”

Alders, Peter; Schut, Frederik

doi:10.15171/ijhpm.2019.110

Financing Long-term Care: The Role of Culture and Social Norms; Comment on “Financing Long-term Care: Lessons From Japan”

Document Type: Commentary

Authors

Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands

10.15171/ijhpm.2019.110

Abstract

Based on the experiences of Japan and Germany, Ikegami argues that middle-income countries should introduce public long-term care insurance (LTCi) at an early stage, before benefits have expanded as a result of ad hoc policy decisions to win popular support. The experience of the Netherlands, however, shows that an early introduction of public LTCi may not prevent, but instead even facilitate later extensions of public coverage. We argue that social norms and cultural values about caring for the elderly might be the main driver of expansions of LTCi coverage. Furthermore, we posit that this expansion may reinforce the social norms supporting it. Hence, politicians and policy-makers should be aware of this possible self-reinforcing effect.

Keywords

Main Subjects

Health Insurance

References

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
OECD. OECD Health Statistics 2019. https://www.oecd.org/health/health-data.htm.
Schut FT, Van Den Berg B. Sustainability of comprehensive universal long-term care insurance in the Netherlands. Soc Policy Adm. 2010;44(4):411-435.
Costa-Font J. Family ties and the crowding out of long-term care insurance. Oxford Rev Econ Policy. 2010;26(4):691-712. doi:10.1093/oxrep/grq040
Hofstede G, Hofstede GJ, Minkov M. Cultures and Organizations: Software of the Mind. 3rd ed. New York: McGraw-Hill; 2010.
Haberkern K, Szydlik M. State care provision, societal opinion and children’s care of older parents in 11 European countries. Ageing & Society. 2010;30(2):299-323. doi:10.1017/S0144686X09990316
Nakabayashi M. From family security to the welfare state: Path dependency of social security on the difference in legal origins. Economic Modelling. 2019;82:280-293. doi:10.1016/j.econmod.2019.01.011
Alders P, Costa-Font J, de Klerk M, Frank R. What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands. Health Policy. 2015;119(6):814-820.
Alders P, Deeg DJ, Schut FT. Who will become my co-residents? The role of attractiveness of institutional care in the changing demand for long-term care institutions. Arch Gerontol Geriatr. 2019;81:91-97. doi:10.1016/j.archger.2018.11.014
Maarse JAM, Jeurissen PP. The policy and politics of the 2015 long-term care reform in the Netherlands. Health Policy. 2016;120:241-245.
Alders P, Schut FT. The 2015 long-term care reform in the Netherlands: Getting the financial incentives right? Health Policy. 2019;123(3):312-316. doi:10.1016/j.healthpol.2018.10.010
Kromhout M, Kornalijnslijper N, de Klerk M. Veranderde zorg en ondersteuning voor mensen meteen beperking, Landelijke evaluatie van de Hervorming Langdurige Zorg. Den Haag: Sociaal en Cultureel Planbureau; 2018.