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A decade of public long-term care insurance in South Korea: Policy lessons for aging countries

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  • Kim, Hongsoo
  • Kwon, Soonman

Abstract

South Korea proactively introduced public long-term care insurance (LTCI) in 2008 when older people were only about one-tenth of the total population. At that time, Korea switched from a tax-based, local-government-operated LTC program targeting low-income older people to the current universal public LTCI run by the National Health Insurance Service, the single public insurer. The LTCI program provides a comprehensive package of home- and institution-based care mainly targeting older people who need assistance in daily living. Over the past decade, the program has continued to expand its population and service coverage: older people in high need have been covered, and an infrastructure for service provision has been established. Future agendas include financial sustainability, care coordination, and the role of local governments. Korea’s experiences suggest having an LTCI separate from the NHI has the benefit of potential de-medicalization of LTC, which, in turn, creates challenges for the coordination of health care and LTC. A centralized LTCI system with a single payer has the benefit of bigger risk-pooling, but this may become a barrier to designing integrated community care systems at the local level. There is a tradeoff between population coverage, benefits/cost coverage, and fiscal sustainability.

Suggested Citation

  • Kim, Hongsoo & Kwon, Soonman, 2021. "A decade of public long-term care insurance in South Korea: Policy lessons for aging countries," Health Policy, Elsevier, vol. 125(1), pages 22-26.
    • Handle: RePEc:eee:hepoli:v:125:y:2021:i:1:p:22-26
    DOI: 10.1016/j.healthpol.2020.11.003
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    References listed on IDEAS

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    1. John Creighton Campbell & Naoki Ikegami & Soonman Kwon, 2009. "Policy learning and cross‐national diffusion in social long‐term care insurance: Germany, Japan, and the Republic of Korea," International Social Security Review, John Wiley & Sons, vol. 62(4), pages 63-80, October.
    2. Kim, Hongsoo & Kwon, Soonman & Yoon, Nan-He & Hyun, Kyung-Rae, 2013. "Utilization of long-term care services under the public long-term care insurance program in Korea: Implications of a subsidy policy," Health Policy, Elsevier, vol. 111(2), pages 166-174.
    3. World Bank, 2016. "Live Long and Prosper," World Bank Publications - Books, The World Bank Group, number 23133.
    4. Kim, Hongsoo & Jung, Young-Il & Kwon, Soonman, 2015. "Delivery of institutional long-term care under two social insurances: Lessons from the Korean experience," Health Policy, Elsevier, vol. 119(10), pages 1330-1337.
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    Cited by:

    1. Hwang, Inuk & Lee, Tae-Jin, 2022. "Health improvements of older adults based on benefit duration: Lessons from Korean social pension policies," Social Science & Medicine, Elsevier, vol. 315(C).
    2. Kim, Seung Hoon & Park, Eun-Cheol & Jang, Suk-Yong, 2023. "Impact of long-term care insurance on medical costs and utilization by patients with Parkinson's disease," Social Science & Medicine, Elsevier, vol. 317(C).
    3. Kotschy, Rainer & Bloom, David, 2022. "A Comparative Perspective on Long-Term Care Systems," CEPR Discussion Papers 17213, C.E.P.R. Discussion Papers.
    4. You-Shyang Chen & Chien-Ku Lin & Jerome Chih-Lung Chou & Su-Fen Chen & Min-Hui Ting, 2022. "Application of Advanced Hybrid Models to Identify the Sustainable Financial Management Clients of Long-Term Care Insurance Policy," Sustainability, MDPI, vol. 14(19), pages 1-25, September.
    5. Guangbo Ma & Kun Xu, 2022. "Value-Based Health Care: Long-Term Care Insurance for Out-of-Pocket Medical Expenses and Self-Rated Health," IJERPH, MDPI, vol. 20(1), pages 1-20, December.

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