Introducing social insurance for long‐term care in Taiwan: Key issues

Abstract

Nadash P, Shih Y.-C. Introducing social insurance for longterm care in Taiwan: Key issues Taiwan will shortly complete its comprehensive social safety net, which includes national health insurance, retirement security, and unemployment insurance, by introducing long-term care (LTC) insurance -putting it ahead of the many countries that rely on a patchwork of policies to address the need for LTC. The program, to be implemented in 3 to 5 years, will cover all citizens on a primarily social insurance basis. The range of LTC policy options considered is discussed, particularly how to structure the program, how to finance and regulate it, and how to develop its inadequate LTC infrastructure and workforce. Particularly thorny issues include the choice of social insurance, the feasibility of cash benefits, and how to address Taiwan's heavy reliance on foreign workers. Taiwan's increasingly democratic character, along with high levels of public support for the program, creates significant pressure on politicians to deliver on their promises to implement LTC reform.Key Practitioner Message: • Emphasizes the importance of policy learning from other environments; • Highlights the need for a strong regulatory and provider infrastructure for delivering long-term care services; • Emphasizes the need for training, support, and appropriate regulation of the long-term care workforce.

Financing institutional long-term care for the elderly in China: a policy evaluation of new models

“…While Japan and South Korea have instituted their respective LTC insurance systems, Taiwan is also moving towards this (Tamiya et al 2011;Chon 2012;Nadash and Shih 2013). The pilot in Qingdao City echoes this regional trend.…”

Long‐Term Care Insurance Adoption in East Asia: Politics, Ideas, and Institutions

“…After setting up a pilot program in 2000, the DPP created a plan for developing LTC services in 2002, commissioned an LTC Task Force in 2005 and, most importantly, issued a Ten‐Year Plan for LTC in 2007 (Lin ). In devising its policy alternative, the DDP clearly used policy ideas developed in Japan, while also learning from Germany and the United Kingdom (Nadash and Shih ). Like the Golden Plan, the Ten‐Year Plan foresaw universal LTC provision at the community‐level provided by LTC management centers in every city (Wang ; Wang and Tsay ).…”

“…The universalist framing of LTCI was highly successful as public opinion supported a universal LTCI. In general, however, Taiwanese pressure groups have had limited impact on LTC policy reform (Nadash and Shih ). Although the KMT was framing LTCI as a socialization of LTC to relieve family burdens, both parties (KMT and DPP) regarded LTC as an opportunity to enhance economic development (Wang ; Wang and Tsay ) as an increase in LTC provision by the market might result in the growth of the elderly care or “silver” industry.…”

Is China facing the social risks associated with reliance on hospitalization for the care of the elderly with chronic diseases?

“…Ageing populations have become the largest group of patients occupying hospital beds in the United States, the United Kingdom, Germany, Canada, and even in a few Latin American countries . Apart from Japan, South Korea, Singapore, India, and Taiwan are facing the phenomenon. However, the phenomenon is uncommon among other Asian countries because of their less developed economies and imperfect medical insurance systems.…”