Long-Term Care in Latin America and the Caribbean? Theory and Policy Considerations

Abstract

Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in Long-Term Care in Latin America and the Caribbean? Theory and Policy Considerations SEPTEMBER 2017Any opinions expressed in this paper are those of the author(s) and not those of IZA. Research published in this series may include views on policy, but IZA takes no institutional policy positions. The IZA research network is committed to the IZA Guiding Principles of Research Integrity. The IZA Institute of Labor Economics is an independent economic research institute that conducts research in labor economics and offers evidence-based policy advice on labor market issues. Supported by the Deutsche Post Foundation, IZA runs the world's largest network of economists, whose research aims to provide answers to the global labor market challenges of our time. Our key objective is to build bridges between academic research, policymakers and society. IZA Discussion Papers often represent preliminary work and are circulated to encourage discussion. Citation of such a paper should account for its provisional character. A revised version may be available directly from the author. services in Latin America. Demand for these services will rise as the region undergoes a swift demographic transition from its currently young population to a rapidly aging one, especially since the region's aging cohorts are more prone to experience a decline in their functional and physical abilities than elderly people elsewhere in the world. We argue that private insurance markets are ill-equipped to provide coverage to meet the need for LTC, while the amount of personal savings required to afford self-insurance is prohibitively high.We study how developed economies have dealt with the issue of LTC and pay special attention to the most salient features of their LTC programs. We then direct the discussion to Latin America, where LTC may not be an immediate priority, but governments are likely to encourage the development of LTC programs as demand for them steadily grows. In particular, policymakers are probably going to focus initially on LTC programs for the poor and the vulnerable, for whom LTC affordability is a greater problem. We therefore study how basic elements of policy design affect cost-effectiveness of LTC programs by means of a formal model. Our study shows that pro-poor programs are more cost effective when people have the option to receive cash subsidies, and the availability of in-kind and in-cash choices reduces program costs overall. We argue th...

Mapping Long-Term Care in Jamaica: Addressing an Ageing Population

“…It inadvertently contributes to a growing informal care gap as the out-of-pocket payments and private financing needed for LTC is less accessible to those with fewer financial resources [22][23][24]. A more strategic state involvement, for example with state supported expansion of formal in-home services, will provide individuals, particularly women, with the opportunity to participate in the formal labour market and to be compensated for their care work [4]. For example, in South Korea, the expansion and strengthening of their LTC system led to the employment of 1 million people since 2008, with 95% of the LTC workers being women [4,36].…”

“…To date, there have been limited, if any, attempts from the state to manage the LTC market. This reality is evident in the wider LAC region that lacks any comprehensive LTC market or strategy, arguably hindered by micro and macro-economic challenges [4]. Of note, Uruguay is the only country within the region that includes LTC in its National Integrated Care System.…”

“…Of note, Uruguay is the only country within the region that includes LTC in its National Integrated Care System. Despite this, their system prioritises infant care, and its sustainability is uncertain due to current and future financing challenges [4]. Neither the desk review nor consultations conducted to date suggested attempts in Jamaica to encourage service development either through tax breaks or other forms of financing.…”

“…Those 60 years and older are projected to constitute 18% of the population by 2050. The shift in Jamaica's demographics and the projected continued increase of the older population, consistent with the wider Latin America and Caribbean (LAC) region [4], signals the importance of robust and sustainable long-term care (LTC) services and systems. These are services and systems that meet the medical and non-medical needs of ageing persons who are not able to care for themselves for short (as in the case of those approaching death) or longer periods of time (as in the case of chronic illnesses or disability).…”

“…Population ageing is also a major contributor to the high prevalence of non-communicable diseases (NCDs) concentrated in low-and middle-income countries (LMICs) such as Jamaica [5]. Further, in Jamaica and the wider LAC region, while life expectancy has increased, improvements in living standards and nutrition have not, contributing to the burden of NCDs [4].…”