Nursing Care for Elderly People in Germany and China: A Bilateral Comparison and Exploration of Policy Transfer

Abstract

This article is dedicated to outlining two nursing care models for elderly people in Germany and China. Shaped by the European welfare state model, Germany has launched a statutory long-term care insurance program aimed at integrating multiple actors, such as the family, intermediary organizations, non-profit organizations and private providers into a supply structure within a mandatory social care insurance system, where the welfare state acts as lawmaker and regulator for public nursing care. Compared to the German system, China has a rudimentary nursing care system characterized by a hybrid model, which relies on both conventional family care and individual private insurance. After introducing elderly care in both countries, this review article explores the possibility of transferring the German model of long-term care insurance to China to reduce the increasing problem of elderly care. The soaring demand for elderly care and underdeveloped public services for nursing care represent a great challenge for contemporary Chinese society.

The hybridization of policy learning in multilevel regimes: a case study of the long-term care insurance in China

“…As LTCI in Germany has gradually improved, the system attracted great attention in the fields of social policy, politics and industry in China and Japan (T. Liu, 2014). After nearly three years of discussion, Japanese government finally passed the bill and began to implement LTCI on April 1st, 2000 (Kazuki & Wang, 2019).…”

“…Chinese central and local governments have been keen on learning from Germany and Japan in creating a comprehensive LTCI system (T. Liu, 2014). The Ministry of Human Resources and Social Security (MHRSS) released a list of 15 pilot cities in July 2016, which entitled local governments autonomy to explore and implement their own LTCI programs and models according to local conditions (e.g., economic affluence and medical insurance fund balance).…”

“…It is intriguing that the learning processes differ across levels and localities, which give an ideal context to examine the mechanisms of policy learning and reinvention. Local governments in Shanghai and Qingdao in coastal provinces had their own preferences in learning LTCI models, and they learned from Germany and Japan respectively, which were then targeted by other local governments in inland regions as hubs of policy learning (T. Liu, 2014).…”