Who Wants Long-Term Care Insurance? A Stated Preference Survey of Attitudes, Beliefs, and Characteristics

Abstract

Approximately half of people turning 65 years between 2015 and 2019 are projected to need long-term support and services. Yet the long-term care insurance (LTCI) market is depressed, with only 7.4 million people owning policies. The objective of this study was to provide an analysis of potential LTCI purchasers. We investigate (1) who wants to purchase LTCI, (2) what are the attitudes and beliefs among those who have a preference for LTCI, and (3) who would prefer a law mandating the purchase of LTCI and how that view relates to willingness to purchase LTC. We combine a discrete choice experiment with a survey on attitudes toward LTCI. We estimate odds ratio for choosing a plan based on sociodemographic characteristics, attitudes, and beliefs. Our sample consists of a population of 12 936 people who completed an Internet panel survey. Female respondents were substantially less likely to choose an LTCI plan (OR = 0.74). Income and assets over $100 000 were strong predictors of LTCI uptake (OR = 1.27 and OR = 1.48, respectively). Having adult children live close by was not associated with preference for LTCI. People who support almost any government intervention are more likely to purchase private insurance (OR = 1.12-1.33). Minorities expressed a preference for mandatory enrollment relative to whites. There is a relationship between attitudes toward long-term care financing reform and preference for LTCI, but it is not limited to supporters of private sector initiatives. While support for mandatory LTCI is low overall, it is strongest among racial/ethnic minorities and people with health problems, who potentially have the most to gain.

Private Long-Term Care Insurance Decision: The Role of Income, Risk Propensity, Personality, and Life Experience

“…On the other hand, individuals with higher personal discretionary income (PDI) demonstrated greater ability to purchase LTCI. Findings are consistent with previous research [ 27 , 28 ]. Particularly, PDI in the range of NTD 30,001~40,000 showed higher likelihood of LTCI ownership, indicating risk sharing is common among those with middle income.…”

Demand for Long-Term Care Insurance in China

“…In line with previous studies on demand for LTCI [ 24 , 26 , 27 ] and on health insurance [ 15 , 17 , 18 , 20 , 21 , 22 , 23 ], we found that the demand for LTCI increased as income, a proxy of ability to pay, increased. The findings that demand for LTCI among the lowest income quartile was quite low were worrisome since this population segment is already the most vulnerable group.…”

“…We also demonstrated that among different age groups, the older population (65 or above) revealed less demand for LTCI than the younger population (35 or below), but no significant difference from the population in the middle age group (35 to 64). These results are similar to one systematic review on the demand for health insurance indicating that age was negatively correlated with WTP for health insurance [ 37 ] and similar to the previous study showing that older individuals in the U.S were no more likely to reveal a higher possibility of buying LTCI [ 27 ]. However, these results are contradictive to the previous study based in Spain revealing that age was positively associated with the demand for LTCI [ 26 ].…”

“…Some researchers relied on CVM to estimate WTP for LTCI in Japan [ 24 ] and Spain [ 25 ]. Other used a discrete choice experiment, another stated preference approach, to explore WTP for LTCI in Italy [ 26 ] and the U.S. [ 27 ]. However, until now, no papers have been published on WTP for LTCI in China.…”

Does COVID-2019 have an Impact on the Purchase Intention of Commercial Long-Term Care Insurance among the Elderly in China?

“…A recent study revealed that the needs of commercial LTCI of the elderly in America were affected by the following elements: preferences, substitutes for LTCI, such as public welfare and characteristics of insurance [29]. Other studies have illustrated the crowding-out effect of informal care [30] in demand for commercial LTCI. Gender is another feature that may impact the demand for LTCI.…”