Japan, Korea and Germany introduced universal, mandatory public long-term care insurance (LTCI) as their populations began to age. LTCI is a social insurance program that covers the cost of care in case people need assistance to manage their daily living activities. In these countries LTCI covers a broad range of activities for daily living associated with aging and disability, from light home-helper services to intensive institutional care. The coverage is available for any level of care need, not simply for the most severe cases of disability.
These countries serve as good examples of countries that have paved different paths by focusing on the continuum of care, public insurance system and regulations. Japan, Korea and Germany share a couple of basic principles in the set-up of the financial mechanisms for LTCI:
1) a universal public social care system dedicated to LTC; and
2) a continuum of care system, starting from light home-based services all the way to intensive institutional care.
In developing LTCI, governments also developed regulations to cover how care needs could be assessed and by whom, who can provide care and under what conditions, the costs of care services, and the training, skills and wages of care workers. Government regulation is also important to ensure good-quality, accessible LTC.
With COVID-19, we see that the benefits of the continuum of care principle extend beyond economics and quality of life: this approach also removes people from the types of multi-residential locations that are most prone to the rapid spread of infection.
Many of our international peers have been more active and thoughtful with LTC policies than Canada, and we have lots to learn as we go about reforming our LTC systems. This system would help people with activities of daily living where they need it, and it would not cost the government much more than what it is spending now. Further, Canada also needs to develop a better set of regulations if we want to ensure good-quality and accessible LTC for all.
Original article “We can draw lessons from countries with strong long-term care system” was published in Policy Option, the digital magazine by the Institute for Research on Public Policy (IRPP), June 5, 2020.
This article is part of the Facing up to Canada’s long-term care policy crisis special feature.