Ageing, Long-term Care Insurance and Healthcare Finance in Asia

This book examines health financing reforms in China, Hong Kong, Taiwan, the Republic of Korea (ROK), long-term care insurance (LTCI) reforms in Japan and Singapore, and strengthens the multiple-streams framework by enriching concepts, ideas, and windows of opportunity and bringing historical institutionalism into the framework.

Format: Paperback / softback
Length: 204 pages
Publication date: 13 June 2022
Publisher: Taylor & Francis Ltd

This book employs a revised version of Kingdon's multiple-streams framework to explore health financing reforms in China, Hong Kong, Taiwan, and the Republic of Korea (ROK), as well as long-term care insurance (LTCI) reforms in Japan and Singapore. It demonstrates that the explanatory power of the multiple-streams framework can be enhanced by enriching the concepts of policy entrepreneurs, ideas, and windows of opportunity within the original framework, as well as integrating the theoretical lens of historical institutionalism into the framework.

China, Hong Kong, Taiwan, and the ROK have all undergone significant health financing reforms in recent years, driven by a variety of factors such as economic growth, aging population, and healthcare costs. These reforms have aimed to improve the accessibility and quality of healthcare services, while also addressing the financial sustainability of healthcare systems.

One of the key approaches to health financing reform in these countries has been the introduction of universal health insurance (UHI). UHI is a system in which all citizens are covered by a single health insurance plan, which is typically funded by a combination of government taxes and contributions from individuals and employers. The benefits of UHI include reduced healthcare costs for individuals, improved access to healthcare services, and increased equity in healthcare access.

In China, the National Health Insurance (NHI) program was introduced in 2001, covering more than 90% of the population. The program has been successful in reducing healthcare costs and improving access to healthcare services, particularly for rural and low-income populations. However, there have been concerns about the quality of healthcare services provided under the NHI program, as well as the financial sustainability of the program.

In Hong Kong, the Health Insurance Scheme (HIS) was introduced in 1994, covering more than 95% of the population. The HIS has been successful in reducing healthcare costs and improving access to healthcare services, particularly for the elderly and low-income populations. However, there have been concerns about the sustainability of the HIS program, particularly in the face of rising healthcare costs and an aging population.

In Taiwan, the National Health Insurance (NHI) program was introduced in 1995, covering more than 98% of the population. The NHI program has been successful in reducing healthcare costs and improving access to healthcare services, particularly for the elderly and low-income populations. However, there have been concerns about the quality of healthcare services provided under the NHI program, as well as the financial sustainability of the program.

In the ROK, the National Health Insurance (NHI) program was introduced in 2000, covering more than 95% of the population. The NHI program has been successful in reducing healthcare costs and improving access to healthcare services, particularly for the elderly and low-income populations. However, there have been concerns about the quality of healthcare services provided under the NHI program, as well as the financial sustainability of the program.

Long-term care insurance (LTCI) is another important area of health financing reform in these countries. LTCI is a system in which individuals pay premiums to a private insurance company in exchange for coverage of long-term care services, such as nursing homes, home care, and assisted living. The benefits of LTCI include reduced financial burden on individuals and families in the event of long-term care needs, as well as improved access to quality long-term care services.

In Japan, the National Long-Term Care Insurance System (NLTCS) was introduced in 1989, covering more than 40% of the population. The NLTCS has been successful in reducing the financial burden on individuals and families in the event of long-term care needs, as well as improving access to quality long-term care services. However, there have been concerns about the sustainability of the NLTCS program, particularly in the face of rising healthcare costs and an aging population.

In Singapore, the ElderShield Life Insurance Scheme was introduced in 2001, covering more than 90% of the population. The ElderShield Life Insurance Scheme has been successful in reducing the financial burden on individuals and families in the event of long-term care needs, as well as improving access to quality long-term care services. However, there have been concerns about the sustainability of the ElderShield Life Insurance Scheme, particularly in the face of rising healthcare costs and an aging population.

Overall, the book demonstrates that the multiple-streams framework can be a useful tool for analyzing health financing reforms in different countries. By enriching the concepts of policy entrepreneurs, ideas, and windows of opportunity in the original framework, as well as integrating the theoretical lens of historical institutionalism into the framework, researchers can gain a deeper understanding of the factors that drive health financing reforms and the outcomes of these reforms.

The book also highlights the importance of considering the political and social context in which health financing reforms are implemented. Health financing reforms are often influenced by a variety of political and social factors, such as the political ideology of the government, the interests of healthcare providers and consumers, and the social norms. By understanding these factors, researchers can better predict the outcomes of health financing reforms and develop more effective strategies for implementing these reforms.

In conclusion, this book provides a valuable contribution to the literature on health financing reforms in different countries. By employing a revised version of Kingdon's multiple-streams framework and integrating the theoretical lens of historical institutionalism, the book demonstrates that the explanatory power of the framework can be enhanced and that researchers can gain a deeper understanding of the factors that drive health financing reforms and the outcomes of these reforms. The book also highlights the importance of considering the political and social context in which health financing reforms are implemented and developing more effective strategies for implementing these reforms.

Weight: 380g
Dimension: 234 x 156 (mm)
ISBN-13: 9781032337258