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Mandatory aged care insurance: a case for Australia

Published online by Cambridge University Press:  13 November 2013

FRANCESCO PAOLUCCI
Affiliation:
Australian Centre for Economic Research on Health, Australian National University, Canberra, Australia. School of Health, Community and Education Studies, University of Northumbria at Newcastle, UK.
PRZEMYSLAW M. SOWA*
Affiliation:
Australian Centre for Economic Research on Health, Australian National University, Canberra, Australia.
MANUEL GARCÍA-GOÑI
Affiliation:
Departamento de Economía Aplicada II, Universidad Complutense de Madrid, Spain.
HENRY ERGAS
Affiliation:
SMART Infrastructure Facility, University of Wollongong, Australia.
*
Address for correspondence:Przemyslaw M. Sowa, Australian Centre for Economic Research on Health, Australian National University, Bldg 63a ANU, Canberra, ACT, Australia. E-mail: prem.sowa@anu.edu.au

Abstract

This paper assesses the feasibility and welfare-improving potential of an insurance market for aged care expenses in Australia. As in many other countries, demographic dynamics coupled with an upward trend in costs of personal care result in consumer co-contributions imposing a risk of expenses that could constitute a significant proportion of lifetime savings, in spite of the presence of a government-run aged care scheme. We explore issues around the development of an insurance market in this particular setting, considering adverse selection, moral hazard, timing of purchase, transaction costs and correlation of risks, as well as such contextual factors as longevity and aged care cost determinants. The analysis indicates aged care insurance is both feasible and welfare-enhancing, thus providing a gainful alternative to the aged care reform proposed by the Productivity Commission in 2011. However, while the insurance market would benefit the ageing Australian population, it is unlikely to emerge spontaneously because of the problem of myopic individual perceptions of long-term goals. Consequently, we recommend regulatory action to trigger the market development.

Type
Forum Article
Copyright
Copyright © Cambridge University Press 2013 

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References

Baldini, M. and Beltrametti, L. 2006. Alternative approaches to long-term care financing: distributive implications and sustainability in Italy. Schweizerische Zeitschrift furVolkswirtschaft und Statistik/Swiss Journal of Economics and Statistics, Special Issue, 142(V), 117–21.Google Scholar
Bell, D. and Bowes, A. M. 2006. Financial Care Models in Scotland and the UK. Joseph Rowntree Foundation, York, UK.Google Scholar
Blomqvist, A. and Busby, C. 2012. Long-term Care for the Elderly: Challenges and Policy Options. Commentary No. 367, C. D. Howe Institute, Toronto, Canada.Google Scholar
Borch, K. 1975. Optimal insurance arrangements. ASTIN Bulletin, 8, 3, 284–90.Google Scholar
Brown, J. R. and Finkelstein, A. 2007. Why is the market for long-term care insurance so small? Journal of Public Economics, 91, 1967–91.CrossRefGoogle Scholar
Brown, J. and Finkelstein, A. 2009. The private market for long term care in the U.S. A review of the evidence. Journal of Risk and Insurance, 76, 1, 529.Google Scholar
Costa-Font, J., Karlsson, M. and van den Berg, B. 2012. Redesigning long-term care finance and delivery. Applied Economic Perspectives and Policy, 34, 2, 215–9.Google Scholar
Courbage, C. and Roudault, N. 2008. Empirical evidence on LTC insurance purchase in France. Geneva Papers on Risk and Insurance, 33, 645–58.CrossRefGoogle Scholar
Cremer, H., Pestieau, P. and Ponthiere, G. 2012. The economics of long-term care: a survey. CORE Discussion Paper No. 2012/30. Université catholique de Louvain. Lovaine, Belgium.Google Scholar
Cutler, D. 1996. Why Don't Markets Insure Long Term Risks? Available online at http://scholar.harvard.edu/files/cutler/files/ltc_rev.pdf [Accessed 20 September 2013].Google Scholar
Cutler, D., Finkelstein, A. and McGarry, K. 2008. Preference heterogeneity and insurance markets: explaining a puzzle of insurance. American Economic Review, 98, 2, 157–62.Google Scholar
Dowd, K., Blake, D. and Cairns, A. 2010. Facing up to uncertain life expectancy: the longevity fan charts. Demography, 47, 1, 6778.Google Scholar
Finkelstein, A. and McGarry, K. 2006. Private information and its effect on market equilibrium: new evidence from long-term care insurance. American Economic Review 96, 4, 938–58.Google Scholar
Grabowski, D. C. 2006. The cost-effectiveness of noninstitutional long-term care services: review and synthesis of the most recent evidence. Medical Care Research and Review, 63, 1, 328.Google Scholar
Grignon, M. and Bernier, N. F. 2012. Financing Long-term Care in Canada. IRPP Study No. 33, Institute for Research in Public Policy, Montreal, Canada.Google Scholar
Henry, K. 2010. Australia's Future Tax System: Final Report. The Treasury, Canberra.Google Scholar
Jagger, C., Matthews, R. J., Matthews, F. E., Spiers, N. A., Nickson, J., Paykel, E. S., Huppert, F. A. and Brayne, C. 2007. Cohort differences in disease and disability in the young-old: findings from the MRC Cognitive Function and Ageing Study (MRC-CFAS). BMC Public Health, 7, 1, 156.CrossRefGoogle ScholarPubMed
Karlsson, M. 2004. An International Comparison of Long-term Care Arrangements. Cass Business School, London.Google Scholar
Nyman, J. A. 2003. The Theory of Demand for Health Insurance. Stanford University Press, Stanford, California.Google Scholar
Organisation for Economic Co-operation and Development 2011. Private long-term care insurance: a niche or a ‘big tent’? In Colombo, F., Llena-Nozal, A., Mercier, J. and Tjadens, F. (eds), Help Wanted? Providing and Paying for Long-term Care. Organisation for Economic Co-operation and Development, Paris, 247–61.Google Scholar
Paolucci, F. 2010. Health Care Financing and Insurance: Options for Design. Springer, New York.Google Scholar
Paolucci, F. and Ergas, H. 2011. Providing and financing aged care in Australia. Risk Management and Healthcare Policy, 4, 6780.CrossRefGoogle Scholar
Pestieau, P. and Ponthiere, G. 2011. Long term care insurance puzzle. In Costa-Font, J. and Courbage, C. (eds), Financing Long Term Care in Europe: Institutions, Markets and Models. Palgrave Macmillan, Basingstoke, UK, 4152.Google Scholar
Productivity Commission 2011 a. Caring for Older Australians Report No. 53, Productivity Commission, Canberra.Google Scholar
Productivity Commission 2011 b. Disability Care and Support. Report No. 54, Productivity Commission, Canberra.Google Scholar
Sloan, F. A. and Norton, E. C. 1997. Adverse selection, bequests, crowding out, and private demand for insurance: evidence from the long-term care insurance market. Journal of Risk and Uncertainty, 15, 201–19.Google Scholar
Swan, W. 2010. The Intergenerational Report 2010: Australia to 2050 – Future Challenges. Commonwealth of Australia, Canberra.Google Scholar
The Society of Actuaries 2012. 2011 Risks and Process of Retirement Survey: Report of Findings. The Society of Actuaries, Schaumburg, Illinois.Google Scholar