Social Policy and Administration · 2010 · 153 citations · 3 references
Public AffairsInsuranceSocial PolicyHealth InsuranceLong-term Care PolicySocial InsuranceCare PolicyLong-term CareLong-term Care CoverageLong-term Care FinancingLong-term Care InsuranceSocial Insurance ReformContribution Rate ReformLong-term Care Financing ReformLong-term Care Insurance FinancingLong-term Care ReformLong-term Services CoverageSocial Insurance BenefitsSocial Insurance DesignSocial Insurance Financing
Germany’s long‑term care insurance, established fifteen years ago, has achieved successes and weaknesses and is now undergoing continuous reform. The study evaluates Germany’s model and recent reform to derive general lessons for designing long‑term care social insurance schemes. The 2008 reform focused on quality improvements, care management, and careful benefit adjustments. Although the reform’s quality and care‑management initiatives show promise, the new benefit‑adjustment rules and modest contribution‑rate increase are disappointing and merely postpone financing challenges.
Abstract After fifteen years of existence, Germany's long‐term care insurance shows both successes and weaknesses. The latter led to the 2008 reform, which concentrated on quality improvements, care management and careful adjustments of benefits. While attempts to improve quality and care management contain promising elements, new rules for adjustment are disappointing. This is also true for the issue of future financing as the modest increase in the contribution rate, which is part of the reform, only buys time. Thus, the next round of reform is already in the making, marking the scheme as a system of permanent reform. As Germany is one of the most clear‐cut examples of social insurance, the assessment of this scheme and its recent reform also allow us to draw some general lessons for the design of long‐term care social insurance schemes.
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