Understanding the motivations of long-term care insurance owners: the importance of retirement planning

This article is based on two recent reports by the American Council of Life Insurers (ACLI) that illuminate the reasons why individuals purchase private long-term care insurance in both the group and individual markets. This information suggests that a younger and more diverse group of individuals are becoming increasingly interested in private long-term care insurance and that workplace education linkage the purchase of long-term care insurance to retirement planning may promote coverage.     

Financing long-term care: employee needs and attitudes, and the employer's role.

Because of increasing life expectancies, high costs for nursing home and home health care, declining levels of informal family care, and the stated policy of the federal and state governments to foster self-reliance, individuals are increasingly exposed to the risk of financial ruin from long-term care (LTC) expenses. Yet, because of psychological barriers and aversions, particularly to thinking about residing in a nursing home, most individuals have not purchased LTC insurance. Hence, it may be the responsibility of employers to provide education to employees about LTC and to sponsor either individual or group plans of LTC insurance. Educational efforts may be particularly effective at the time of retirement when employees are in a more serious mood to consider the contingencies of retired life. A formal and perhaps more economical response for employers would be to offer combined life annuity and LTC insurance benefits through the retirement plan, provided certain regulatory and tax barriers can be removed.     

Issuance Decisions and Strategic Focus: The Case of Long-Term Care Insurance

Increasing costs of long-term care are placing ever greater burdens on state and federal budgets, yet private long-term care insurance remains a relatively minor financing vehicle. Although many researchers provide rationales for the limited private market, some life–health insurers have forged ahead into this relatively new and risky line of business. We investigate what makes these insurers different and whether managers are following a diversification or strategic focus strategy. We find that strategic focus is a consistently important factor and that managers' participation and volume decisions are made independently.     

日本社区综合护理体系研究

应对2025年人口老龄化高峰期的到来,日本政府为了方便老年人在自己住惯了的社区接受医疗护理服务,对原有的护理保险制度和医疗保险制度进行了改革,加强了医疗与护理的联系。在护理保险制度中引进定期巡回随时应对型上门护理和复合型护理服务两项新型护理形式;在医疗保险制度改革中通过病床的分化与合作,促进居家医疗;住宅政策中创建附带服务功能的老年住宅。过去的医疗护理政策主要考虑护理供给方的立场,积极建设护理设施,而此次的社区综合护理体系考虑更多的是老年人的立场,将医疗、护理、预防、居住、生活支援有机结合起来方便老年人接受社区综合护理。在市町村主导下,日本正在构建自助、互助、共助、公助相结合的,由全社会共同支撑的社区综合护理体系。     

定向支持政策能缓解民营企业的融资约束吗？——基于民营企业债务融资支持工具政策的研究

本文考察了民营企业债务融资支持工具政策缓解民营企业融资约束的作用和传导机制。研究显示,民营企业债务融资支持工具政策具有信号传递效应和CRMW(信用风险缓释凭证)的保险效应,能显著降低民营企业债券的发行成本并提升债券发行成功率。同时,较强的政策信号传递效应使得这一政策具有普惠性影响,对不同信用资质的民营企业均有缓解融资约束的作用。在使用双重差分方法进行稳健性检验,这一政策缓解民营企业融资约束的作用依然显著。对CRMW保险效应进一步研究则显示,虽然CRMW能提升民营企业债券发行成功率,但其降低债券发行价格的作用并不明显,表明现阶段CRMW主要能缓解企业的融资难问题。本文不仅为理解民营企业债务融资支持工具政策提供了理论依据和大样本经验证据,而且在实践上为科学运用、发展CRMW提供了决策参考。     

Long-term care financing: options for the future

The aging of the baby boomers will have an enormous impact on the future of long-term care costs. This article projects the magnitude of that impact, discusses sources of financing, and considers the cost and feasibility of three options for financing future long-term care services. The authors investigate the alternatives of increasing personal savings, raising payroll taxes and expanding employer-sponsored private long-term care insurance coverage, respectively.     

The Private Market for Long-Term Care Insurance in the United States: A Review of the Evidence

This article reviews the growing literature on the market for private long-term care insurance, a market notable for its small size despite the fact that long-term care expenses are potentially large and highly uncertain. After summarizing long-term care utilization and insurance coverage in the United States, the article reviews research on the supply of and the demand for private long-term care insurance. It concludes that demand-side factors impose important limits on the size of the private market and that we currently have a limited understanding of how public policies could be designed to encourage the growth of this market.     

社保模式下实物给付型长期护理保险发展瓶颈及对策

伴随着相关政策的出台,社保模式下的长期护理保险制度逐渐浮出水面,并在各试点地区开始尝试实物给付型长期护理保险,以满足消费者多层次、多样化的需求。随着老年人护理需求和意愿不断增长,长期护理保险的市场需求正在逐步扩大。但是,和巨大的潜在市场需求相比,长期护理保险市场的供给相对缺失,试点实践中存在给付方式单一、法律法规缺失、筹资机制不完善、护理设施及资源不足等诸多问题。借鉴国外经验,本文针对以上问题提出了完善建议,以期为我国社保模式下实物给付型长期护理保险的发展提供可鉴思路。     

互助保险机制在长期护理保障中的应用:典型案例的政策设计及绩效

自长期护理保险政策试点启动以来,部分地区以互助保险为基础架构的长期护理保险制度,在制度框架、筹资机制、支付范围、服务提供方式等方面均具有一定的创新性。基于北京市海淀区试点政策的评估表明,以自愿参保、同质群体风险分摊和收益分享为前提的互助保险机制不能兼顾保障公平性、可持续性和可负担性等多重目标。应坚持以社会保险为基础构建多层次长期护理保障体系,支持商业健康保险公司提供多层次、补充性的保险产品。同时,要做好医疗、养老服务体系的改革和衔接,充分发挥护理保险基金的保障功能和保障潜力。     

老龄危机背景下我国长期护理保险制度试点方案的比较与思考

通过梳理15个试点地区长期护理保险制度的实施方案,对参保对象、基金来源、给付对象、评定依据、服务项目、服务形式以及待遇支付等进行比较分析。以老龄危机为背景,深入思考与探讨长期护理保险制度参保对象的覆盖、给付对象的界定、筹资主体的确定、保障内容的提供等问题,同时提出了针对性建议:参保对象应延伸至农村;给付对象暂定为重度失能失智老年参保者;筹资主体做到真正多元化;服务项目以生活照料为主;待遇水平体现出对居家护理的支持;给付形式引入现金给付。     

环境污染责任保险对企业债务融资成本的影响研究

在欧美发达经济体中,环境污染责任保险在实现经济与环境可持续发展中发挥着重要作用.环境污染责任保险在中国尚处于推广阶段,企业投保意愿不强,参保率较低,急需提高企业对环境污染责任保险的价值认同.环境污染责任保险是否具有资金融通效应,是企业主动接纳该类保险的重要驱动因素.为检验环境污染责任保险能否为企业带来资金融通的价值,文...     

美国长期护理保障制度改革及其对我国的启示

本文主要运用文献研究法,对美国长期护理保障制度的现状进行了分析。分析发现,当前关国长期护理保障制度存在两大问题,分别是政府财政转移支付缺乏可持续性、私人保单难以覆盖广大中低收入阶层。为解决上述问题,关国政府对长期护理保障制度采取了一系列改革措施,但改革始终没能达到预期效果。美国长期护理保障制度改革启示我们,长期护理保障...     

Life Insurance Lapse Behavior

Life insurance policy lapses are detrimental to issuing insurers when lapses substantially deviate from insurer expectations. The extant literature has proposed and tested, using macroeconomic data, several hypotheses regarding lapse determinants. While macroeconomic data are useful in providing a general test of lapse determinants, the use of aggregate data precludes an analysis of microeconomic factors that may drive the lapse decision. We develop and test a microeconomic model of voluntary life insurance lapse behavior and provide some of the first evidence regarding household factors related to life insurance lapses. Our findings support and extend the prior evidence regarding lapse determinants. Consistent with the emergency fund hypothesis we find that voluntary lapses are related to large income shocks, and consistent with the policy replacement hypothesis we find that the decision to lapse a life insurance policy is directly related to the purchase of a different life insurance policy. We also find that age is an important moderating factor in the lapse decision. Changes in income appear to more directly affect the decision to lapse for younger households, while they are generally unrelated to the lapse decision for older households.     

社会互动与健康保险购买意愿关系研究

本文系统检验了社会互动对受访者购买健康保险意愿的影响。结果表明:网络互动和传统互动均显著提高消费者为自己购买健康保险的意愿,而且网络互动的影响力更大;网络互动对为父母健康保险的购买意愿没有解释力,传统互动则显著提高了消费者为父母购买健康保险的意愿。本文在检验影响健康保险购买意愿的传统因素之外,重点关注社会互动的影响,为分析个体的保险决策提供新的视角。     

Power purchase agreements with incremental tariffs in local currency: An innovative green finance tool

Investment volume in green projects, specifically in the green electricity market, suffers from limitations such as inadequate long-term financing, various risks, and a low rate of return on investment. Renewable energy power purchase agreements (PPAs), as a direct legal contract between a power provider and a power buyer, are one of the most popular instruments to increase investment. In this study, we model an adjusted PPA in the local currency framework to lower exchange rate risk and incremental tariffs by having the government pay part of the spillover tax revenues to the PPA, leading to a higher return on investment. The major conclusion of this study is that the use of tax revenue through the spillover effect of green electricity supply is a suitable source of financing for PPAs. As one policy implication, we recommend that developing countries allocate 50% of the tax revenue originating from power supply and adopt incremental PPAs to encourage private investment in green projects.     

夫妻联合长期护理保险的定价模型与应用

在人口老龄化和人口长寿背景下,社会对老年长期护理保障的需求不断增长,基于家庭保障的理念,本文将多元寿险模型推广到夫妻联合长期护理保险,构建了健康、轻度失能、重度失能和死亡的马尔科夫四状态转移模型,并在联合个体状态转移相互独立的假设下给出了夫妻联合长期护理保险定价模型.最后基于中国老年健康影响因素跟踪调查微观数据,实现了...     

Opting Out of Public Insurance: Is It Socially Acceptable?

The privatization of social services is being increasingly discussed. The market of social services is often characterized by market failures, like informational asymmetries, externalities, distributional problems, which all justify public intervention. But the quality of services provided by public authorities or by private insurers in the context of health insurance is different and could be observable. The public reimbursement of health care is often conditional on rules, like the choice of the physician or the hospital, that induce a disutility of using social insurance instead of private insurance. An alternative solution to a complete privatization is to allow some individuals to opt out. We can imagine that the government allows and even in some cases favors part of the population leaving the public health insurance system. We analyze the situations where the opting out is welfare improving. We then study the optimal policy depending on the characteristics of the economy considering a Rawlsian criterion.     

Marktversagen auf dem geförderten Pflegezusatzversicherungsmarkt?

This study analyzes the supply side of the private German long term care insurance market. It compares loads and comprehensiveness of subsidized and unsubsidized insurance policies for three age groups. The results show that subsidized insurance policies are less comprehensive than unsubsidized insurance policies. In addition the premiums of subsidized policies are marked up substantially above expected benefits compared to unsubsidized policies. All in all these results indicate market failure due to adverse selection within the subsidized private long term care insurance market. Furthermore, the results show that due to unisex pricing, private long term care policies are in general more attractive to women than to men. As this is not reflected in demand, other factors than supply side failure seem to contribute to an overall low demand for private long term care insurance policies.     

民营企业融资的影响因素研究

近年来,党中央、国务院出台多项政策措施,优化民营企业政策环境,支持民营企业增信融资。基于民营企业融资的相关文献,总结梳理了民营企业融资的影响因素,运用2008—2018年上市民营企业样本数据,对民营企业融资的影响因素进行实证检验。研究发现,地方政府融资平台对民营企业融资形成"挤出效应"的同时,也可能存在"溢出效应";国有企业对财政金融资源的利用一定程度上影响了民营企业的融资能力;同时,直接融资发展不足,也在一定程度上加大了民营企业的融资约束。基于此,建议通过推动地方政府融资平台有序转型、推行"竞争中性"原则打造公平市场环境、支持民营企业加大直接融资等措施,进一步缓解民营企业融资问题。     

Social long-term care insurance and redistribution

We study the role of social long-term care (LTC) insurance when income taxation and private insurance markets are imperfect. Policy instruments include public provision of LTC as well as a subsidy on private insurance. The subsidy scheme may be linear or nonlinear. For the linear part we consider an arbitrary number of types, characterized by earnings and survival probabilities. In the nonlinear part, society consists of three types: poor, middle class and rich. The first type is too poor to provide for dependence; the middle class type purchases private insurance and the high income type is self-insured. The main questions are at what level LTC should be provided to the poor and whether it is desirable to subsidize private LTC for the middle class. Interestingly, the results are not totally similar under both linear and nonlinear schemes. First, whereas in the linear case a subsidy of private LTC insurance is desirable, it is not in the nonlinear case (at least at the margin). Second, the desirability of public provision of LTC services depends on the way the income tax is restricted. In the linear case, it may be desirable only if no demogrant (uniform lump-sum transfer) is available. In the nonlinear case, public provision is desirable when the income tax is sufficiently restricted. Specifically, this is the case when the income is subject only to a proportional payroll tax while the LTC reimbursement policy can be nonlinear.