Long term care insurance as public policy
The rising number of elderly in the world brings forth a set of problems which were unanticipated ere the dawn of the modern era. Bismarck, when he created the forerunner to the modern welfare state, did not imagine it needing to take care of a large number of people in their 70s and 80s. Yet here we are, living in a world in which people routinely live to their mid to late 80s.
This would traditionally not be seen as a problem. Having ancestors live long has historically had multiple advantages. However, with decreasing birth rates and increasingly high standards of living, some parts of the world have been contending with the surprising fact that taking care of elders is not exactly an easy thing to do.
The Netherlands was the first country to introduce mandatory universal social insurance scheme which provided long term care services in a variety of settings. Germany was the first country to do implement long term care insurance (LTCI) in the form of social legislation in 1995. It has gone on to become the fifth pillar insurance after endowment insurance, medical insurance, accidental injury insurance, and unemployment insurance. The United States has also gone on to formally enact public LTCI.
Japan was the first country in Asia to go down this route. With a birth rate below replacement for the longest time, the country has been dealing with epidemics of loneliness and single elders having no one to care about them. Japan's post service actually provides a service in which children living away from their parents can get a postman to visit and take stock of the situation at home.
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