Type of Publication: Article in Journal

Long term care financing in four OECD countries: Fiscal burden and distributive effects

Author(s):

Karlsson, Martin; Mayhew, Les; Rickayzen, Ben

Title of Journal:

Health Policy

Volume (Publication Date):

80 (2007)

Keywords:

Long term care, International comparisons, Tax burden, Distributive effects

Digital Object Identifier (DOI):

doi:10.1016/j.healthpol.2006.02.002

Link to complete version:

https://www.sciencedirect.com/science/article/pii/S0168851006000273

Citation:

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Abstract

This paper compares long term care (LTC) systems in four OECD countries (UK, Japan, Sweden and Germany). In the UK, provision is means tested, so that out of pocket payments depend on levels of income, savings and assets. In Sweden, where the system is wholly tax-financed, provision is essentially free at the point of use. In Germany and Japan, provision is financed from recently introduced compulsory insurance schemes, although the details of how each scheme operates and the distributive consequences differ somewhat. The paper analyses the effects of importing the other three countries’ systems for financing LTC into the UK, focussing on both the distributive consequences and the tax burden. It finds that the German system would not be an improvement on the current UK system, because it uses a regressive method of financing. Therefore, the discussion of possible alternatives to the present UK system could be restricted to a general tax-based system as used in Sweden or the compulsory insurance system as used in Japan. The results suggest that all three systems would imply increased taxes in the UK.