The Health Effects Of Long-Term Care Insurance

In order to promote the strategies of "Active Aging" and "Healthy China",to continuously meet the health needs of middle-aged and elderly people,to solve the problem of protection for the disabled,and to further improve the health level of middle-aged and elderly people,China has started the long-term care insurance pilot since 2012.Long-term care insurance is designed to address the risk of disability that comes with aging.While aging reflects the progress of society and the improvement of people’s overall health,it can also,in turn,hinder the long-term positive development of society.The health problems of such a large but vulnerable group of people will definitely bring unprecedented pressure and challenges to our social life and economic development.With the difficulty of meeting the needs of family elderly function,the risk of elderly disability will gradually change from family risk to social risk.At present,China’s long-term care insurance is still in the pilot stage,and many scholars have discussed the substitution effect of long-term care insurance on medical costs and medical service utilization,but whether its implementation is effective in promoting people’s health.In other words,whether it is in line with the concept of "value-based care",is still to be studied.This thesis attempts to evaluate the health effects of long-term care insurance in pilot cities from two perspectives: subjective health and objective health,supported by the China Health and Retirement Longitudinal Study(CHARLS)four-period panel data and mortality data for 25 cities in Shandong Province,Jiangsu Province,Beijing,Chongqing,Shanghai,and Tianjin from2006 to 2015.The results of this study showed that the implementation of long-term care insurance significantly improved the subjective health of individuals relative to those who were not covered by long-term care insurance,specifically: the implementation of long-term care insurance increased the probability of self-rated good health by 10.4% and the probability of good mental health by 5.2%;the results of the sub-sample regression of subjective health showed that the health effect of long-term care insurance was more significant for people under60 years old;the effect of long-term care insurance improved more significantly for women than for men relative to higher income groups.The sub-samples regression results of subjective health showed that long-term care insurance had a more significant effect on the health of people under 60 years old;it improved the health of low-income groups more significantly than high-income groups,and had a greater effect on women than men.The objective health results show that long-term care insurance can significantly reduce the population mortality rate in the pilot cities.The implementation of long-term care insurance reduced the urban mortality rate in Qingdao by 0.79 per 1,000 in 2015,which improving the objective health of the city.The preliminary cost-benefit analysis also shows that the long-term care insurance system is consistent with the concept of "value-based care" and can achieve the health effects of low investment and high return,which can help to improve the health level of Chinese people.The research in this study will provide theoretical support and policy reference for national and local governments to improve and adjust the long-term care insurance system and explore the impact of long-term care insurance on national health: first,expand the care content of longterm care insurance and pay attention to mental health and the risk of dementia;second,the object of protection should emphasize both mild and severe disability;third,pay attention to the accessibility of long-term care insurance for urban and rural residents,and gradually expand the pilot area and coverage of long-term care insurance;fourth,pay equal attention to daily care and basic medical care,and give full play to the health effects of long-term care insurance.