Abstract

In 2016, the number of the elderly population over 65 was 6.9 million, 13,3% of total beneficiaries of Health Insurance and Medical Aid. It has increased by 31% over the past 7 years. With the rapid growth of aging population, more nuclear families and women’s economic activities due to industrialization and modernization, an elder care has become a social issue in Korea. Consequently, the Long-Term Care Insurance for the Elderly (LTCI) was implemented in 2008 to ensure the proper quality of life among the frail elderly due to aging process or chronic illnesses and alleviate family caregivers’ burden. The Korean government has also expected positive outcomes such as job creation and saving medical expenses, etc.

The LTCI in Korea is quite different from that in Japan, yet, it is pretty similar to the LTCI in Germany. However, there are some differences in terms of the applicant’s qualification and the diversity of insurance benefit. For instance, in Korea, those who apply for LTCI must be over 65, or if younger than 65, they must have some kinds of geriatric diseases. In addition, the benefits are not as varied as in Germany, especially for the informal carers.

In 10 years after the implementation of LTCI in Korea, it is time to appraise the actual achievement of the goal of LTCI. The purpose of this paper is, therefore, to examine the outcomes, especially, in terms of the favourable effects and challenges of LTCI in Korea.

For the purpose of the study, the data from the published and unpublished journal articles, government documents, relevant conferences, and websites will be analysed. In addition, the data from the Korean Statistical Information Service and from LTCI time series in the National Health Insurance Service will be also used.

In the first, the history and development of the LTCI will be described from problem formulation to policy formulation. In the second, the general overview of the Korean LTCI system, e.g. eligibility criteria, coverage, insurance benefit, coverage process and financing, and market in LTC, will be presented.
In next, the successes will be noted by analysing the statistical data. The LTC service has transformed from the selective service (applicable only to low-income groups) to the universal service (applicable to all income groups), so the number of facilities and the professional care workers have been increased dramatically. Additionally, a few points to illustrate the magnitude of the problems related to long-term care will be mentioned. For instance, the limitation of service quality due to free competition among service providers in service markets, regional disparities in long-term care institutions, and the lack of public infrastructure and financing.

Finally, the challenges to the present LTCI will be explored. First of all, the LTC protection needs to be expanded, especially in the service of the aging in the place, which is strongly related to strengthen social responsibility of elder care and the quality of life of the elderly. Then, it is also necessary to promote the community care such as supporting the informal carer and in-home services and the consumer-oriented medical care and nursing care systems need to be improved.