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Public-private interactions and intergenerational phenomena in long-term care financing

English title Public-private interactions and intergenerational phenomena in long-term care financing
Applicant Courbage Christophe
Number 169662
Funding scheme Project funding (Div. I-III)
Research institution Haute Ecole de Gestion Genève HES-SO
Institution of higher education University of Applied Sciences and Arts Western Switzerland - HES-SO
Main discipline Economics
Start/End 01.09.2017 - 31.08.2020
Approved amount 333'984.00
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Keywords (4)

public-private partnership; insurance ; intergenerational phenomena; long-term care financing

Lay Summary (French)

Lead
Le vieillissement des populations en Suisse et dans la plupart des pays industrialisés a pour effet d'accroître substantiellement les besoins de soins de dépendance. Face à un financement public relativement faible et aux changements dans les structures familiales qui remodèlent les modes traditionnels de soins, le fardeau financier à supporter en cas de perte d'autonomie peut être catastrophique pour les personnes âgées et leurs familles. Le financement de la dépendance pour des populations vieillissantes est donc un enjeu économique et public crucial en Suisse comme ailleurs. Une solution pour pallier la faiblesse du financement de la dépendance est de développer des mécanismes d'assurance.
Lay summary

Contenu et objectifs du travail de recherche

L'objectif de cette recherche est d'étudier deux dimensions qui conditionnent fortement le développement de l'assurance dépendance. La première dimension considère l'interaction entre la couverture publique et l'assurance, de sorte que le financement public encourage l'achat d'une assurance dépendance plutôt que de l'évincer. La deuxième dimension vise à mieux comprendre les rôles des phénomènes intergénérationnels, et en particulier le comportement des enfants en tant que fournisseurs potentiels de soins, en relation avec le développement des marchés d'assurance dépendance.

Contexte scientifique et social du projet de recherche

Les résultats de notre recherche permettront de conseiller les gouvernements et autres institutions intéressées au financement des soins de dépendance. Ils permettront aussi de mieux comprendre les défis liés au financement des risques de dépendance et de faire prendre conscience de l'urgence de trouver des solutions au financement de tels risques.

Direct link to Lay Summary Last update: 18.05.2017

Responsible applicant and co-applicants

Employees

Publications

Publication
On the characteristics of reporting ADL limitations and formal LTC usage across Europe
Fuino Michel, Rudnytskyi Iegor, Wagner Joël (2020), On the characteristics of reporting ADL limitations and formal LTC usage across Europe, in European Actuarial Journal, 0.
The effect of long-term care public benefits and insurance on informal care from outside the household: empirical evidence from Italy and Spain
Courbage Christophe, Montoliu‐Montes Guillem, Wagner Joël (2020), The effect of long-term care public benefits and insurance on informal care from outside the household: empirical evidence from Italy and Spain, in The European Journal of Health Economics, 1-17.
Estate recovery and long‐term care insurance
Courbage Christophe, Montoliu‐Montes Guillem (2020), Estate recovery and long‐term care insurance, in Journal of Public Economic Theory, jpet.12428-jpet.12428.
Duration of long-term care: Socio-economic factors, type of care interactions and evolution
Fuino Michel, Wagner Joël (2020), Duration of long-term care: Socio-economic factors, type of care interactions and evolution, in Insurance: Mathematics and Economics, 90, 151-168.
Drivers of Old-Age Dependence and Long-Term Care Usage in Switzerland—A Structural Equation Model Approach
Rudnytskyi Iegor, Wagner Joël (2019), Drivers of Old-Age Dependence and Long-Term Care Usage in Switzerland—A Structural Equation Model Approach, in Risks, 7(3), 92.
Long-term care insurance research and trajectory
Courbage Christophe, Costa-Font Joan, Wagner Joël (ed.) (2019), Long-term care insurance research and trajectory, Palgrave Macmillan, UK.
Old-age care prevalence in Switzerland: drivers and future development
Fuino Michel, Wagner Joël (2018), Old-age care prevalence in Switzerland: drivers and future development, in European Actuarial Journal, 8(2), 321-362.
Long-term care models and dependence probability tables by acuity level: New empirical evidence from Switzerland
Fuino Michel, Wagner Joël (2018), Long-term care models and dependence probability tables by acuity level: New empirical evidence from Switzerland, in Insurance: Mathematics and Economics, 81, 51-70.
Customer Preferences in German Life Insurance Savings Products: A Conjoint Analysis Approach
Fuino Michel, Maichel-Guggemoos Liselotte, Wagner Joël, Customer Preferences in German Life Insurance Savings Products: A Conjoint Analysis Approach, in Journal of Insurance Issues, 0.

Collaboration

Group / person Country
Types of collaboration
London School of Economics Great Britain and Northern Ireland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Institut sur la retraite et l’épargne - HEC Montréal Canada (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Exchange of personnel
Swiss Re France France (Europe)
- Industry/business/other use-inspired collaboration
University of Zurich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Ministry of Health Singapore Singapore (Asia)
- in-depth/constructive exchanges on approaches, methods or results
University Claude Bernard of Lyon 1 France (Europe)
- in-depth/constructive exchanges on approaches, methods or results

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
4th World Risk and Insurance Economics Congress Talk given at a conference On Children’s Motives to Influence Parents’ Long-Term Care Insurance Purchase 03.08.2020 New York, United States of America Montoliu Montes Guillem;
6th International Workshop on the Socio-Economics of Ageing Talk given at a conference The non-take-up of nursing home public benefits: Theory and empirics from France 25.10.2019 Lisbon, Portugal Montoliu Montes Guillem;
Swiss Health Economics Workshop 2019 Talk given at a conference On the Characteristics of Reporting ADL Limitations and Formal LTC Usage across Europe 13.09.2019 Lucerne, Switzerland Fuino Michel;
2019 American Risk and Insurance Association Annual Meeting (ARIA) Talk given at a conference Duration of Long-Term Care: Socio-Economic Drivers, Evolution and Type of Care Interactions 04.08.2019 San Francisco, United States of America Fuino Michel;
2019 World Congress on Health Economics (iHEA) Talk given at a conference Estate recovery and long-term care insurance 13.07.2019 Basle, Switzerland Montoliu Montes Guillem;
22nd International Congress on Insurance: Mathematics and Economics (IME) Talk given at a conference Duration of Long-Term Care: Socio-Economic Drivers, Evolution and Type of Care Interactions 10.07.2019 Munich, Germany Fuino Michel;
39th Annual conference of the Spanish Health Economics Association (AES) Talk given at a conference The non-take-up of nursing home public benefits: Theory and empirics from France 12.06.2019 Albacete, Spain Montoliu Montes Guillem;
Annual Meeting of the German Insurance Science Association 2019 (DVfVW) Talk given at a conference An Econometric Study on the Duration of Long-Term Care: Main Drivers and Substitution Effect 27.03.2019 Bernlin, Germany Fuino Michel;
40th edition of the Journées des Economistes de la Santé Français (JESF) Talk given at a conference Estate fiscal policies, long-term care insurance and informal care 06.12.2018 Paris, France Montoliu Montes Guillem;
Longevity 14 Conference Talk given at a conference An Econometric Study on the Duration of Long-Term Care: Main Drivers and Substitution Effect 20.09.2018 Amsterdam, Netherlands Fuino Michel;
45th Annual Seminar of the European Group of Risk and Insurance Economists (EGRIE) Talk given at a conference Estate fiscal policies, long-term care insurance and informal care 17.09.2018 Nuremberg, Germany Courbage Christophe;
1st Conference of the Swiss Society of Health Economics (SGGÖ) Talk given at a conference Estate fiscal policies, long-term care insurance and informal care 14.09.2018 Lucerne, Switzerland Montoliu Montes Guillem;
4th European Actuarial Journal Conference (EAJ) Talk given at a conference An Econometric Study on the Duration of Long-Term Care: Main Drivers and Substitution Effect // On the Socio-demographic and Medical Drivers of Long-Term Care Needs in Europe 09.09.2018 Leuven, Belgium Fuino Michel; Wagner Joël;
5th European Health Economics Association PhD Student-Supervisor and Early Career Researcher Conference Talk given at a conference Estate fiscal policies, long-term care insurance and informal care 05.09.2018 Catane, Italy Montoliu Montes Guillem;
Brown bag seminar of Retirement and Savings Institute (HEC Montréal) Individual talk Estate Fiscal Policies, Long-Term Care Insurance and Informal Care 29.08.2018 Montréal, Canada Courbage Christophe;
38th Annual conference of the Spanish Health Economics Association (AES) Talk given at a conference Informal care, long-term care insurance and intra-family moral hazard: empirical evidence from Italy and Spain 20.06.2018 Palmas de Gran Canaria , Spain Montoliu Montes Guillem;
31st International Congress of Actuaries (ICA) Talk given at a conference Old-Age Care Prevalence in Switzerland: Drivers and Future Development // Long-Term Care Models and Dependence Probability Tables by Acuity Level: New Empirical Evidence from Switzerland 05.06.2018 Berlin, Germany Wagner Joël; Fuino Michel;
10th Conference in Actuarial Science & Finance Talk given at a conference Long-Term Care Prevalence and Actuarial Tables: New Empirical Evidence from Switzerland 01.06.2018 Samos, Greece Wagner Joël;
CEFRA Seminar, EMLyon Business School Talk given at a conference Long-Term Care Prevalence and Actuarial Tables: New Empirical Evidence from Switzerland 26.04.2018 Lyon, France Wagner Joël;
Annual Meeting of the German Insurance Science Association 2018 (DVfVW) Talk given at a conference Informal care, long-term care insurance and intra-family moral hazard: empirical evidence from Italy and Spain // Long-term care models and dependence probability tables by acuity level: new empirical evidence from Switzerland 21.03.2018 Munich, Germany Montoliu Montes Guillem; Fuino Michel;
Actuarial and Financial Mathematics Conference 2018 (AFMC) Talk given at a conference Long-term care models and dependence probability tables by acuity level: new empirical evidence from Switzerland 08.02.2018 Brussels, Belgium Wagner Joël;
Conference Dynamic models for human Longevity with Lifestyle Adjustments (LoLita) Talk given at a conference Long-Term Care Prevalence and Actuarial Tables: New Empirical Evidence from Switzerland 15.01.2018 Paris, France Wagner Joël;
International Actuarial Association (IAA) Life Colloquium 2017 Talk given at a conference Long-term care models and dependence probability tables by acuity level: new empirical evidence from Switzerland 23.10.2017 Barcelona, Spain Fuino Michel; Wagner Joël;
4th European Health Economics Association PhD Student-Supervisor and Early Career Researcher Conference Talk given at a conference Informal care, long-term care insurance and intra-family moral hazard: empirical evidence from Italy and Spain 06.09.2017 Lausanne, Switzerland Montoliu Montes Guillem;


Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
Rencontre parlementaire ASA (session d'hiver 2019) Talk 02.12.2019 Berne, Switzerland Wagner Joël;
Conférence de l'Institut des Actuaires : Lois biométriques pour le risque de perte d’autonomie Talk 27.05.2019 Paris, France Wagner Joël;
Forum de l’économie de la Côte : Prévoyance vieillesse : imprévoyance financière ? Talk 25.03.2019 Rolle, Switzerland Wagner Joël;
Association Suisse des Diplômes en Assurances, Section Vaud, Assemblée Générale : Soins-dépendance: comprendre les enjeux, préparer des solut Talk 26.10.2017 Jouxtens-Mézery, Switzerland Wagner Joël;


Self-organised

Title Date Place

Awards

Title Year
Best Paper Award, 31st International Congress of Actuaries 2018, Long-Term Care Models and Dependence Probability Tables by Acuity Level: New Empirical Evidence from Switzerland 2018

Associated projects

Number Title Start Funding scheme
180350 Development of Personalized Health in Switzerland: Social Sciences Perpectives 01.01.2019 Sinergia
159428 Solvency Levels, Asset Allocation and Risk Management in Swiss Pension Funds 01.08.2015 Project funding (Div. I-III)

Abstract

Switzerland like most industrialized countries is confronted with a rapid ageing of its population. This growing number of old people, and in particular of the very old, is increasing the need for long-term care (LTC). LTC is defined as ‘a range of services required by persons with a reduced degree of functional capacity, physical or cognitive, and who are consequently dependent for an extended period of time on help with basic activities of daily living’. Many countries, including Switzerland, are under pressure to find solutions to finance LTC and have put this item at the top of their economic and social agenda.In this research project, we want to study two themes related to the financing of LTC so as to extend the current academic literature, to apply methods and results to Switzerland and abroad and to address current and future challenges in the field.The first theme considers the interaction between public and private sources of LTC financing and is divided in two subtopics. First, we analyze how public financing and insurance models can be organized in order to have both sources of funding complementing each other rather than creating crowding-out effects. In particular, we investigate how public schemes and insurance could be structured so as to increase the benefits of acquiring LTC insurance coverage in the presence of public financing. The second subtopic studies the impact on the LTC insurance purchase decision of public policy aimed at recovering public LTC benefits from beneficiaries’ estate. Such policies are being introduced to recoup payments to LTC recipients as a way to reduce public LTC expenditure.The second theme investigates how intergenerational phenomena, and in particular children’s behavior as potential informal caregivers, interact with the development of LTC insurance markets. It is also divided in two subtopics. The first subtopic focuses on the motives, existence and extent of intra-family moral hazard, i.e. whether children as potential informal caregivers have disincentives to provide care when their parents have LTC insurance. The second subtopic studies the interests of children in having their elderly parents contracting LTC insurance and investigates the motives and roles of children in encouraging or influencing their elderly parents to contract LTC insurance. In light of the importance of finding an adequate organization for the financing of LTC in rapidly ageing countries, this research project is of high relevance to governments, individuals, insurers and other funders of LTC, as well as to society at large. Furthermore, the project aims to build on interdisciplinary research making use of economic thoughts and actuarial approaches on the topic of LTC financing by linking research groups from HEG Genève and HEC Lausanne
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