The effect of long-term care public benefits and insurance on informal care from outside the household: empirical eviden
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ORIGINAL PAPER
The effect of long‑term care public benefits and insurance on informal care from outside the household: empirical evidence from Italy and Spain Christophe Courbage1 · Guillem Montoliu‑Montes1,2 · Joël Wagner3 Received: 14 January 2020 / Accepted: 23 June 2020 © The Author(s) 2020
Abstract This article uses cross-sectional data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) database to test the effect of both long-term care (LTC) public benefits and insurance on the receipt of informal care provided by family members living outside the household in Italy and Spain. The choice of Italy and Spain comes from the fact that informal care is rather similar in these two countries while their respective public LTC financing systems are different. Our results support the hypothesis of LTC public support decreasing the receipt of informal care for Spain while reject it for Italy. They tend to confirm that the effect of public benefits on informal care depends on the typology of public coverage for LTC whereby access to proportional benefits negatively influences informal care receipt while access to cash benefits exerts a positive effect. Our results also suggest that private LTC insurance complements the public LTC financing system in place. Keywords Long-term care · Public benefits · Insurance · Informal care JEL Classification G22 · I11 · J14
Introduction The ageing of populations in most industrialised countries is accompanied by an increase in the needs for long-term care1 (LTC). Informal caregivers, mainly relatives or family members, and in particular children, meet a large part of LTC needs [1]. Informal care, therefore, contributes to attenuate LTC expenditures’ increases. However, providing Financial support from the Swiss National Science Foundation (grant number 100018_169662) is gratefully acknowledged. * Christophe Courbage [email protected] 1
Geneva School of Business Administration, University of Applied Sciences Western Switzerland (HES-SO), Geneva, Switzerland
2
Department of Actuarial Science, Faculty of Business and Economics (HEC), University of Lausanne, Lausanne, Switzerland
3
Department of Actuarial Science, Faculty of Business Economics (HEC Lausanne), Swiss Finance Institute, University of Lausanne, Lausanne, Switzerland
informal care could also be detrimental for the caregiver’s physical and mental health and employment participation [2, 3]. Thus, better understanding the determinants of informal care is crucial in designing LTC financing programmes. Several factors, such as the degree of dependency, the number of children, family disintegration, geographical remoteness, women’s work, fertility rates and the amount of inheritance, can influence the amount and the organization of informal help [4]. The availability of public and private LTC financing can also influence informal care. In that respect, public LTC support has mainly been shown to decrease informal care. For instance, Ettner [5], Pezzin et al. [6] and Stabile et al. [7]
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