The Pilot Programme of Long-term Care Insurance in China: Fragmentation and Policy Implications

Abstract:China implemented a long-term care insurance (LTCI) pilot programme in 15 cities in 2016. This study examines the pilot programme through a systematic literature review and discusses the implications of its implementation in a national framework. Findings show evidence of fragmentation in the LTCI design in the 15 pilot cities with respect to its coverage, eligibility, funding, benefits, and reimbursement rates and caps. China aims to emulate Germany to cover all public medical insurance recipients regardless of disabilities and age. But its fundraising levels and reimbursement rates in pilot cities were mostly lower than those in Germany, Japan and South Korea. Fragmentation in the LTCI can be attributed to the incremental and decentralised model of policy reform, path dependency and competing objectives. China’s experience could serve as a useful reference for other countries that plan to adopt the LTCI system.