Model Construction and International Reference for the Moderate Guarantee Level of Long-Term Care Insurance

doi:10.19546/j.issn.1674-3830.2026.3.010

China Health Insurance ›› 2026, Vol. 0 ›› Issue (3) : 79-90. DOI: 10.19546/j.issn.1674-3830.2026.3.010

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Model Construction and International Reference for the Moderate Guarantee Level of Long-Term Care Insurance

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Abstract

During the 15th Five-Year Plan period, China's long-term care insurance system will transit from localised pilot schemes to comprehensive institutionalisation. Establishing a broadly accessible and financially sustainable moderate guarantee framework for long-term care insurance has become a critical issue. This study constructs a measurement model for the appropriate level of long-term care insurance, embedding risk factors such as adverse selection and moral hazard, based on the theory of adequate social security levels. Through theoretical analysis and international comparison, it examines institutional tools employed by Germany and Japan in areas such as participation constraints and risk pool balancing. It demonstrates how these countries mitigate risk factors through mechanisms including compulsory participation, third-party quality inspections, and service standardisation, which can effectively addresse information asymmetry, reduce operational losses within the system, and align benefit levels with the economically and socially sustainable optimal range. Drawing on China's pilot initiatives, the study proposes policy recommendations including optimising co-financing mechanisms, enhancing standardised service provision systems, promoting institutional coordination, and cultivating the silver economy, so as to offer theoretical underpinnings and practical pathways for establishing a comprehensive long-term care insurance system with Chinese characteristics.

Key words

long-term care insurance / moderate benefit level / adverse selection / moral hazard / risk governance

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Model Construction and International Reference for the Moderate Guarantee Level of Long-Term Care Insurance[J]. China Health Insurance. 2026, 0(3): 79-90 https://doi.org/10.19546/j.issn.1674-3830.2026.3.010

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