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1

2 ,.,..,..,.,..,.

3 ..,.,,...,

4 . :,.,.,,... 1) 65 ( % %) ) % % %.

5 ii ( % %). ( ), ( % %).,. 46%O ECD.,.,. /..

6 iii. (Long-Term Care).,. (Lon g-term Care Insu rance).,....

7 iv.,,....,..,.

8 v..,,,,,

9 vi.. (, Financial Advisors).,..,.,., (, ).

10 < > 72

11 <-1> 65 4 <-2> 65 5 <-3> 6 <-4> 7 <-5> () 8 <-6> 8 <-7> 9 <-8> 10 <-9> 1 11 <-10> <-11> <-12> 14 <-13> 15 <-14> 17 <-15> 18 <-16> 19 <-17> <-18> 20 <-19> 21 <-20> 24 <-21> O ECD 26 <-22> 27 <-23> 28 <-24> 29 <-25> 30 <-1> 35

12 <-2> 36 <-3> 38 <-4> 40 <-5> 42 <-6> LTC 45 <-1> 46 <-2> 49 <-3> 50 <-4> 54 < -1> < -2> 22

13 % UN. 14% 20%..,...,...,.,,..

14 2.,..,,..

15 3. 1..,..., , (baby boom ) <-1> 19602, % 19703,224., %, % ,

16 4 <-1> 65 ( :, %) ,012 32,241 38,124 42,869 47,008 49,594 50,650 50,296 () 1 ) ,456 2,195 3,395 5,302 7,667 11,604 () 1 ) () : :,, 2001., UN % %, %, % % %, %, % %..

17 5. 1), % 34.., (<-2> ). <-2> 65 ( : %) :,, : UN Population Division, World Population Prospect,

18 6 U.N., 7% (Aging Society). 1960, 1970, )..,. 65 7% 14 %, 14 % 20%, 19 7 (Aged Society) (<-3> ). <-3> 65 ( : ) 7% 14 % 20% 714% 1420% : 7%(aging society), 14% (aged society). : 1. UN Population Division, World Population Prospect, ,,

19 7...,. 1) 1960., , (< -4> ). <-4> ( : ) () :,, 2001.

20 8, (<-5> ). <-5> () ( : ) : UN Population Division, World Population Prospect, ) , , (<-6> ). <-6> ( : ) :,, 2001.

21 9, , (<-7> ). <-7> ( : ) : UN Population Division, World Population Prospect, ,..

22 , , 60, 65 (<-8> ). 60, %. <-8> ( : %) :,, 2001.

23 11. 1 ( ) <-9>. 1,. 60, , , <-9> 1 ( : ) : 1= / :,, 2001., (<-10> ).

24 12 <-10> 651 ( : ) : UN Population Division, World Population Prospect, , (<-11> ) 2). 2), 45.

25 13 <-11> 65 (1998) ( : %) :,1998, <-12> % %., , 65., 65, ,

26 14 <-12> ( :, %) ,278 2,919,772 5,977,453 11,379, , ,297 1,207,561 1,993,922 ( ) () ,503 2,022,294 4,041,754 7,452,536 ( ) () , , ,138 1,933,247 ( ) () : () = [ (/ )]100 :,, 1985, 1990, 1995.,, 1999.,.

27 ,. <-13> <-13> ( : ) :,, , %, 2

28 %, % (< -1> ) % 3) 10 19%p. < -1> 65(2000) :, 2000 ( ), ) ; 1(8.9%), 1 (16.9%), 2 (23.4%), 3 (47.6%), 4 (2.0%), (1.2%)

29 17. (<-14> ),. <-14 > ( : %) : 15. :,, <-15> % %10%p, %1970 5%p., % %3.9%p.

30 18 <-15> ( : %) :, KOSIS , %, %., % % (<-16> ).

31 19 <-16> ( :, %) ,112 9,617 13,683 18,085 21, S O C :,, 2000.,, <-16> % % , %10 1, 53.7% (<-17> )., 5.

32 20 <-17> 55(2000) ( :, %) 55 3, , , :. :, KOSIS, 15, 1, 2, (<-18> ). <-18> ( : %) :,, 2000.

33 21.. <-19> , 1 323() <-19> ( : ) ,615 23,662 45,694 68, , :,, , %, %, %, %, % % %(< -2> ).

34 22 < - 2> (1999) :,, 2000.,.,.

35 ) 1963., , , ,, 3.,, (<-20> ).,,

36 24, 50%. <-20> (2001) ( : %) () :,, ,,,. 2) ) (Co v e rag e ) / /

37 25. MRI,... ) ( ) 55%, 40%, 30%, 20%.,. 46% OECD (< -21> ). () (),. OECD 1221% 9.0%OECD. (19.4%).

38 26 <-21> O EC D (1998) GDP ( : %) 8.5 2, , , , , , , , , , , , , , , , , , , , , : OECD, OECD in Figures 2001, 2001.

39 27 ). (<-22> ). <-22> ( : ) ,420 20,660 25,240 29,850 35,000 :, ),

40 28. 1) () (). (:, ),,,., ,532 (10.4 %), 5,882 (8.5%)(<-23> ). <-23> (2000 ) ( :, 10, %) 14,291 5, , :,,

41 29 2) (coverage),.., (<-24> ). <-24> (1998) ( : %) : GNP. : CEA ECO, Health Insurance in Europe, ,

42 30.. (adverse selection) (grou p insurance) (<-25> ).. <-25> (1998) ( : %) : CEA ECO, Health Insurance in Europe, U.S. Bureau of Censu s, Health Insurance Coverage /,.,.

43 (long-term care), (care)., (care). / (lon g-term care). ( 180), 24...,, ) ).,, )

44 32 (domiciliary care home care), ) (residential / nursing homes)(residential care)., ), ), ).. ) ).,.,,,.. ), ) (voluntary organizations) ).,.

45 33,,,. ( ),..,,, (nursin g care), (resid ential care), (d ay care). (nursing care places).,,, 50. (residential care places). (nursing care places). (d ay care places).

46 34..,,.. (fu ll-tim e)(p art-tim e). 2.. (long-term care in surance)..., 6 (ADL : Activities of Daily Livin g)..

47 35. 1) (<-1> ). <-1> ( : ) ,749 2,545 9,000 12,000 18,000 2,300 2,600 3,300 : 1.,, US General Accounting Office. 3. London Economics & IPPR. (Sw iss Re), (full-tim e),.(ippr), 30 47%, 1,000.

48 36, (<-1> ). 2),. (<-2> )., / 4, 20311/ 2. <-2> ( : 10) : London Economics & Institute of Public Policy Research

49 37. 3).,.., %203161%., % %..,..,.,,.

50 (<-3> ) <-3> , ,, 1992,,,,,,, ,,, : Munich Re,

51 39. 1) 1, $56,895, $124,370.. M edicaidmedicare %, 36%, 4 %. 1974, % %. 4% %. (reimbursement-of-cost products), (fixed-benefit products)2.

52 40. 2) %202025% ( 16% 19% ) , N ew Gold Plan 10., , 50% 50%(p ay-as-you-go)(< -4> ). <-4> (50%) : 33% 65: 17% (50%) : 25% : 12.5% : 12.5%

53 , ( ), 1989 ( ).. 3,. Am erican Fam ily. 3) 1995.,,,. 78,300

54 42., 78, %, %., ( ), (h om e health care) 128( : 35.4 %, : 64.6%), (nursin g hom e care) 55( : 23.3%, : 76.7%). (7) (3)10., %, 61.0% (<-5> ). <-5> (1999) ( : %) : Munich Re,

55 , , ) 1997PSD (Prestation Sp écifiqu e Dép end ance) % (group insurance)., ) (stan d-alone), ), ), ) 4. ( ),. ( )2000 AXA.

56 44 5) 1993 Com m unity Care Act., ,. (p re-fund ed) (p oint of need)..,. 6) (home care). 1989, 50%.

57 45.,. <-6> LTC MedicaidMedicare Reimbursement/ indemnity policies ( ) - 21%( ) % ( ), ,, LTC - 40 ( ) ( ) ( ) Daily cash 1 (1985); LTC allowance, - Reimbursement of (9,000 ) costs 2 (1992); LTC (69,800 ) (PSD) - - (570,000 ) 1 (1985); / 2 (1994); LTC , Annuity with inflation protection Pre-funded plans (Community Care Act) - 35,000 - Impaired life - - ; point-of-need, pre-funded annuities LTC ( ) % ( )

58 , ( ),. ( 13 ) ()(< -1> ). <-1> 200, (80 ),, (40) 2000, 10 :,

59 47,. ( ), , ), ), )...,..,.

60 48.,..,.., ) (100), (28) (9 ) ( 77

61 49 25) (<-2> ). <-2> (2001) , : (nursin g care hom e)18, (residential care hom e)55 2, 578 (1999 ), 568 (1996 ).. (< -3> )..

62 50 <-3> ( : ) , : :,,, ) ).,.,,. (h om e care).,.

63 51. (form al care),.., 4).. )..,. (com m u nity),. 4) 1.5.

64 52 ).. 80%.. 1) ,....

65 ) )...., (reform ing).,.,. 15%

66 54 (<-4> ) 7.1%. <-4> % % % % % : UN Population Division, World Population Prospect, Munich Re, LTCI International Situation (social w elfare), (social in surance)..,.

67 55 ).,. ( 50% ),.,,.,., ,

68 56... (data-base).

69 (LTC in surance product),,.,,,,...,,,,,..,.

70 58.., 6 (ADL : Activities of Daily Living) (cognitive im p airm ent). (ADL ),. 6ADL 4. (stan d-alone p olicy) ( : rider).. 1) (S ta nd -Alo ne Po lic y), (regular prem ium ) (single prem ium ).,..

71 59, ADL 2 50%, 3 100%.,... (deferred p aym ent p eriod), 3. 3(: 6 ). 180( 90 ). 3.,.., ( 10)

72 60.. 2) (Rid e r to Othe r Po lic ie s ). (w h ole life p olicies)., (accelerated benefits).,.,.. /. /, ADL. (60 65) /.

73 61. /...., ( ).., (),.. (tax benefits).

74 62. (Imme d iate Care Annuitie s ).., (). 60, (,, )....,.

75 63. 30,....,.. 5).. (Pe ns io n Linke d Pro d ucts ) (p ension ben efits) (long-term care benefits).,. ADL 100%., 5).

76 64.,. ( ).,.. (Ho me Care Only Pro ducts ). (nursin g h om e) (nu rsing h om e ),..,., ( )..

77 65 2..,,,.. (Targ e t Co ns ume r) (60 65 )..,,. 1),,,,,.. 23

78 66..,.,.,,. 2)..,.,,..,

79 67.,..., ( ).,.,.,,.,.,...,.

80 68 AXA., 24,,. AXA. Allianz 2,..,,,,. (ADL 4)(ADL 2) (ADL 3 4). 90. (lim it).

81 69.,.,..,., ), ), ), ). FA (Financial Advisors).,, /,..,,.

82 70.. (d ay care center)..,..,,..,, (claim m anagem ent).,.

83 %..,.,,...,..,.,.

84 72 < >,, 1999,, ,Health Care Business, ,, ,, 97-02,, ,,, 32,, ,, 1985, 1990, 1995.,,, 25,, ,1998, 98-04,, ,, 2001.,, ,, 2000.,, 2000.,, 2000.,, 2000.,2000 ( ),

85 73 Allianz Group, Long Term Care Insurance in Germany, CEA ECO, Health Insurance in Europe 1998 Data, July 2000 Crosby, Long-Term Care Insurance... the complete guide, D avid Du llaw ay & Su san Elliott, Long-Term Care Insurance, A Guide to Product Design & Pricing, Edw ard Rich ar d s, "P ayin g for Lon g-term Car e", Institute for Public Policy Research, 1995 & Laing & Buisson, Care of Elderly People M arket Survey , Mu nich Re, Long Term Care Insurance, July 2001., LTCI International Situation, O ECD, OECD in Figures 2001, PPP lifetim e care, A world-wide review f or long term care, Sw iss Re U K, Long Term Care Insurance Underwriting Guidelines, 1996., Long Term Care Data Pack, U.N. Population Division, W orld Population Prospect, U.S. Bureau of Censu s, Health Insurance Coverage 1998.

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