2001. 12
,.,..,..,.,..,.
..,.,,...,. 200112
. :,.,.,,... 1) 65 ( 19854.7%199917.0%). 199965 3. 1) 19602.9%20007.1%203019.3%.
ii (1990 25.8%200044.9%). ( 19700.4 19992.5), (15199011.9% 199925.9%).,. 46%O ECD.,.,. /..
iii. (Long-Term Care).,. (Lon g-term Care Insu rance).,....
iv.,,....,..,.
v..,,,,,........
vi.. (, Financial Advisors).,..,.,., (, ).
. 1. 3 1. 3 2. 10 3. 15 4. 23. 31 1. 31 2. 34 3. 38. 46 1. 46 2. 48. 57 1. 57 2. 65. 71 < > 72
<-1> 65 4 <-2> 65 5 <-3> 6 <-4> 7 <-5> () 8 <-6> 8 <-7> 9 <-8> 10 <-9> 1 11 <-10> 651 12 <-11> 65 13 <-12> 14 <-13> 15 <-14> 17 <-15> 18 <-16> 19 <-17> 55 20 <-18> 20 <-19> 21 <-20> 24 <-21> O ECD 26 <-22> 27 <-23> 28 <-24> 29 <-25> 30 <-1> 35
<-2> 36 <-3> 38 <-4> 40 <-5> 42 <-6> LTC 45 <-1> 46 <-2> 49 <-3> 50 <-4> 54 < -1> 65 16 < -2> 22
1. 2000 7% UN. 14% 20%..,...,...,.,,..
2.,..,,..
3. 1..,..., 625 1960, (baby boom ) 1970. <-1> 19602,50110 30% 19703,224., 1970 18%, 1980199010% 2000 4,701. 2000.
4 <-1> 65 ( :, %) 1960 1970 1980 1990 2000 2010 2020 2030 25,012 32,241 38,124 42,869 47,008 49,594 50,650 50,296 () 1 ) 28.9 18.2 12.4 9.7 5.5 2.1-0.7 65 726 991 1,456 2,195 3,395 5,302 7,667 11,604 () 1 ) 36.5 46.9 50.8 54.7 56.2 44.6 51.3 () 2.9 3.1 3.8 5.1 7.2 10.7 15.1 23.1 : 6510. :,, 2001., UN 65 1960 2000. 196010 65 73 992636.5%. 1970 46.9%, 1980 50.8%, 1990 54.7%. 203011.. 1960 2.9% 19905.1%, 19955.9%, 20007.2%. 2030 23.1%..
5. 1), 1980 10% 34.., 1960 2000. 2010 2030 (<-2> ). <-2> 65 ( : %) 1960 1970 1980 1990 2000 2010 2020 2030 9.2 11.7 11.6 11.5 5.7 10.6 2.9 9.8 12.9 12.9 13.7 7.1 12.2 3.1 11.2 15.1 14.0 15.6 9.0 13.9 3.8 12.4 15.7 14.0 15.0 12.0 14.7 5.1 12.5 16.0 15.9 16.4 17.1 16.4 7.2 13.2 17.1 16.6 19.8 21.5 18.3 10.7 :,, 2001. : UN Population Division, World Population Prospect, 1998. 16.6 19.8 20.1 21.6 26.2 21.2 15.1 20.6 23.1 23.2 26.1 27.3 25.2 23.1
6 U.N., 7% (Aging Society). 1960, 1970, 2000. 2)..,. 65 7% 14 %, 14 % 20%, 19 7 (Aged Society) (<-3> ). <-3> 65 ( : ) 7% 14 % 20% 714% 1420% 1942 1929 1864 1932 1887 1970 2000 2013 1976 1979 1972 1972 1994 2019 2028 2021 2020 2012 2012 2006 2026 71 47 115 40 85 24 22 : 7%(aging society), 14% (aged society). : 1. UN Population Division, World Population Prospect, 1998. 2.,, 2001. 15 45 41 40 40 12 10
7...,. 1) 1960., 1960 42.1 199015.4, 2000 12.9. 2000 20307.7 (< -4> ). <-4> ( : ) () 1960 1970 1980 1990 2000 2010 2020 2030 42.1 31.2 22.7 15.4 12.9 10.1 8.4 7.7 :,, 2001.
8, 19601.82.5 1990 2020 (<-5> ). <-5> () ( : ) 1960 1970 1980 1990 2000 2010 2020 2030 23.1 16.9 15.4 15.8 13.5 12.7 12.4 11.6 17.3 16.1 12.7 13.3 11.5 11.0 11.4 10.7 18.2 16.8 14.3 13.3 12.0 11.7 11.5 11.1 17.2 13.7 10.6 10.6 8.8 8.3 8.7 8.4 17.7 18.5 14.0 10.3 10.0 9.5 8.6 9.0 18.4 16.3 12.8 11.7 10.1 9.5 9.5 9.2 : UN Population Division, World Population Prospect, 1998. 2) 2000 74.9, 1960 52.4 22.5, 203081.5 (<-6> ). <-6> ( : ) 1960 1970 1980 1990 2000 2010 2020 2030 52.4 63.2 65.8 71.7 75.9 78.8 80.7 81.5 :,, 2001.
9, 1960 1518, 1990 2010 (<-7> ). <-7> ( : ) 1960 1970 1980 1990 2000 2010 2020 2030 69.9 70.9 73.9 75.3 77.1 78.4 79.5 80.5 70.6 71.7 73.4 75.6 77.6 78.7 79.7 80.7 70.3 72.0 74.2 76.6 78.5 79.5 80.4 81.4 69.7 70.9 73.2 75.4 77.5 78.7 79.6 80.6 67.9 72.2 76.2 78.9 80.2 80.9 81.7 82.6 69.8 71.6 73.8 76.1 77.9 79.1 80.0 81.0 : UN Population Division, World Population Prospect, 1998...,..
10 2..., 556060 55, 60, 65 (<-8> ). 60, 1990 2010 14%. <-8> ( : %) 1960 1970 1980 1990 2000 2010 2020 2030 65 2.9 3.1 3.8 5.1 7.2 10.7 15.1 23.1 60 5.0 5.1 6.0 7.8 11.1 15.2 22.4 30.8 55 7.5 7.7 9.0 11.5 15.4 20.8 30.4 39.0 :,, 2001.
11. 1 ( ) <-9>. 1,. 60, 1960 10.6 1, 19908.5 1, 20006.1 1 20302.1 1. <-9> 1 ( : ) 1960 1970 1980 1990 2000 2010 2020 2030 65 18.9 17.7 16.3 13.5 9.9 6.7 4.7 2.8 60 55 10.6 6.7 10.2 6.4 10.0 6.4 8.5 5.5 6.5 4.7 4.8 3.5 3.2 2.3 2.1 1.7 : 1= / :,, 2001.,. 1995 651 12.0 2 2010 2030 (<-10> ).
12 <-10> 651 ( : ) 1995 2000 2010 2020 2030 5.21 5.28 5.13 3.91 2.98 4.09 4.06 3.86 3.21 2.61 4.36 4.10 3.96 3.11 2.59 4.41 4.17 3.38 3.03 2.31 4.77 3.99 2.96 2.28 2.17 4.31 4.08 3.64 3.04 2.39 : UN Population Division, World Population Prospect, 1998..., (<-11> ) 2). 2), 45.
13 <-11> 65 (1998) 5.0 19.6 16.5 35.3 23.6 ( : %) 15 6569 7074 75+ 6.1 37.6 36.9 17.3 2.2 5.4 21.0 17.0 33.4 23.2 4.8 17.6 16.9 35.1 25.6 4.7 19.7 15.4 38.1 22.1 100.0 100.0 100.0 100.0 100.0 :,1998, 1998. <-12>. 1999 65 19 114 17%. 1999 6.8%., 014 1564, 65., 65,. 1985110.5 1995206.8 2, 1999 248.5 3.
14 <-12> ( :, %) 1985 1990 1995 1999 583,278 2,919,772 5,977,453 11,379,705 0-14 161,259 658,297 1,207,561 1,993,922 ( ) 27.7 22.5 20.2 17.5 () 91.7 88.1 86.5 80.5 15-64 394,503 2,022,294 4,041,754 7,452,536 ( ) 67.6 69.3 67.6 65.5 () 103.1 100.0 95.6 91.7 65 27,516 239,182 728,138 1,933,247 ( ) 4.7 8.2 12.2 17.0 () 110.5 160.0 206.8 248.5 : () = [ (/ )]100 :,, 1985, 1990, 1995.,, 1999.,.
15 3... 3 1970.,. <-13> 1960 5.619953.3. <-13> ( : ) 1960 1970 1980 1990 1995 5.6 5.2 4.6 3.7 3.3 :,, 1999.12. 65, 2000 44.9%, 2
16 23.9%, 3 30.8% (< -1> ). 199025.8% 3) 10 19%p. < -1> 65(2000) :, 2000 ( ), 2001. 9. 26.. 3) 199065 ; 1(8.9%), 1 (16.9%), 2 (23.4%), 3 (47.6%), 4 (2.0%), (1.2%)
17. (<-14> ),. <-14 > ( : %) 1994 62.1 33.1 7.6 8.7 1.6 11.1 37.6 0.3 1998 58.2 27.0 10.9 8.9 1.8 9.6 41.6 0.2 82.1 72.2 56.2 48.1 45.1 35.2 25.3 20.7 16.9 14.7 11.0 7.4 8.1 9.5 8.9 8.7 3.0 2.4 1.6 1.5 9.1 10.3 9.4 9.7 16.9 27.6 43.6 51.8 1.0 0.3 0.1 0.2 : 15. :,, 2000.. <-15> 1970 39.3% 200048.3%10%p, 2000 41.3%1970 5%p., 197077.9% 200074.0%3.9%p.
18 <-15> ( : %) 1970 1980 1990 1995 2000 39.3 42.8 47.0 48.3 48.3 77.9 76.4 74.0 76.5 74.0 36.5 38.2 40.8 40.4 41.3 :, KOSIS..... 1960, 19601 58.6%, 200010.9%., 2 3 1960 41.4% 2000 89.1% (<-16> ).
19 <-16> ( :, %) 1960 1970 1980 1990 2000 8,112 9,617 13,683 18,085 21,061 58.6 50.4 34.0 17.9 10.9 10.4 14.3 22.5 27.6 20.2 S O C 31.0 35.3 43.5 54.5 68.9 28.0 41.2 57.3 74.4 79.7 :,, 2000.,, 2000.. <-16> 1960 28.0% 200079.7% 10 8.. 55, 2000 11.4%10 1, 53.7% (<-17> )., 5.
20 <-17> 55(2000) ( :, %) 55 3,456 16.4 53.7 11.4 60 2,120 10.1 40.2 6.0 65 1,058 5.0 23.4 2.6 :. :, KOSIS, 15, 1, 2, (<-18> ). <-18> ( : %) 29.3 23.5 20.8 10.7 4.8 4.5 3.3 1.9 1.2 30.4 21.3 21.5 11.0 5.0 4.7 3.1 1.8 1.0 24.5 32.9 17.5 9.0 4.0 3.6 4.4 2.0 2.1 55 32.6 29.4 13.3 9.2 3.6 4.6 3.7 1.8 1.9 :,, 2000.
21.. <-19>1999 12 1970 1210, 1 323(). 19700.41999 2.5. <-19> ( : ) 1970 1980 1990 1995 1999 11,615 23,662 45,694 68,279 118,014 0.4 0.6 1.1 1.5 2.5 :,, 2000. 1999,. 5 31.4%, 51023.5%, 101519.2%, 1520 15.7%, 2010.2%. 15 199011.9% 1999 25.9%(< -2> ).
22 < - 2> (1999) :,, 2000.,.,.
23 4.. 1) 1963.,. 197771, 500 486. 1989 10,. 1998101 1. 200071. 200211.,, 3.,, (<-20> ).,,
24, 50%. <-20> (2001) ( : %) () 1.4 1.4-2.8 1.7-1.7 3.4 1.7 1.02 0.68 3.4 1.4-1.4 2.8 :,, 1998. 12...,,,. 2) ) (Co v e rag e ) / /
25. MRI,... ) ( ) 55%, 40%, 30%, 20%.,. 46% OECD (< -21> ). () (),. OECD 1221% 9.0%OECD. (19.4%).
26 <-21> O EC D (1998) GDP ( : %) 8.5 2,036 69.4 16.8 8.2 1,968 70.7 11.5 8.8 2,081 89.8 15.3 9.5 2,312 69.5 15.4 8.3 2,133 81.9 12.2 9.5 2,055 75.8 13.6 10.6 2,424 74.5 16.6 8.3 1,167 56.6 11.9 8.3 2,103 84.3 21.5 6.4 1,436 75.0 16.2 8.4 1,783 66.7 11.2 7.6 1,822 78.9 18.5 8.6 2,070 69.8 12.7 8.6 2,330 82.6 14.9 7.8 1,237 66.7 12.0 7.1 1,218 76.1 13.4 8.4 1,746 83.3 11.5 10.4 2,794 74.0 20.0 6.7 1,461 83.6 14.5 13.6 4,178 44.9 19.4 5.9 2,215 91.5 12.4 5.0 730 46.0 9.0 : OECD, OECD in Figures 2001, 2001.
27 ). (<-22> ). <-22> ( : ) 2000 2001 2002 2003 2004 16,420 20,660 25,240 29,850 35,000 :, 2001. ), 200071....
28. 1) () (). (:, ),,,.,. 2000 53,532 (10.4 %), 5,882 (8.5%)(<-23> ). <-23> (2000 ) ( :, 10, %) 14,291 5,353 10.4 1,944 588 8.5 :,, 20009.
29 2) (coverage),.., (<-24> ). <-24> (1998) ( : %) 0.59 0.38 0.13 0.24 1.01 0.11 0.16 1.29 0.40 0.15 : GNP. : CEA ECO, Health Insurance in Europe, 2000. 7..,
30.. (adverse selection) (grou p insurance) (<-25> ).. <-25> (1998) ( : %) 100 92.5 71.4 61.8 54.2 49.4 43.0 36.6 27.5 10.0 : CEA ECO, Health Insurance in Europe, 2000. 7. U.S. Bureau of Censu s, Health Insurance Coverage 1998. /,.,.
31. 1.. (long-term care), (care)., (care). / (lon g-term care). ( 180), 24...,, ) ).,, )
32 (domiciliary care home care), ) (residential / nursing homes)(residential care)., ), ), ).. ) ).,.,,,.. ), ) (voluntary organizations) ).,.
33,,,. ( ),..,,, (nursin g care), (resid ential care), (d ay care). (nursing care places).,,, 50. (residential care places). (nursing care places). (d ay care places).
34..,,.. (fu ll-tim e)(p art-tim e). 2.. (long-term care in surance)..., 6 (ADL : Activities of Daily Livin g)..
35. 1) (<-1> ). <-1> ( : ) 2000 2010 2020 797 1,749 2,545 9,000 12,000 18,000 2,300 2,600 3,300 : 1.,, 1997. 2. US General Accounting Office. 3. London Economics & IPPR. (Sw iss Re), (full-tim e),.(ippr), 30 47%, 1,000.
36, (<-1> ). 2),. (<-2> )., 1995 1/ 4, 20311/ 2. <-2> ( : 10) 1995 2001 2011 2021 2031 12.0 13.2 17.6 24.8 33.5 33.8 34.2 34.6 33.3 31.7 45.8 47.4 52.2 58.1 65.2 : London Economics & Institute of Public Policy Research
37. 3).,.., 1995 27%203161%., 199544% 202570%..,..,.,,.
38 3.. 1980 (<-3> ).. 2030. <-3> 1974 1985, 1986 1988 1989 1990 1991,, 1992,,,,,,, 1995 1996 1998,,, : Munich Re, 2001. 8.
39. 1) 1, 2020 13 4. $56,895, $124,370.. M edicaidmedicare1966. 60%, 36%, 4 %. 1974, 119 6. 12 80%. 1987199710 21%. 4% 2010 10%. (reimbursement-of-cost products), (fixed-benefit products)2.
40. 2). 199565 14 %202025% ( 16% 19% ).. 198912, N ew Gold Plan 10., 200041. 40, 50% 50%(p ay-as-you-go)(< -4> ). <-4> (50%) 40 64 : 33% 65: 17% (50%) : 25% : 12.5% : 12.5%
41.. 40 64 15, 65. 200. 1985 ( ), 1989 ( ).. 3,. Am erican Fam ily. 3) 1995.,,,. 78,300
42., 78,300. 50%, 110.92 1.7%., (30 46.73 80 516.80 ), 5. 1999 (h om e health care) 128( : 35.4 %, : 64.6%), (nursin g hom e care) 55( : 23.3%, : 76.7%). (7) (3)10., 80 43.4 %, 61.0% (<-5> ). <-5> (1999) ( : %) 059 20.8 12.6 6079 35.8 26.3 80 + 43.4 61.0 : Munich Re, 2001. 8.
43. 10 1985, + + 9. 1992 19997., 1999 57. 4) 1997PSD (Prestation Sp écifiqu e Dép end ance)60.. 1985 65. 46% (group insurance)., ) (stan d-alone), ), ), ) 4. ( ),. ( )2000 AXA.
44 5) 1993 Com m unity Care Act.,. 1989 35.,. (p re-fund ed) (p oint of need)..,. 6) 198865. (home care). 1989, 50%.
45.,. <-6> LTC - 1966 - MedicaidMedicare - 1974 - Reimbursement/ - 119 580 indemnity policies (1996.6.30) - 21%(1987-1997) - 12 80% - 20004-1985( ), 1989 -,, LTC - 40 ( ) ( ) - 192 - ( ) - 1995 - - Daily cash 1 (1985); LTC allowance, - Reimbursement of (9,000 ) costs 2 (1992); LTC (69,800 ) - 1997 (PSD) - - (570,000 ) 1 (1985); / 2 (1994); LTC - 1985-650,000 - - Annuity with inflation protection - 1993-1989 - Pre-funded plans (Community Care Act) - 35,000 - Impaired life - - ; point-of-need, pre-funded annuities - 1988-1989 - LTC ( ) - - 50% ( )
46. 1.., ( ),. ( 13 ) ()(< -1> ). <-1> 200, (80 ),, (40) 2000, 10 :, 2001. 9.
47,. ( ), 180 90.., ), ), )...,..,.
48.,..,..,... 2.. 1) 20016 (100), (28) (9 ) 137. 102( 77
49 25) (<-2> ). <-2> (2001) 77 65 13 10, 25 3 9 : (nursin g care hom e)18, (residential care hom e)55 2, 578 (1999 ), 568 (1996 ).. (< -3> )..
50 <-3> ( : ) 517 105 412 1,015 97 918 625 36 589 : 1998. 20013. :,,, 1998. 10. 2) ).,.,,. (h om e care).,.
51. (form al care),.., 4).. )..,. (com m u nity),. 4) 1.5.
52 ).. 80%.. 1) 20. 120,....
53... 2) )...., (reform ing).,.,. 15%
54 (<-4> ) 7.1%. <-4> 1966 9.6% 1993 15.8% 1995 15.7% 1997 15.2% 2000 17.1% : UN Population Division, World Population Prospect, 1998. Munich Re, LTCI International Situation. 2001. (social w elfare), (social in surance)..,.
55 ).,. ( 50% ),.,,.,.,. 10...,
56... (data-base).
57. 1. (LTC in surance product),,.,,,,...,,,,,..,.
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 ).,..
59, ADL 2 50%, 3 100%.,... (deferred p aym ent p eriod), 3. 3(: 6 ). 180( 90 ). 3.,.., ( 10)
60.. 2) (Rid e r to Othe r Po lic ie s ). (w h ole life p olicies)., (accelerated benefits).,.,.. /. /, ADL. (60 65) /.
61. /...., ( ).., (),.. (tax benefits).
62. (Imme d iate Care Annuitie s ).., (). 60, 90100. (,, )....,.
63. 30,....,.. 5).. (Pe ns io n Linke d Pro d ucts ) (p ension ben efits) (long-term care benefits).,. ADL 100%., 5).
64.,. ( ).,.. (Ho me Care Only Pro ducts ). (nursin g h om e) (nu rsing h om e ),..,., ( )..
65 2..,,,.. (Targ e t Co ns ume r) (60 65 )..,,. 1),,,,,.. 23
66..,.,.,,. 2)..,.,,..,
67.,..., ( ).,.,.,,.,.,...,.
68 AXA., 24,,. AXA. Allianz 2,..,,,,. (ADL 4)(ADL 2) (ADL 3 4). 90. (lim it).
69.,.,..,., ), ), ), ). FA (Financial Advisors).,, /,..,,.
70.. (d ay care center)..,..,,..,, (claim m anagem ent).,.
71. 2000 7%..,.,,...,..,.,.
72 < >,, 1999,, 1998. 12.,Health Care Business, 2000-02,, 2000. 1,, 97-02,, 1997. 12,,, 32,, 1999. 5.,, 1985, 1990, 1995.,,, 25,, 1998. 10.,1998, 98-04,, 1998. 12,, 2001.,, 1999. 12.,, 2000.,, 2000.,, 2000.,, 2000.,2000 ( ), 2001. 9.
73 Allianz Group, Long Term Care Insurance in Germany, 2001. CEA ECO, Health Insurance in Europe 1998 Data, July 2000 Crosby, Long-Term Care Insurance... the complete guide, 1996. D avid Du llaw ay & Su san Elliott, Long-Term Care Insurance, A Guide to Product Design & Pricing, 1988. Edw ard Rich ar d s, "P ayin g for Lon g-term Car e", Institute for Public Policy Research, 1995 & 1996. Laing & Buisson, Care of Elderly People M arket Survey 1995-1996, 1996. Mu nich Re, Long Term Care Insurance, July 2001., LTCI International Situation, 2001. O ECD, OECD in Figures 2001, 2001. PPP lifetim e care, A world-wide review f or long term care, 1995. Sw iss Re U K, Long Term Care Insurance Underwriting Guidelines, 1996., Long Term Care Data Pack, 1998. U.N. Population Division, W orld Population Prospect, 1998. U.S. Bureau of Censu s, Health Insurance Coverage 1998.