Long-term care financing: how countries finance long-term care

Many LMICs do not have formal LTC systems. In these settings, the demand for care exists, but the costs of accessing needed care are shifted to families and communities. Pressures on the economy may result when family caregivers must reduce their participation in the labour force. Alternatives to private out-of-pocket spending include insurance premiums and general taxation. Mandatory insurance contributions funded mostly or partly by payroll contributions from employers or employees are a stable source of LTC funding in high-income settings; however, the reliance on payroll contributions for insurance schemes requires a high level of participation in the formal workforce and may be unsustainable in LMICs where the informal workforce is large.