Long‐Term Care Insurance Adoption in East Asia: Politics, Ideas, and Institutions

Abstract

Since the 1990s, Japan, South Korea, and Taiwan have adopted long‐term care social insurance (LTCI) systems to face the growing “aging crisis” in their countries. The comparative scholarship suggests the diffusion of the Japanese model among East Asian states. Bridging policy learning, agenda setting, and historical institutionalist approaches, this study comparatively examines how ideational and institutional processes have impacted political competition and ultimately the adoption of LTCIs in Japan, South Korea, and Taiwan. I argue that each country's LTCI design differs greatly from one another, displaying distinctive forms of institutional bricolage—not institutional isomorphism. In this process, time has been a crucial factor. Time affects ideational, institutional, and political processes differently. The relative weight of ideational and institutional processes at a particular moment in time and their evolution over time has a significant impact on whether policy change occurs, and whether this change may gradually undermine the logic of welfare regimes. Related Articles Butz, Adam M., Michael P. Fix, and Joshua L. Mitchell. 2015. “Policy Learning and the Diffusion of Stand‐Your‐Ground Laws.” Politics & Policy 43 (3): 347‐377. ://doi.org/10.1111/polp.12116 Cho, Sungik, and Yool Choi. 2017. “Convergent or Divergent? The Hidden Dynamics of Institutional Changes in the Labor Markets and Social Welfare Systems in South Korea and Japan.” Politics & Policy 45 (4): 594‐625. ://doi.org/10.1111/polp.12208 Maags, Christina, and Ioan Trifu. 2019. “When East Meets West: International Change and its Effects on Domestic Cultural Institutions.” Politics & Policy 47 (2): 326‐380. ://doi.org/10.1111/polp.12296

The “Isms” of Regional Integration: What Do Underlying Interstate Preferences Hold for the ECOWAS Union?

“…We assume that ideational and institutional processes impact upon regional governance at different points in time. Furthermore, “institutional forces create major constraints and opportunities that affect both the behaviour of actors and the diffusion of their ideas, it is the dynamic interaction between ideational, political, and institutional processes that determines policy change and, by extension, policy outcomes” (Maags 2020, 75).…”

“…As a starting point, we reflect upon realism, neoliberalism, intergovernmentalism, institutionalism, and intergovernmentalism in regionalism connected to the “isms” alluded to in the title of this article. We examine the interplay of regional integration and political processes—particularly regarding the timing and sequence of events—to understand how these processes result in diverging patterns of policy change (Maags 2020).…”

“…Historical institutionalism, agenda setting, and policy learning approaches present different perspectives (Maags 2020). A prominent approach has been utilized to understand the mechanism of radical policy changes over the past years of ECOWAS' existence.…”

Introduction of Long-Term Care Systems: The Nascent Diffusion of an Emergent Field of Social Policy

“…Nevertheless, we can see that over the past three decades in particular, debates, policy proposals, and reforms dealing with social protection for LTC dependency have picked up in many states as well as in international and transnational exchange. For instance, specific social LTC insurance schemes have been established in countries such as Israel, Germany, Luxembourg, Japan, and South Korea (Schmidt 2005;Companje 2014, 102;Maags 2020). In Latin America, Uruguay recently introduced a National System of Care, and similar proposals are being discussed elsewhere in the region (Matus-Lopez and Cid Pedraza 2016;Esquivel 2017).…”

Note from the Editor

“…Amanda L. Beal Krause examines how regime type affects different types of social expenditure for the elderly in "The Aged Population and Social Spending in Latin America: Comparing the Demographic Functionalist Theories and Political Pressure Arguments." The article forms a great comparative complement to former articles in this journal on institutional change and social welfare in South Korea and Japan (Cho and Choi 2017), Mexico (Montes de Oca Barrera 2019), and East Asia (Maags 2020). Turning to a critical sector for economic development in the region, Peter R. Kingstone and Aldo F. Ponce focus on how variations in key institutional traits of the executive and legislative branches affect "Investment in the Latin American Telecommunications Sector: Assessing the Role of Political Institutions."…”