Cash‐Out Puzzle and Long‐Term Care Insurance: Welfare of the Elderly
利用中国纵向健康长寿调查数据，研究长期护理保险中实物支付与现金支付对老年人福利的不同影响，发现实物支付显著降低一年内死亡率并改善健康，而现金支付效果不显著，形成“现金支付谜题”。
This study investigates the effects of diverse payment methods within long-term care insurance (LTCI) on the well-being of elderly individuals, encompassing both in-kind and cash payments. Utilizing panel data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we leverage a generalized difference-in-differences (DID) approach and the LTCI pilots across various Chinese cities to identify the impacts of different LTCI payment methods. Our findings indicate that an in-kind LTCI policy significantly decreases the one-year mortality of older adults, with significant improvements on ADL-related care receipt as well as health status. Conversely, no significant impacts are observed under the framework of a cash LTCI policy. We term the weaker effects regarding older adults in cash LTCI policy versus in-kind LTCI policy as "the cash-out puzzle". Our findings emphasize the critical importance of developing right incentives of LTCI payment schemes thoughtfully worldwide.