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Context: Financing long-term services and supports (LTSS) for the elderly is a pressing issue in the United States with reforms of long-term care insurance (LTCI) presently being explored. Singapore, with 65% of residents aged 40 to 83 covered by basic LTCI, including 22% with supplementary LTCI plans, has the highest voluntary LTCI rate in the world. This article contributes to the discourse by presenting the case of LTSS financing in Singapore. Methods: We first reviewed Singapore's LTSS policies through a comprehensive search of academic papers, governmental reports, parliamentary debate transcripts, print media, and official websites of LTSS providers. We then estimated the LTSS financing mix, conducted an in-depth analysis of the main policies, and illustrated the financial protection they procure for the elderly using realistic hypothetical scenarios. Findings: The main principles governing Singapore's LTSS policies are shared responsibility for long-term care financing, targeted assistance for the poor, centralized governance and administration, separation from other income and housing policies, and limited intergenerational cross-subsidizing. We estimate the financing mix to consist of out-of-pocket spending (40%), government spending (42%), long-term care insurance (9%), and charitable donations (9%). Assuming a monthly LTSS bill of US$1,545 to US$2,575, between 11% and 19% of LTSS expense is offset by LTCI for severely disabled individuals with basic coverage. Overall, 63% of care recipients are eligible for public subsidies that amount to 20% to 80% of their expenses. Conclusions: The high take-up of voluntary LTCI in Singapore is explained by the high prevalence of plans offering partial coverage, medical underwriting, early automatic enrollment, direct debit of insurance premiums, and defined cash benefits. We recommend setting the coverage of voluntary long-term care insurance plans at levels that maximize the population's total contribution by striking the right balance between coverage adequacy and take-up rate while targeting subsidies to low-income individuals.

In 2012, China issued the “Green Credit Guidelines” policy to guide the green transformation of companies, and at the same time, the investment and financing behaviors of heavy polluters during the green transition have received widespread attention. In the view of the investment and financing maturity structure, we take China’s A-share listed enterprises from 2009 to 2021 assamples, and construct a difference-in-differences (DID) model to examine the implication of the green credit policy on the short-term financing for long-term investment (SFLI) of heavy polluters. We found that: (1) green credit policy can reduce the level of SFLI of heavy polluters; (2) the size of short-term debt and the level of over-investment can play a mediating effect, and government subsidies can weaken the relationship between green credit policy and SFLI; (3) this effect is more significant when directors, supervisors, or senior executives have a financial institution background. (4) this effect is not significant in enterprises with bank-firm shareholding relationships and a stronger innovation intensity; (5) the effect is more significant in areas with stronger environmental regulations. This paper argues that heavily polluting enterprises should reduce short-term debt financing and over-investment, so, to solve the problem of investment and financing term mismatch under the credit risk; banks should prevent the credit rent-seeking problem caused by the equity association between banks and enterprises, and promote the consistency of green credit standards. The government can provide subsidies to enterprises in green transformation and strengthen the construction of regional environmental regulations in order to guide the smooth innovation and upgrading of heavy polluters. Our research expands the study of the micro-economic consequences of green credit policy, providing references for how to reduce maturity mismatch risk and guide the smooth transformation of heavy polluters from the multi-perspective of the government, banks, and enterprises, thus helping to promote companies’ smooth transit.

Based on the perspective of investment and financing term structure, this study verifies that local government debt crowds out bank loans available to corporates, resulting in corporate maturity mismatch between investment and financing, namely, short-term financing for long-term investment. According to our heterogeneity analyses, the real impact of local government debt on maturity mismatch between investment and financing is more pronounced for non-state-owned enterprises and firms with high financing demand, located in cities with more local government debt and low financial development. Furthermore, our study reveals that local government debt and corporate maturity mismatch between investment and financing bring about underinvestment and default risk, which ultimately affects local sustainable economic development. This research contributes to the literature on Chinese-specific maturity mismatches.

A rapid ageing population coupled with changes in family structure has brought about profound implications to social policy in China. Although the past decade has seen a steady increase in public funding to long-term care (LTC), the narrow financing base and vast population have created significant unmet demand, calling for reforms in financing. This paper focuses on the financing of institutional LTC care by examining new models that have emerged from local policy experiments against two policy goals: equity and efficiency. Three emerging models are explored: Social Health Insurance (SHI) in Shanghai, LTC Nursing Insurance (LTCNI) in Qingdao andameans-testedmodelinNanjing. Afocusedsystematic narrative review of academic and grey literature is conducted to identify and assess these models, supplemented with qualitative interviews with government officials from relevant departments, care home staff and service users. This paper argues that, although SHI appears to be a convenient solution to fund LTC, this model has led to systematic bias in affordable access among participants of different insurance schemes, and has created a powerful incentive for the over-provision of unnecessary services. The means-tested method has been remarkably constrained by narrow eligibility and insufficiency of funding resources. The LTCNI model is by far the most desirable policy option among the three studied here, but the narrow definition of eligibility has substantively excluded a large proportion of elders in need from access to care, which needs to be addressed in future reforms. This paper proposes three lines of LTC financing reforms for policy-makers: (1) the establishment of a prepaid financing mechanism pooled specifically for LTC costs; (2) the incorporation of more stringent eligibility rules and needs assessment; and (3) reforming the dominant fee-for-service methods in paying LTC service providers. Le vieillissement rapide de la population associé à des mutations de la structure familiale a entraîné de profondes implications pour la politique sociale en Chine. Bien qu’on ait été témoins d’une augmentation constante du financement public des soins de longue durée (SLD) au cours de la dernière décennie, l’étroite base de financement et l’immense population ont créé une demande non satisfaite, appelant à des réformes dans le financement. Le présent document met l’accent sur le financement institutionnel des soins SLD en examinant de nouveaux modèles qui ont émergé des expériences politiques locales visant à atteindre deux objectifs stratégiques: l’équité et l’efficacité. Trois nouveaux modèles sont explorés: l’assurance sociale de la santé (SHI) à Shanghai, LTC Nursing Assurance (ASLD) à Qingdao et un modèle fondé sur l’examen du revenu à Nanjing. Une revue narrative systématique ciblée de la littérature académique et grise est effectuée pour identifier et évaluer ces modèles; elle est complétée par des entretiens qualitatifs avec des fonctionnaires des services compétents, le personnel et les utilisateurs des foyers de soins. Ce document soutient que, même si l’assurance sociale SHI semble être une solution pratique pour financer les soins SLD, ce modèle a entraîné une distorsion systématique de l’accessibilité pour les adhérents des différents régimes d’assurance, et a créé une puissante incitation à solliciter davantage de services inutiles. La méthode fondée sur l’examen des revenus a été nettement limitée par le rétrécissement des critères d’admissibilité et l’insuffisance des financements. Le modèle LTCNI est de loin l’option politique la plus souhaitable parmi les trois étudiées ici, mais la définition étroite des critères d’admissibilité a pratiquement exclu une grande proportion de personnes âgées désireuses d’avoir accès aux soins; cet écueil doit être surmonté dans les futures réformes. Le document propose trois lignes de réformes du financement des SLD pour les décideurs politiques: 1) la mise en place d’un mécanisme de financement prépayé mis en commun spécifiquement pour les frais des SLD; 2) l’évaluation de l’incorporation de critères d’admissibilité plus stricts; et 3) la réforme des méthodes prédominantes actuelles de paiement des prestataires de services SLD à l’acte. Un rápido envejecimiento de la población, junto con cambios en la estructura familiar ha provocado profundas implicaciones en la política social en China. Aunque la última década ha visto un aumento constante de fondos públicos para el cuidado a largo plazo (CLP), la base escasa de financiación y la enorme población han creado una demanda no atendida, pidiendo reformas en la financiación. Este documento se centra en la financiación del CLP institucional mediante la examinación de nuevos modelos que han surgido a partir de experimentos locales de política contra dos objetivos de la política: equidad y eficiencia. Tres modelos emergentes son explorados: Seguro Social de Salud (SSS) en Shanghái, Seguro de Enfermería del CLP (SECLP) en Qingdao y un modelo con comprobación por ingresos en Nanjing. Una revisión sistemática enfocada de la narrativa de la literatura académica y gris se llevó a cabo para identificar y evaluar estos modelos, complementada con entrevistas cualitativas con funcionarios del gobierno de los departamentos relevantes, personal del cuidado doméstico y de los usuarios de los servicios. Este artículo sostiene que, a pesar de que el SSS parece ser una solución conveniente para financiar el CLP, este modelo ha dado lugar a un sesgo sistemático en el acceso asequible entre los participantes de los diferentes sistemas de seguros, y ha creado un poderoso incentivo para la sobre-provisión de servicios innecesarios. El método con comprobación por ingresos ha sido muy limitado por la escasa elegibilidad y la insuficiencia de recursos financieros. El modelo SECLP es definitivamente la opción política más deseable entre los tres estudiados aquí, pero la angosta definición de la elegibilidad ha excluido sustancialmente a una gran proporción de ancianos con necesidad de acceso al cuidado, lo cual debe ser abordado en futuras reformas. Este artículo propone tres líneas de reformas de la financiación del CLP para los formuladores de política: (1) el establecimiento de un mecanismo de financiación de prepago agrupado específicamente para los costos del CLP; (2) la incorporación de normas más rigurosas de elegibilidad y la evaluación de las necesidades; y (3) la reforma de los métodos dominantes de cuota-porservicio en el pago de proveedores de servicios de CLP. 人口急速老龄化和家庭结构变化给中国的社会政策带来了深 远影响。虽然过去十年投入长期照护(LTC) 的公共资金持续 增长, 但资金基础和人口之间的差距导致很多需求不能满足, 需要在筹资方面进行改革。本研究关注长期机构照护的资金 支持, 根据公平和效率这两个政策目标评估地方政策实验中产 生的筹资新模式。共讨论 3 个新兴模式:上海的社会医疗保险 (SHI), 青岛的长期护理保险(LTCNI) 和南京以经济状况调查 为基础的模式。为明确和评估上述模式, 我们对学术文献和灰 色文献进行了系统叙述性综述, 同时对相关部门的政府官员、 养老院工作人员和服务使用者进行定性访谈。作者认为, 虽然 SHI看似是解决长期照护筹资问题的便捷方法, 但该模式导致 不同保险的参保人员在负担能力方面出现了系统差异, 并且强 烈地刺激了非必要服务的供给。以经济状况调查为基础的模 式由于控制适用资格和资金不足, 受到很多制约。在这三种模 式中, LTCNI模式是目前为止最理想的, 但适用资格较为严格, 排除了一大部分需要长期照护服务的老年人, 未来改革需要解 决这一问题。作者建议政策制定者从三方面改革LTC筹资: (1) 建立预付集合筹资机制, 专门用于LTC支出; (2) 采用更加严格 的适用资格和需求评估; (3) 改革目前LTC服务提供方普遍采 用的按项目收费方式。

Policymakers around the world have created several schemes to support financially constrained SMEs. However, whether these mechanisms improve the access to external sources of finance or on the contrary crowd out private players remains a relevant question. In this paper, we study the effectiveness of a recent form of government support, called participative loan, in improving recipient SMEs' access to external financial debt. Relying on the literature about the certification effect, we develop hypotheses on the conditions under which the improvement is stronger. The empirical analysis is based on a sample of 488 Spanish SMEs that received participative loans from a Spanish government agency and a control group of 719 matched twins. We show that the former register a significantly higher external financial debt (+31.5%). The effect is stronger for smaller firms, or for those operating in hightechnology sectors, which suffer more acutely from information asymmetries, and negligible for firms that already received a support from another governmentsupported institution. After ruling out alternative explanations, we interpret this result as a positive evidence of government certification of SMEs towards banks.

ABSTRACT Context: in Brazil, there was an expansion of private funding via bond issuances, especially since 2017. Before that period, the sources of long-term financing were concentrated on public funding. Objective: this study aims to explore the main factors that could have positively affect Brazilian bond market and if it would be possible to improve project financing through this debt instruments. Methods: using mixed methods with econometric tests and qualitative interview analysis, this study assesses which were the factors that supported this growth and if there is any difference across industries. Results: we found that a change in the market trend has indeed happened around 2017, and it was more pronounced in specific industries such as electricity. Interviewees suggested that increases in demand (possibly triggered by the reduction of public sources of funding and the fall in local interest rates) could be the main factors that supported this change in trend. Conclusions: therefore, this study reinforces the importance of local market conditions and government policies affecting the relative attractiveness of private versus public sources of corporate investment. RESUMO Contexto: houve no Brasil uma expansão de captações privadas via debêntures, especialmente a partir de 2017. Antes disso, as fontes de financiamento de longo prazo se concentravam na captação via recursos estatais. Objetivo: o estudo examina as possíveis razões dessa expansão e como ela poderia sugerir uma nova tendência de financiar uma maior parcela de projetos de infraestrutura com capital privado. Métodos: por meio de uma abordagem de pesquisa mista, envolvendo testes econométricos de quebra estrutural em séries temporais e análises qualitativas de entrevistas com profissionais do mercado financeiro. Resultados: foi confirmado que houve uma mudança na tendência de emissão de debêntures a partir de 2017, mais pronunciada em alguns setores específicos, como o elétrico. Utilizando entrevistas, sugerimos que os fatores determinantes estão relacionados ao crescimento da demanda por esses títulos de dívida e à redução nas taxas de juros no Brasil. Conclusões: assim, o estudo reforça a ideia da importância das condições do mercado local e das políticas governamentais e seu efeito na atratividade relativa entre o capital privado e o capital público no financiamento corporativo.

This study aims to examine the characteristics of long-term care (LTC) financing in Organization for Economic Cooperation Development (OECD) countries. To this end, the 26 OECD countries that have introduced LTC systems were classified into three types of models: tax-based, health insurance, and LTC insurance (LTCI) systems. Thereafter, these systems were analyzed using Gilbert and Terrell’s policy analysis framework. The results indicated differences in the characteristics of each type of financing in terms of allocation, benefit provision, service delivery, and finance. It is likely that while the LTC insurance model was mainly based on universalism and showed the highest level of coverage, the tax-based and health insurance models adopted selectivism with lower level of benefits per capita. In terms of service delivery, local authorities tended to have the responsibility to decide LTC service users and provide services in many countries, regardless of the type of model. In terms of finance, LTC insurance-based countries had the highest LTC expenditure as a percentage of GDP, followed by countries with tax-based and health insurance systems.

Insurance can provide a way to plan for and finance the risk of needing paid long-term-care (LTC) services. Effective use of insurance can play a crucial role in mitigating risk for individuals, which in turn can facilitate economic growth on a larger scale. But the total number of private LTC insurance policies in effect in the United States remains small. The need to insure against LTC risk remains; this article lays out ways in which the public and private markets could work together to offer insurance coverage.

Little is known about the factors important in explaining the demand for long-term care (LTC) insurance benefits in the context of universal public coverage. In this paper, we utilize data from the 2014-2018 Korean Longitudinal Study of Aging to examine who applies for LTC service benefits in South Korea’s LTC social insurance system. Subjects are community-dwelling adults aged 60 and above. Our research design considers multiple dimensions of health, including physical health, cognitive health, as well as mental health. We also examine whether people’s expectations of receiving care in the future differ depending on their mental well-being. We find that all three dimensions of health are germane to formal LTC demand: specifically, the presence of functional limitations, depressive symptoms, and moderate-severe cognitive impairment are all independently and positively associated with the outcome. Also, those who apply for benefits tend to have greater trust in the scheme administrator and expect care from hired help. Older Koreans who anticipate receiving informal care from a family member are less likely to apply for formal LTC. Notably, this negative association is driven by people’s expectation of spousal care rather than expectation of care from a child or grandchild. We find suggestive evidence that the effects of spousal care expectation on accessing formal LTC services are most pertinent for older persons who are depressed. Policymakers should take into account the various dimensions of older adults’ health status and recognize their heterogeneity in care expectations in estimating future demand for benefit claims in public LTC schemes.