From Socially Weak to Potential Consumer: Changing Discourses on Elder Status in South Korea

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From Socially Weak to Potential Consumer: Changing Discourses on Elder Status in South Korea Powered By Docstoc
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This article explores social and political dimensions associ-           problem,” or ro jin mondai in Japanese (Traphagan, 2000).1 Indeed,
                                                                                        ¯
ated with providing care for elders in South Korea. We look at          over the past 10 years, a discourse on aging has developed in Korea
changes in welfare policy since the 1980s and discuss the emer-         in which interest groups related to supporting elder rights and
gence of a long-term care insurance program in Korea similar            professional groups focused on coping with social issues associated
to the program promulgated in Japan in 2000. We argue that              with population aging have become increasingly evident.2
while the status of South Korean elderly is undergoing change               The changes in the public discourse on aging in Korea are
as new policies provide opportunities for elders to move from           closely related to the rapid increase in the population of persons
positions of dependency to increased independence as consum-            over the age of 65. The total distribution rate of the old increased
ers of health care services, there are some reasons for concern.        dramatically, from 3.8% to 7.2%, in the 20 years leading up to
The capacity of elders to function as consumers remains tied to         2000 (see Table 1). This, in turn, has forced a corresponding
the fact family members or elders themselves must pay supple-           increase in the need for government programs for the elderly (and
ments to their health insurance premiums as well as significant          in increase in their associated costs). Much like other countries in
co-payments for services rendered, and government policies              Asia (and elsewhere), Korea has been experiencing a combination
retain a strong bias toward requiring in-home, family-centered          of increased life expectancy and a declining birthrate. Figure 1
care of frail and bedfast elders.                                       shows the decline over the past 30 years from a total fertility rate
                                                                        (TFR) of 4.53 in 1970 to 1.08 in 2005 with a slight increase to
                                                                        1.13 in 2006. This low TFR, when combined with increasing
Keywords: South Korea; elder care; government policy; politics;
                                                                        longevity due to dramatically improved health care (see Figure 2),
long-term care
                                                                        has put South Korea in a situation similar to other recently indus-
                                                                        trialized societies in which there has been a very rapid process of
                                                                        population aging (see Table 2).
                                                                            As a result of these demographic trends, the South Korean gov-
                                                                        ernment has needed to develop strict policies very quickly for con-
                                                                        trolling expenses associated with population aging. At the center
From Socially Weak to                                                   of this has been the creation of a long-term-care insurance pro-
                                                                        gram (LTCI) similar to what has been operating in Japan since
Potential Consumer:                                                     2000 (see Traphagan & Nagasawa, 2008). The creation of this
                                                                        program began when Korean policymakers established a long-

Changing Discourses                                                     term-care initiative committee that included experts from various
                                                                        fields in 2003. This process has led to the creation of a categoriza-
                                                                        tion system for the elderly based on a combination of long-term-
on Elder Status in                                                      care needs that are intended to be determined apart from income
                                                                        or family situation.
South Korea
                                                                              THE 1981 WELFARE LAW FOR THE AGED
Heekyoung Kim, MA                                                       While the new LTCI program is the most recent outcome of
                                                                        Korean policies related to health and aging of the population, it is
John W. Traphagan, PhD
                                                                        the result of a long process of adjustments that have involved 18
                                                                        revisions since the promulgation of the Welfare Law for the Aged
                                                                        in 1981, which originally was quite limited in scope. For example,


T
         his article investigates the social and political dimensions   th
				
DOCUMENT INFO
Description: This article explores social and political dimensions associated with providing care for elders in South Korea. We look at changes in welfare policy since the 1980s and discuss the emergence ofa long-term care insurance program in Korea similar to the program promulgated in Japan in 2000. We argue that while the status of South Korean elderly is undergoing change as new policies provide opportunities for elders to move from positions of dependency to increased independence as consumers of health care services, there are some reasons for concern. The capacity of elders to function as consumers remains tied to the fact family members or elders themselves must pay supplements to their health insurance premiums as well as significant co-payments for services rendered and government policies retain a strong bias toward requiring in-home, family-centered care of frail and bedfast elders.
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