经济学人下载:护理保险 前景光明

Care insurance
护理保险

Forever young
前景光明

Nobody wants to insure themselves against the cost of end-of-life care
没有人能保证他们不需要生命终期护理

GOOD news for cruise ships: the ranks of the over-65s grew by 1.4m over the past decade. But old age will not be kind to all of them. One in three will develop dementia, around one in six will end up in a nursing or care home and nearly half will need some form of care. Few will have laid plans to pay for it.
游轮迎来好消息啦：过去十年间65岁以上人群增加了140万人次。但如此高龄的年纪却并不会善待每一位老人。其中有1/3的人会患老年痴呆，1/6的老人会在护理之家或是在护理中心走完人生的最后一程，而且有近一半的老人需要各种形式的护理。但几乎没人会为护理制定支付计划。

The average stay in a nursing home lasts 17 months and costs 57,000 (85,000) according to the Centre for Economics and Business Research, a think-tank. People with assets under 23,250 get most of their residential care paid for but everyone else is more-or-less on their own, with the unluckiest facing bills as high as 200,000. Ever-attuned to the plight of elderly voters, the government is moving to change that. Next year it will put a cap of 72,000 on the sum that a person will have to pay towards care, and will raise the means-testing threshold from 23,250 to 118,000.
据一智囊团——英国经济和商业研究中心称，在护理之家平均停留时间长达17个月，花费达57000欧元（合85000美金）。当不幸的面对高达20万欧元的护理费用之时，资产总值不足23250欧元的人会免付家庭护理，但其他人或多或少都要自己支付了。曾面对过老龄选民的费用困境，所以政府正在努力做改变。明年，政府将出台一项政策，没人必须支付的护理费用总值最高为72000欧元，并且会将资产评估的阀值从23250欧元提升至118000欧元。

The government had hoped that this reform would not just soothe elderly nerves but also stimulate an insurance market for end-of-life care. Unfortunately, that is not happening.
政府希望此项改革能够舒缓老年人的神经并且以生命终期护理来刺激保险市场。可惜，现实太过骨感。

Many people continue to assume, wrongly, that the NHS will pay, says Yvonne Braun from the Association of British Insurers. And most are overly optimistic about their health in old age, underestimating the risks and costs they will suffer. Joan Costa-Font, from the London School of Economics, adds that the idea of care insurance seems to conflict with social values. A kind of familial moral hazard kicks in, as people fear their children will no longer look after them if they are insured.
来自英国保险协会的伊冯布劳恩表示，与政府期望恰恰相反，有很多人仍在持续为本应NHS（英国国民健康保险制度）承担的费用来买单。而且很大一部分人低估了他们将会承担的风险和费用，所以他们对自己晚年健康表现的过度乐观。来自伦敦经济学院的 Joan Costa-Font补充道，护理保险这一说法似乎与社会价值观存在冲突。随着很多人担忧若是他们投保之后他们的子女会将自己弃之不顾，一种类似家庭性的道德危机开始蔓延。

Care costs are so hard to predict that insurers tend to protect themselves with big premiums, making insurance unaffordable. The government's new cap, which was supposed to sort this out, comes with alarming caveats. It does not include the cost of bed and board, which makes up a large chunk of care home costs. It is also up to local authorities to determine which care counts towards the cap, meaning people may end up spending more after all. And the cap is higher than the 25,000-50,000 recommended to the government by Andrew Dilnot, an economist who reviewed the market.
护理费用的难以预测，也使得保险公司采取抬高保险费用来保护自己，而这些费用总是昂贵的难以承受。政府最新出台的带有强烈警示意味条例的上限要求，目的就是解决这一问题。保险费用并不包括食宿花费，而这正是护理中心花费的一大部分。同样，地方当局决定那一项会触及政府的上限，这意味着人们终将结束过度支付的境况。一位名为安德鲁迪尔洛特的经济学家，在重新审视过市场之后，向政府建议，上限要求高于25000欧元-50000欧元。

According to the Institute and Faculty of Actuaries, the real maximum of self-funded costs might be around 140,000. “Like the rest of the industry, we couldn't make it pay,” says Stephen Lowe from Age UK, a charity that also sells insurance.
据英国精算师协会表示，真实的自费费用最大值应该是在140000欧元左右。来自老年英国——英国老年人慈善机构—的史蒂芬洛表示，“像其他老年人福利一样，我们本不用为此买单。”

If a care insurance market fails to materialise, alternatives will be available. Worried middle-aged folk might take out immediate-needs annuities, which give fixed care payouts for life in return for a lump sum. Some insurers are starting to offer a care element as part of their life-insurance policies. Zurich Insurance, one of Britain's largest insurers, looked into offering care-only insurance but found that people much prefer a guaranteed payout over the “risk” of not needing care and losing their premiums altogether. From next month it will offer a new policy that allows people to withdraw a portion of their life insurance, which normally only pays out at death, as soon as they need care.
若是一个护理保险市场无法成功立足，那么就会有其他的可供选择。令人担忧这些中年人很可能会拿出他们眼前急需的养老金，而这笔养老金的一大部分是要为他们一生中固定的保健支出来买单的。部分保险公司开始在他们的人寿保险政策中开辟出护理的部分。全英最大的保险公司之一的苏黎世保险公司，曾致力于提供专门的护理保险，但其随后发现，人们更倾向于无须护理保险和丢失保险金的“风险”保证费用。自下月起，该保险公司会运行新政策，一旦人们需要护理，允许他们撤回其人寿保险的一部分，这一部分通常是为死亡支付的费用。

From next month much will change for retirees, as the government drops the requirement to buy annuities with private pension pots. The government hopes that people will use the new flexibility to plan for their old age, including the possibility that their final years will be spent in a nursing home rather than on the Costa del Sol. But Richard Sadler from Zurich points out that most people do not even save enough for retirement—something they are fairly certain will happen and even look forward to. It is less likely they will save for long-term care, which they think and hope they will never need.

从下月开始，随着政府降低对私人养老金年金的购买要求，针对退休人员的很多政策会有所变化。政府希望人们利用新政策的灵活性来为自己晚年做出计划，包括在他们晚年可能要给一家护理中心付费而不是为西班牙的阳光海岸买单。但是来自苏黎世保险公司的理查德萨德勒却指出，有很多人甚至并未为退休攒足资金——只应付得了他们完全预料甚至期待的事情。对于那些他们认为并希望永不需要的长期护理费用来说，他们所能积攒的远远不够。