KWDI Korean Women’s Development Institute

2017 KWDI Abstract

 

A Study for the Re-establishment of Sustainable Care Policy

 

Eun-Ji Kim

So-Young Kim

Bo-Young Sun

Kyung Sung

Nan-joo Yang

Su-Jeong Kim

Hye-Young Kim

 

The impending crisis of the low fertility and aging population was addressed and heralded about ten years ago, and the care policy has been expanded in the Korean society for the past decade as a countermeasure. However, each of the care policy-related policies was developed within its area, resulting in confusion over policy objectives and absence of future directions for supporting ‘care’ of families as a ‘care policy.’ The objective of this study is not to establish goals of individual policies, but to examine the current status of the Korean ‘families’ and ‘family policy’ from a sustainability perspective, to investigate the extent to which care can become socialized and public goods, and to suggest future directions for the ‘package’ of care policy.

 

This study defines ‘sustainable care policy’ as ‘a policy system designed to continuously provide secure and sufficient care support,’ and also defines sustainability from the following three perspectives. The first perspective is established with service users’ standpoints regarding whether the users are provided with sustainable high-quality services. The second perspective is developed with the standpoint of service providers (service providing organizations and service workers) in terms of whether high quality services can be provided sustainably. The third perspective, with the standpoint of public finance, considers whether the finances for services can sustainably be secured.

 

That is, sustainability is composed of these important elements: comprehensiveness of support target populations, kinds of benefit types, service delivery systems, and finance structures. This study aims to suggest policy directions of which target populations should receive what types of benefits, of which working conditions and ecosystem are to be comprised for service delivery systems, and of how to share responsibility for financing in order to establish a sustainable care policy.

 

The policy implications are as follows. First, it is important to strengthen national responsibility and publicness. The most fundamental and critical policy alternative is needed to provide sustainable services for service users and sustainable and secure jobs for service providers. To achieve this, it requires the expansion of state-run organizations and the reinforcement on entrusting private services to public organizations and switching public care service centers, most of which are entrusted to private organizations, into state-run management.

 

Second, for the care service organizations managed by private sectors, it is imperative to strengthen service quality control. Although this will not come up with an option better than the first policy alternative for service users and service providers, the care service market in Korea needs to be improved due to its private-sector-oriented system. It is needed to raise entry barriers by tightening a restriction on debt ratio concerning the establishment of care service institutions, and to fundamentally exclude the entry of for-profit businesses and individuals. Also, there is much concern about small institutions with financial hardships that tend to pursue unreasonable profitability; therefore, it needs to induce and adjust gradual reduction of those institutions.

 

Furthermore, it is critical to strengthen the management and evaluation of care service institutions such as assessment of accounting audit and financial management, and to exterminate the inappropriate use of national finance.

 

Third, with the reorganizations of structure of delivery systems, it needs to increase an amount of payroll costs for service workers and to improve takeoff criteria for payroll costs. Especially, care service workers who are part-time on-call workers not only receive low wage but also unstable living expenses due to part-time employment. Child care service workers for children and home care service workers for the elderly may experience this difficulty. Therefore, it needs to reform the service support system which currently supports payroll costs per a service recipient. This structure is not capable of reflecting work experiences of the care service workers, which interrupts a chance of improving their wage.

 

Fourth, it is desired to reduce Cash-Grant about family care work which is a substitute for the use of care services because the cash support system deprives the right to use care services. Even though the families of care recipients use care services, it is hard for them to completely escape from the caring responsibility; therefore, care services may encourage de-familiarization of the caring responsibility. Otherwise, the Cash-Grant which is against the de-familiarization will raise concerns regarding social exclusion and exhaustion due to the workers’ ‘care without others’ help’ which will subsequently yield unsustainable care services.

 

Fifth, a considerable amount of finance is required to establish a sustainable care policy. To achieve this, it is important to better understand the needs about care services and to clearly clarify the status of the service use according to the needs by having the service users pay for use fee based on their income levels. It is critical to distinguish between the needs for ‘use fee support’ and the needs for ‘hours of service use’ and between the needs for ‘child care service’ and those for ‘home-care service.’ For child care services, the re-consideration of a system like means test child care subsidy is needed. For care services for the institutionalized elderly, it needs to make efforts to utilize Long-Term Care finance for caring costs which should be distinguished from housing costs.