Long‐term care insurance adoption in East Asia : politics, ideas, and institutions

Since the 1990s, Japan, South Korea, and Taiwan have adopted long-term care social insurance (LTCI) systems to face the growing “aging crisis” in their countries. The comparative scholarship suggests the diffusion of the Japanese model among East Asian states. Bridging policy learning, agenda setting, and historical institutionalist approaches, this study comparatively examines how ideational and institutional processes have impacted political competition and ultimately the adoption of LTCIs in Japan, South Korea, and Taiwan. I argue that each country's LTCI design differs greatly from one another, displaying distinctive forms of institutional bricolage—not institutional isomorphism. In this process, time has been a crucial factor. Time affects ideational, institutional, and political processes differently. The relative weight of ideational and institutional processes at a particular moment in time and their evolution over time has a significant impact on whether policy change occurs, and whether this change may gradually undermine the logic of welfare regimes.