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The World Cup through LTCI eyes

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One fun marketing brainstorming game is to think about anything — your computer, your coffee, your light fixture, or even the driver cutting you off in traffic — and ask yourself, “What marketing insight can I get out of this?”

This month, the obvious brainstorming starter is the 2014 FIFA World Cup soccer tournament. 

  • Insight 1: It would be great for anyone trying to sell protection insurance in Europe or South America to have a billboard in the World Cup stadiums in Brazil.
  • Insight 2 (for any agents and brokers selling long-term care insurance (LTCI) or disability insurance): Your carriers would probably like you to filter out consumers who spend their days butting soccer balls with their heads. Maybe you could use a soccer anecdote to begin a customer blog or newsletter item about the value of avoiding traumatic brain injury…
  • Insight 3 (for anyone selling LTCI, disability insurance, or any other financial products): The World Cup is a prism you can use to segment interesting U.S. niche markets you might not normally spend much time analyzing. Such as: High-income immigrant markets.

Chances are that you’ve already considered ways to reach U.S. consumers who have roots in Mexico. You may have read an occasional article about consumers from China and India. 

But how much attention have you paid to U.S. residents from Brazil? The staff at Nate Silver’s FiveThirtyEight sports data blog at the ESPN website has named that country as the one most likely to get its soccer team past the bewildering World Cup “group play” stage and into the more easily grasped “Round of Eight” stage.

At press time — 9:39 a.m. EDT, June 23 — the seven other national teams that had a decent chance of reaching Round of Eight play were from countries with vibrant economies of their own.

Some countries send us huddled masses yearning to breathe free. The countries at the top of FiveThirtyEight’s World Cup rankings have sent us bright young university graduates who were willing to give up a chance to earn a steady income and enjoy good, or lavish, government safety net benefits for a chance to be a star, baby.

Many of the U.S. residents who immigrated from the Round of Eight countries are doctors, top-level engineers, nurse practitioners, consultants who wow the crowd at trade show general session events, or the kinds of artists who have proved the realists wrong and found that, yes, thank you, it is still possible to make a very nice living in the arts. If you’re them.

In many cases, those highly paid immigrants socialize with other highly paid immigrants — groups of people who may still remember the quadratic equation but have only a vague understanding of how their birth countries now handle acute health insurance, let alone disability insurance or long-term care (LTC) finance, and little understanding of how U.S. commercial and government insurance programs work.

One thing to remember about U.S. residents from wealthy countries is that their home countries may be facing the same demographic and budget pressures that the United States faces. The immigrants may have hazy childhood memories of a flock of aunts and great-aunts taking care of great-grandparents in a mansion that still employed a few servants.

The home country government may have provided lavish home care or nursing home care benefits for their grandparents, and may have promised the same to their parents. But the government may now be trying to nickel and dime the parents — and to make big cuts in the benefits now being promised to workers in their 30s and 40s.

Especially if these immigrants are still just green cardholders in the United States, not citizens, or if they have tried to continue to be citizens both of the United States and their birth countries, they may need specialized help with understanding how their mixed status affects eligibility for government benefits, commercial insurance, and tax breaks for commercial insurance both in the United States and in their home countries.

These people may also need help with understanding how eligibility and tax rules governing matters such as U.S. Social Security, the U.S. Medicare program, U.S. Medicaid nursing home benefits, and birth country social welfare programs interact with their ability both to inherit estates and to pass estates on to heirs.

Here’s a set of World Cup marketing “playing cards” for those niche markets.

We give three sets of statistics:

  • The number who received legal permanent resident status in the United States in 2012 based on job-based criteria, to serve as a very rough indicator of the size of the opportunity in the United States.
  • The percentage of home country residents who were ages 65 and older, in 2012, to serve as a rough indicator of the pressure facing the birth countries’ social welfare programs.
  • An Organisation for Economic Co-operation and Development (OECD) projection of the percentage of gross domestic product (GDP) that public LTC program costs could eat up in the birth countries in 2060, if current trends continue and the countries take no effective steps to hold down LTC costs. This statistic seems to serve as a rough indicator of the pressure the birth countries may face to eliminate or reduce benefits for citizens living overseas.

In 2012, the biggest supplier of new permanent residents who obtained that status through employment-based preferences was India. That year, 33,408 people born in India used employment-based preferences to get “green cards.” That year, about 14 percent of U.S. residents were ages 65 and older.

OECD analysts are predicting that the United States could be spending 1.3 percent of GDP on public LTC program services in 2060 if cost-containment efforts are ineffective.

 Rio de Janeiro


2012 job-related immigration: 2,615

% of birth country population over 65: 7%

% of birth country GDP going to LTC in 2060:  1.3%

Patricia Knebel reported that some forecasters think 30 percent of the population in Brazil could be 60 or older by 2050. The elderly population has been growing about three times as fast there as the overall population.

The aging of Brazil’s population could hamper the country’s efforts to make good on promises made in 2003 to guarantee older residents free medicine and extra help with getting health care.

See also: Selling life insurance far from home: Leonardo Lerer of Brazil




2012 job-related immigration: 1,733

% of birth country population over 65: 21%

% of birth country GDP going to LTC in 2060: 2.1%

The regions that make up modern Germany have been providing LTC services through institutions like the Hospital of the Holy Spirit in Lubeck, Germany, (pictured above) since the Middle Ages.

Germany introduced a government LTC insurance program in 1995. In 2007, AARP analysts said the program was working well, but the country is now trying to deal with budget pressure by tightening eligibility requirements.

Analysts at the World Health Organization noted in 2012 that some have questions about whether the German system will be sustainable.

See also: European bond yields lowest since Napoleon



2012 job-related immigration: 1,204

% of birth country population over 65: 11%

% of birth country GDP going to LTC in 2060: Not available

U.S. researchers observed in 1988 that Argentina was making much less use of LTC facilities — nursing homes — than countries like the United States were.

In 2004, researchers reported in an article in the Journal of the American Geriatric Society that Argentina had a relatively underdeveloped LTC services system, and that fewer than 2 percent of older people there were living in residential or nursing homes. The government was trying to make up for the gap by improving community-based primary care services.

See also: Swiss Medical Gets Blue Cross And Blue Shield Rights For Uruguay



2012 job-related immigration: 483

% of birth country population over 65: 16%

% of birth country GDP going to LTC in 2060: 3.7%

The Dutch have a recession-plagued but strong economy and a fine acute health care system that has helped them achieve a high average life expectancy. The downside of the high average life expectancy is that the percentage of the population there that’s age 60 or older is increasing rapidly. 

Researchers in the United Kingdom who were trying to get ideas for senior housing programs from the Dutch reported in September that only 8 percent of older people in the Netherlands live with their children, compared with 16 percent in the United Kingdom.

Netherlands researchers have estimated that about 85 percent of Dutch people who might need LTC services are actually living in nursing homes, and that about 15 percent are living in the community. Elderly people living in the community were much more likely to be getting formal home care services than comparable people in the rest of Europe.

An official European Commission review of the Dutch LTC system pointed out that the Dutch government has been emphasizing a need for greater individual responsibility for LTC finance. If Dutch people fail to save or insure their own LTC costs and help care for their own older relatives, the current Dutch LTC system may no longer be affordable in the future, officials have warned.

See also: Health policy questions hang over Dutch elections



2012 job-related immigration: 1,964

% of birth country population over 65: 6%

% of birth country GDP going to LTC in 2060: Not available

Colombia has many affluent residents but faces more development challenges than most of the other countries on this list.

The makers of “Caring for Colombia’s Aging,” a documentary, say the challenge of caring for the aging in a country where half of the workers earn less than $2 per day is overwhelming. One problem is that the country shifted funding away from social services programs to fight drug trafficking.

Paul Juan Realty, a company that helps people from the United States and elsewhere retire in Cartagena, Colombia, is starting to sell homes that come with access to assisted living facilities.

See also: Top 15 best foreign countries for retirement: 2014

 Wine and cheese


2012 job-related immigration: 1,650

% of birth country population over 65: 17%

% of birth country GDP going to LTC in 2060:  2.1%

France has a generous, government-run LTC program that consumes about 1.8 percent of GDP, according to the OECD. About 70 percent of the cash goes to LTC facilities, rather than home care.

Although France has a government LTC program, it’s also a major market for private LTCI coverage. In 2010, about 15 percent of residents ages 40 and older had private LTCI coverage, compared with 5 percent in the United States. About 45 percent of the people who had private LTCI got it through group LTCI programs.

See also: Retirement confidence differs globally



2012 job-related immigration: 329

% of birth country population over 65: 10%

% of birth country GDP going to LTC in 2060: 2.3%

MetLife reported in 2013 that many people in Chile feel insecure about LTC costs. About 69 percent worry about having enough money to pay for LTC services for a spouse, and 68 percent worry about having enough cash and time to pay for care for aging parents or other older relatives.

See also: Banks are big in Latin America life insurance distribution



2012 job-related immigration: 237

% of birth country population over 65: 18%

% of birth country GDP going to LTC in 2060: 3.0%

Belgium has a mandatory federal nursing care program, but it also has a quilt of non-medical residential and home care services provided by regional, local and private organizations, and it encourages families to provide informal care, according to Belgian government analysts.

The Flemish community has its own mandatory non-medical LTCI program.

See also: Belgium considering unprecedented law to grant euthanasia for children, dementia patients


Multi-country data sources:


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