2026 OECD Source Brief - Long-Term Care Spending and Affordability

Sources: NZIER, Assessing the Equity Issues Facing ARC (2022); Treasury, Case Study: Aged Residential Care (2024); Sapere, Aged Care Service Model and Funding Review (2024). Sources: OECD, Health at a Glance 2025; OECD, Health at a Glance 2023; OECD, Long-Term Care and Health Care Insurance in OECD Countries (2023). > The OECD's Health at a Glance 2025 reports: 'In New Zealand, the provision of home care was effectively rationed – providers limited supply to manage costs and absorb wage increases from the Pay Equity Settlement (mandated pay rises for care workers).' This is a significant public acknowledgement from an international body that NZ's home care system is not meeting demand — providers deliberately restricting supply to manage costs. Between 2013 and 2023, the share of 65+ receiving LTC decreased in New Zealand (alongside Netherlands, Denmark, Hungary), while most OECD countries saw stable or increasing uptake. This is consistent with the rationing finding. Health at a Glance 2025 reports no comparable data for NZ on LTC workers — a significant gap that limits international benchmarking of NZ's care workforce. NZ's already-low spending (0.45% GDP) compared to the projected OECD average of 2.8% GDP by 2050 highlights the scale of underfunding. - OOP costs = 70% of older person's median income across OECD - Almost half of older people with LTC needs at risk of poverty after public benefits - NZ mentioned as having reablement programs (alongside Au