Journal Article

Financing Long-term Care: Lessons From Japan

Ikegami, Naoki

2019

Overview

Long-term care (LTC) must be carefully delineated when expenditures are compared across countries because how LTC services are defined and delivered differ in each country. LTC’s objectives are to compensate for functional decline and mitigate the care burden of the family. Governments have tended to focus on the poor but Germany opted to make LTC universally available in 1995/1996. The applicant’s level of dependence is assessed by the medical team of the social insurance plan. Japan basically followed this model but, unlike Germany where those eligible may opt for cash benefits, they are limited to services. Benefits are set more generously in Japan because, prior to its implementation in 2000, health insurance had covered long-stays in hospitals and there had been major expansions of social services. These service levels had to be maintained and be made universally available for all those meeting the eligibility criteria. As a result, efforts to contain costs after the implementation of the LTC Insurance have had only marginal effects. This indicates it would be more efficient and equitable to introduce public LTC Insurance at an early stage before benefits have expanded as a result of ad hoc policy decisions.

• Publisher: Kerman University of Medical Sciences
• Subject: Aged / benefit package / Community Health Services - economics / Comparative analysis / Cost control / Cost reduction / eligibility level / entitlements / Germany / Government liability / Health policy / Hospitals / Humans / Insurance, Health - economics / Insurance, Long-Term Care - economics / Japan / Long term care / Long term care insurance / Long term health care / Long-Term Care - economics / Long-Term Care - organization & administration / Long-term care of the sick / Medical policy / Population Dynamics - trends / Retirement benefits / social insurance / Social security / Social service / Social services / Social Welfare - economics