Long-Term Care Insurance Comes To Japan

Abstract

Japan has moved decisively toward "socialization of care" for the frail elderly by initiating public, mandatory long-term care insurance (LTCI) on 1 April 2000. The LTCI program covers both institutional and community-based caregiving. Everyone age forty and older pays premiums. Everyone age sixty-five and older is eligible for benefits based strictly on physical and mental disability, in six categories of need. Benefits are all services, with no cash allowance for family care, and are generous, covering 90 percent of need. Long-term costs seemed not to be a major consideration in program design. Consumers can choose the services and providers they want, including use of for-profit companies.

Gender and Family Composition Related to Discharge Destination and Length of Hospital Stay after Acute Stroke

“…The availability of long-term care facilities improved over the study period with the introduction of public long-term care insurance, and this would have affected the likelihood of discharge to home. However, access to care resources under the long-term care insurance is determined solely by the patient's functional level and not by socio-economic conditions (Campbell and Ikegami 2000). Therefore, it is less likely that this explained the observed difference across gender and family composition.…”

Public policy response, aging in place, and big data platforms: Creating an effective collaborative system to cope with aging of the population

“…Many long-term care programs for aging in place have been implemented in high-income countries such as Australia, Canada, and the United States (27)(28)(29). Over the past decade, Japan's government-initiated, mandatory, public, long-term care insurance (LTCI) system has ushered in increased use of aging in place at a reduced cost to households (30). Unlike systems elsewhere that rely on cash allowances for long-term care of older people, the Japanese LTCI system only provides services and recipients can choose their services and providers, on the grounds that family caregivers benefit most from direct help with their tasks and that quality of care is best assured by relying on trained, licensed, and supervised caregivers.…”

Horizontal Equity or Gatekeeping? Fiscal Effects on Eligibility Assessments for Long-term Care Insurance Programs in Japan

“…One argument is that this linkage of costs and benefits at the local level provides an incentive for municipalities to contain demand expansion. This is claimed to be an important policy innovation (Campbell and Ikegami, 2000).…”