Trends and Factors in Japan's Long-Term Care Insurance System

Olivares-Tirado, Pedro; Tamiya, Nanako

doi:10.1007/978-94-007-7875-7

Cited by 32 publications

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“…Reacting to demographic change, Japan established its first means‐tested LTC programs in 1963 (Ihara ). Since 1973, however, the Japanese health‐care system (a social insurance system) started providing free medical care for all (Olivares‐Tirado and Tamiya ; Shimizutani ). During this time, welfare policies were increasingly framed along a universalist narrative (Olivares‐Tirado and Tamiya ).…”

Section: The Case Of Japan: the Asian Forerunnermentioning

confidence: 99%

“…Since 1973, however, the Japanese health‐care system (a social insurance system) started providing free medical care for all (Olivares‐Tirado and Tamiya ; Shimizutani ). During this time, welfare policies were increasingly framed along a universalist narrative (Olivares‐Tirado and Tamiya ). The introduction of this narrative demonstrated an ideational change that would influence Japanese political and social discourse as well as acceptable policy alternatives for decades to come.…”

Section: The Case Of Japan: the Asian Forerunnermentioning

confidence: 99%

“…The understanding of the issue changed, transforming from a demographic to a political concern. Consequently, the policy problem was reframed around family difficulties to cope with the situation (Olivares‐Tirado and Tamiya ; Williams ). As concerns about Japan's aging population began to receive widespread media coverage, thereby increasing societal attention toward population aging, the ruling conservative Liberal Democratic Party (LDP) started to promote socializing LTC as a policy solution during the 1990 election campaign (Usui and Palley ).…”

Section: The Case Of Japan: the Asian Forerunnermentioning

confidence: 99%

“…In this “single scheme area‐based system” (Tsutsumi , 28), the premiums of “primary insured” over 65‐year‐olds are deducted from their pensions, while the “secondary insured” (40‐64 years) contribute a percentage of their salary (Inamori ). The insurance covers 90 percent of the costs yet includes a 10 percent copayment (Olivares‐Tirado and Tamiya ). An important difference to previous systems is that LTC funding is centralized (Ikegami, Yamauchi, and Yamada ).…”

Section: The Case Of Japan: the Asian Forerunnermentioning

confidence: 99%

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Long‐Term Care Insurance Adoption in East Asia: Politics, Ideas, and Institutions

Maags

2020

Politics & Policy

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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. Related Articles Butz, Adam M., Michael P. Fix, and Joshua L. Mitchell. 2015. “Policy Learning and the Diffusion of Stand‐Your‐Ground Laws.” Politics & Policy 43 (3): 347‐377. ://doi.org/10.1111/polp.12116 Cho, Sungik, and Yool Choi. 2017. “Convergent or Divergent? The Hidden Dynamics of Institutional Changes in the Labor Markets and Social Welfare Systems in South Korea and Japan.” Politics & Policy 45 (4): 594‐625. ://doi.org/10.1111/polp.12208 Maags, Christina, and Ioan Trifu. 2019. “When East Meets West: International Change and its Effects on Domestic Cultural Institutions.” Politics & Policy 47 (2): 326‐380. ://doi.org/10.1111/polp.12296

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Section: The Case Of Japan: the Asian Forerunnermentioning

confidence: 99%

Section: The Case Of Japan: the Asian Forerunnermentioning

confidence: 99%

Section: The Case Of Japan: the Asian Forerunnermentioning

confidence: 99%

Section: The Case Of Japan: the Asian Forerunnermentioning

confidence: 99%

See 2 more Smart Citations

Long‐Term Care Insurance Adoption in East Asia: Politics, Ideas, and Institutions

Maags

2020

Politics & Policy

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“…The long-term care insurance in Germany and Japan experienced a severe financial crisis (Cuellar and Wiener 2000;Olivares-Tirado and Tamiya 2013). Beginning in 2012, Zhejiang province was among the first to initiate the means-tested aged-care allowance program in rural and urban areas simultaneously, offering subsidies for long-term care for disabled elders living either in institutions or communities (Dong 2012).…”

Section: Policy Implications and Conclusionmentioning

confidence: 99%

The reform of the medical welfare system and health equity for the elderly in China: a study in Zhejiang

Liu

Wong

2016

J. Chin. Sociol.

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Health equity is the basic theory of universal health insurance and the objective of reform of the medical welfare system. Based on health equity theory with the perspective of giving priority to disadvantaged groups, this article takes Zhejiang province as an example and adopts a mixed-method approach to explore the effects of the reform of the medical welfare system on health equity for older people. The structural equation model (SEM)-based nonrecursive path analysis demonstrates an improvement of health equity for insured elders of the Basic Medical Insurance for Employees (BMIE) and the Urban Basic Medical Insurance for Residents (UBMIR) as a result of an increased utilization of healthcare. However, there is little difference in terms of the utilization of healthcare and health outcomes between old people insured by the New Rural Cooperative Medical System (NRCMS) and those without medical insurance. This results from the low-level benefits of the insurance policy and defective policy design. A qualitative analysis further discovers the insufficient protection of health equity for several types of vulnerable aged groups in the process of healthcare delivery. Finally, this study advocates the perspective of health equity for vulnerable groups, a transition from emphasizing opportunity equity to stressing outcome equity, and the construction of universal health insurance and long-term care system for the disabled elderly.

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Physical activity and incident dementia in older Japanese adults: The Okayama study

Liu

Mitsuhashi

Yamakawa

et al. 2019

Int J Geriat Psychiatry

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Objective To evaluate the association between regular physical activity and the risk of incident dementia in older Japanese adults. Methods This was a retrospective cohort study performed in Okayama City, Japan. Overall, 51 477 older Japanese adults were followed from 2008 to 2014. A health checkup questionnaire was used to assess regular physical activity. The Dementia Scale of long‐term care insurance was used as a measure of incident dementia. Cox proportional hazard models were used to calculate adjusted hazard ratios, with their 95% confidence intervals, for the incidence of dementia across the categories of physical activity. Results During a 7‐year follow‐up, 13 816 subjects were considered as having incident dementia. Compared with participants who performed physical activity less than or equal to one time per week, the multivariate adjusted hazard ratio values (95% confidence intervals) for participants who performed physical activity greater than or equal to two times per week but not every day and those who performed physical activity every day were 0.79 (0.75‐0.84) and 0.94 (0.89‐0.98), respectively. The interaction of physical activity and sex was statistically significant (P < .01). In subgroup analysis, the multivariate‐adjusted hazard ratio values (95% confidence intervals) remained low, at 0.76 (0.70‐0.84) in males and 0.81 (0.76‐0.87) in females who performed physical activity greater than or equal to two times per week but not every day; they were 0.82 (0.76‐0.89) in males and 1.01 (0.95‐1.07) in females who performed physical activity every day. Conclusions Regular physical activity could reduce the risk of incident dementia in older Japanese adults, except females who performed physical activity every day.

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Trends and Factors in Japan's Long-Term Care Insurance System

Cited by 32 publications

References 0 publications

Long‐Term Care Insurance Adoption in East Asia: Politics, Ideas, and Institutions

Long‐Term Care Insurance Adoption in East Asia: Politics, Ideas, and Institutions

The reform of the medical welfare system and health equity for the elderly in China: a study in Zhejiang

Physical activity and incident dementia in older Japanese adults: The Okayama study

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