July 1999 Introduction of Long Term Care Insurance System
Introduction of Long-Term Care Insurance System
Ministry of Health and Welfare, Ministry of Finance
Ruling parties (at the time, the Liberal Democratic Party [LDP], Social Democratic Party [SDP] and New Party Sakigake) Service businesses which could expect increased business due to the formation of a nursing care service market
Ministry of Health and Welfare benefit expenses for FY 2000 is estimated at \4.2 trillion (see separate sheet for FY1995 price and revenue source breakdown)
Benefit payment for both in-home care services and institutioned care service will begin in FY2000 (April 2000). Certification for the need for long-term care will begin in October 1999.
1) Socio-Ecnomic Background
As the number of elderly people increases, the number of elderly needing long-term care is expected to increase. Further, the duration of such care is also becoming longer and more serious. Thus, the personal risk arising from care-needs has become universal and large.
There has been a continuous rise in health care costs which used to bear the costs for long-term care. Function of families as a care-provider is declining with the change in the living arrangements (Percentage of three-generation households with elderly 65 years or over: 43.9%(1987) ->30.2%(1997))
Family problems such as cases in which people in the prime working age, especially women, have been forced to retire, or take a leave of absence, or to change jobs in order to take care of the elderly.
Increase in the opportunity costs of quitting work or taking a leave of absence from work in order to assume care-needs of family, The need for employers and society to deal with the problem, the opportunity costs of quitting work or taking a leave of absence from work in order to assume care-needs of family, the need for employers and society to deal with the problem.
2) Need to Establish a New System
To build a social foundations to take care of the new "long-term care" need of the society
To correct discrepancies in costs among different institutions providing the similar service for the similar needs
To introduce a system which respect viewpoints of those receiving the services
To expand the welfare services, both from the demand side, by providing financial support through long-term care insurance system, and from the supply side, by utilizing the private sector.
See above.
People aged 65 and over, and those aged between 45 and 64
Municipalities and special districts
Providers of elderly medical care, health and welfare services
Object of the reform is to establish a long-term care insurance system based on the principle of collective solidarity of the citizens to provide the necessary health care and welfare services to persons who find themselves in situations where they need: care for bathing, excretion, or food intake; functional training, nurse, medical treatment, or other types of medical services due to illness or other condition caused by physical or mental changes arising in the course of aging, and to enable them to lead ordinary lives with a degree of independence suited to their abilities
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Some municipalities: opposition to the idea of becoming insurer. Although these forces and their opinions have not been entirely without effect, until now they have not had an impact on the implementation of the system.
Health care for the elderly, medical care systems, welfare systems for the elderly
Not yet to be implemented
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