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Japan's Universal Long‐Term Care System Reform of 2005: Containing Costs and Realizing a Vision
Author(s) -
Tsutsui Takako,
Muramatsu Naoko
Publication year - 2007
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2007.01281.x
Subject(s) - entitlement (fair division) , incentive , long term care , institutionalisation , medicine , government (linguistics) , popularity , long term care insurance , term (time) , nursing homes , nursing , public economics , economics , political science , market economy , linguistics , philosophy , physics , mathematical economics , quantum mechanics , psychiatry , law
Japan implemented a mandatory social long‐term care insurance (LTCI) system in 2000, making long‐term care services a universal entitlement for every senior. Although this system has grown rapidly, reflecting its popularity among seniors and their families, it faces several challenges, including skyrocketing costs. This article describes the recent reform initiated by the Japanese government to simultaneously contain costs and realize a long‐term vision of creating a community‐based, prevention‐oriented long‐term care system. The reform involves introduction of two major elements: “hotel” and meal charges for nursing home residents and new preventive benefits. They were intended to reduce economic incentives for institutionalization, dampen provider‐induced demand, and prevent seniors from being dependent by intervening while their need levels are still low. The ongoing LTCI reform should be critically evaluated against the government's policy intentions as well as its effect on seniors, their families, and society. The story of this reform is instructive for other countries striving to develop coherent, politically acceptable long‐term care policies.