Trends And Factors In Japans Long Term Care Insurance System

Ageing population poses a set of complex policy and dilemmas for social security systems, intensifying the concerns about rising expenditures in health care and long-term care for elderly. In this context, ageing societies has many valuable lessons to learn by studying Japan's experience dealing with its hyper-aged society and particularly from its strategies to ensure the financial sustainability of the Long-Term Care Insurance (LTCI) system. Based on an exhaustive literature review, and the results from six original researches on long-term care expenditures in Japan (LTCE) conducted during a doctoral program, the book provides a comprehensive view in analyzing trends and factors associated with increasing expenditures in the Long-Term Care Insurance system in Japan. The book address relevant topics such as; the main socio-demographic changes experienced by the Japanese society during the last three decades, predictors of the LTCE, measuring efficiency in nursing homes, the impact of the LTCI 2005-reform to contain expenditures, cost-effectiveness of the in-home and community based services and institutional LTCE in the last year of life. The book end with a discussion on futures challenges and strategies oriented to contribute with the sustainability of LTCI system in Japan.

In an era of changing demographics and values, this volume provides a cross-national and interdisciplinary perspective on the question of who cares for and about the elderly. The contributors reflect on research studies, experimental programmes and personal experience in Japan and the United States to explicitly compare how policies, practices and interpretations of elder care are evolving at the turn of the century.

This book uses a revised version of Kingdon’s multiple-streams framework to examine health financing reforms in China, Hong Kong, Taiwan, and the Republic of Korea (ROK) as well as long-term care insurance (LTCI) reforms in Japan and Singapore. It shows that the explanatory power of the multiple-streams framework can be strengthened through enriching the concepts of policy entrepreneurs, ideas, and windows of opportunity in the original framework as well as bringing the theoretical lens of historical institutionalism into the framework.

Ageing in Asia contains a selection of leading social systems and programs, with interesting case-studies offering innovative and useful lessons. The book covers ageing and related developments occurring in the most dynamic industrializing and urbanizing societies of emerging Asia. It includes topical issues such public policies and responses to current challenges from the growing needs of an ageing population due to rise of chronic non-communicable diseases, amidst rapidly changing social, cultural, economic and political changes in the region. The main purpose of the book is to provide useful comparisons of social care systems undergoing rapid transitions, and to offer some examples of best practices and lessons to respond to the changing needs due to population ageing.

The Japanese health care system provides universal coverage to a healthy but aging population. Its costs are among the lowest in the world and have remained nearly constant as a share of the economy for more than a decade. Americans concerned about runaway medical spending need to know about the successes that Japan has experienced and the problems the country has encountered in its effort to control costs while maintaining quality of care. Offered here is an analysis of the key issues of cost-containment by specialists followed by reactions from some of America's best-known experts on health care delivery and finance. Topics include the macro-and microeconomics of health care, technology and costs, institutions and costs, attitudinal and behavioral aspects, and the politics of health care. This collection provides an authoritative study of successful cost-containment in the Japanese health care system---a chronicle of success that is neither a statistical illusion nor a result of sociocultural factors. Detailed here is information on the key mechanism of cost constraint: a fee schedule that covers virtually all medical services and rewards inexpensive services while making expensive services unprofitable. This system has resulted in the provision of quality health care to the entire population at roughly half the cost of American health care. Is it a single-payer system? Would the United States have to introduce a dramatically altered health care structure to benefit from the Japanese experience? No. Japan relies mainly on fee-for-service medicine financed by multiple insurers---a system familiar to Americans and one from which many lessons may be learned. Based on conferences held in Washington, D.C., and Izu, Japan, this volume collects original chapters on the overall cost structure, how the negotiated mandatory fee schedule works, specific mechanisms for cost control, the politics of health care financing, and the impact of cost cutting on quality, among other topics. These pathbreaking studies will be a significant resource for policymakers and scholars interested in comparative health care systems as well as those interested in health care reform in the United States.

In Latin America and the Caribbean, more than 8 million older people are unable to independently complete at least one basic activity of daily living, such as eating, bathing or showering, or getting in and out of bed. This situation, called care dependence, affects 12% of people over age 60 and nearly 27% of people over age 80 in the region. The demand for long-term care services will more than triple in the next 30 years, due primarily to population aging and the epidemiological transition. The region will also see a drop in the traditional supply of long-term care services, which are based mainly on the unpaid work of women in families. Given this outlook, societies and governments must ready themselves to support care-dependent people and their caregivers, while at the same time advancing gender equity. Countries need to design long-term care systems, and they need to do so now. This publication addresses five key questions for countries in the region that wish to start this process: 1) Why is long-term care an issue that cannot wait?; 2) How do countries design a long-term care system?; 3) What are the countries in the region doing?; 4) How much would a long-term care system cost?; 5) Where should we start? This is the first IDB publication that is interactive and accessible to as many people as possible.

This upper level textbook provides a coherent introduction to the economic implications of individual and population ageing. Placing economic considerations into a wider social sciences context, this is ideal reading not only for advanced undergraduate and masters students in economics, health economics and the economics of ageing, but also policy makers, students, professionals and practitioners in gerontology, sociology, health-related sciences and social care. This volume discusses the fiscal implications of ageing, health economics and long-term care. Fiscal policy issues include generational accounting and national transfer accounts, the relationship between ageing, public expenditure and fiscal policy, the age profiles of public expenditures and taxes, and the relationship between ageing, capital and labour taxation. Health economics with regard to ageing comprises healthy and disability-free life expectancy, the relationship between health inequalities and age, the macroeconomic implications of population health, the socio-economic determinants of health, the interaction between ageing and both individual and aggregate health expenditure, and economic approaches to valuing later life. This volume closes with an exposition of the economics of formal and informal care, as well as questions around insurance, risk and the so-called `sandwich generation'.