International Journal of Health Policy and Management

International Journal of Health Policy and Management

Aging, Pensions and Long-term Care: What, Why, Who, How?; Comment on “Financing Long-term Care: Lessons From Japan”

Document Type : Commentary

Authors
Kieke Okma 1
Michael K. Gusmano 2, 3
1 Independent Researcher
2 School of Public Health, Rutgers University, New Brunswick, NJ, USA
3 The Hastings Center, Garrison, NY, USA
10.15171/ijhpm.2019.117
Abstract
Japan has been aging faster than other industrialized nations, and its experience offers useful lessons to others. Japan has been willing to expand its welfare state with a long-term care (LTC) insurance to finance home care and nursing home care for frail elderly. As Ikegami shows, it created new facilities and expanded specialized staffing for home care, developed a country-wide assessment system and shifted responsibilities between the central and local authorities over that assessment and the determination of co-payments for LTC. Faced with rapid growth in demand for LTC, the government felt the need for new cost control measures. The Japanese experience illustrates that new social policies take time to develop. There is often a need to adjust. But there are also other lessons. The main one is that there is no direct relation between the degree of population aging and total health spending. While aging requires adjustments in the organization of care, and expanding LTC for frail elderly, international studies show there is no need to worry about the ‘unaffordability’ of aging. In this commentary, we have framed four “What, Why, Who, and How” questions about LTC to (re-)define the borderlines between public and private responsibilities for the range of activities for which some (but certainly not all) frail elderly as well as many non-elderly require support in daily life.
Keywords
Aging
Pensions
Healthcare Spending
Defining Long-term Care
Public and Private Responsibilities
International Comparison
Subjects
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International Journal of Health Policy and Management
Volume 9, Issue 5
May 2020
Pages 218-221

  • Received Date 14 September 2019
  • Revised Date 09 November 2019
  • Accepted Date 09 November 2019
  • First Published Date 01 May 2020
  • Published Date 01 May 2020