title: Population ageing and wellbeing: lessons from Japan's long-term care insurance policy.
abstract: Japan's population is ageing rapidly because of long life expectancy and a low birth rate, while traditional supports for elderly people are eroding. In response, the Japanese Government initiated mandatory public long-term care insurance (LTCI) in 2000, to help older people to lead more independent lives and to relieve the burdens of family carers. LTCI operates on social insurance principles, with benefits provided irrespective of income or family situation; it is unusually generous in terms of both coverage and benefits. Only services are provided, not cash allowances, and recipients can choose their services and providers. Analysis of national survey data before and after the programme started shows increased use of formal care at lower cost to households, with mixed results for the wellbeing of carers. Challenges to the success of the system include dissatisfaction with home-based care, provision of necessary support for family carers, and fiscal sustainability. Japan's strategy for long-term care could offer lessons for other nations.
authors: Department of Health Services Research, Graduate School of Human Care Sciences, University of Tsukuba, Ibaraki, Japan.
authors: Nanako
authors: N
authors: Tamiya
authors: Haruko
authors: H
authors: Noguchi
authors: Akihiro
authors: A
authors: Nishi
authors: Michael R
authors: MR
authors: Reich
authors: Naoki
authors: N
authors: Ikegami
authors: Hideki
authors: H
authors: Hashimoto
authors: Kenji
authors: K
authors: Shibuya
authors: Ichiro
authors: I
authors: Kawachi
authors: John Creighton
authors: JC
authors: Campbell
mesh_terms: D005260:Female; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D008297:Male; D011314:Preventive Health Services