A Trip to Study Personal Social Services for Elderly in Japan

Many countries in the world confront an aging population, and, in China, old-age care presents a great challenge to both the State and individuals. It followed the global trend in 1999 with a rapidly aging population and now leads the world with more than 100 million people in this category.

In order to learn from the advanced experience of other countries in developing an old-age care system, CPAFFC organized a delegation consisting of leading members of local government departments of civil affairs and personnel to visit Japan in the latter part of last September. The delegation conducted extensive exchanges with the Japanese Ministry of Health, Labor and Welfare, the Tokyo University of Social Welfare, the China-Japan Medical Workers and Caregivers Exchange Friendship Association, and also visited homes for the aged and organizations providing various facilities. The members of the delegation were deeply impressed by the long-term care insurance program of Japan.

Japan’s Social Security System

In a meeting with the Ministry of Health, Labor and Welfare, it learnt that the development of a universal social security system began shortly after the end of the Second World War. The present system comprises five categories, namely public assistance, welfare services, social security (health insurance, pension for workers, child welfare, employment insurance and accident compensation for workers), health services, personal social services and assistance to the war victims.

With the social and economic development, Japan has perfected its national basic pension system by introducing income-related supplement pension for workers and civil servants, creating a stable social environment for the country’s economic development.

Long-Term Care Insurance for Older People

The continuous growth of the aging population has led to the great need for care and it is difficult to rely on the family alone for this. To cope, the nursing social insurance system has been introduced in some countries. Japan enacted a Long-Term Care Insurance Act in December 1997, only the second country after Germany to introduce this system.

In 2000, a public long-term care insurance system was enforced. All people age 40 and older are required to participate. Those who are insured will be divided into two categories. Senior citizens age 65 and older are allowed to receive insurance benefits if they have a health condition requiring long-term care regardless of the cause. They pay premiums through the municipalities in which they live. Those between 40 and 64 are allowed to receive insurance benefits only if their conditions are caused by illnesses associated with aging (e.g. cerebrovascular strokes and early-onset dementia). They pay premiums through the medical care insurance system in which they are enrolled. Insured persons are entitled to receive insurance benefits such as home care aid services, home-visit nursing care, and medical management, etc. according to their needs for care or the severity of their condition; ten percent of the costs of nursing and care services are paid by the recipient.

Japan’s health insurance system is funded by the central government (25%), local government (12.5%) and insurance revenue (50%).

The delegation visited a home for the aged in Sakai City, Osaka, where it learnt the operational method and management concept and watched a demonstration of home bathing service provided for a disabled man. The members of the delegation were deeply impressed by the meticulous care and excellent services provided.

The long-term care insurance in Japan aims to solve care provision of its older people through socialization of care work. The introduction of this system has included old-age care into the framework of social insurance system, thus ensuring the steady source of funding.

Japan, encountering the problem of population aging earlier than China, has adopted various measures and established insurance systems to cope with it. The visit provided a good opportunity to learn and borrow its successful experiences.