Reforming public long-term care insurance and the caregivers burden in Japan: How to relieve the cost of Care?

Presenter: Fumiaki Yasukawa, Kumamoto University

Abstract

Background: Japanese Public Long-term Care Insurance has passed 8 years from it’s’ introduction. Along with the increasing of the volume of benefits from the insurance, as a passage of reforming in which the frail elderly people are strongly expected to care themselves independently, housing fee and food expenses had converted to uncovered services. At the same time, along with the income decreasing in aged households, the income gap among Japanese has been expanded gradually. Introduction of the policy for reducing sickbed and promoting home care settings make the opportunity of receiving benefits from the insurance narrower, and also it makes the economic burden for caregivers broader simultaneously.

Objectives: In this paper I analyzed what kind of correspondence the caregivers who are faced with the increase of the care costs may select as a way of decreasing their burden, whether the private long-term care insurance has any possibilities and limits as the instrument to relieve the burden, by using the data collected from self-designed survey.

Methodology: For the collection of caregivers' preference in substitution for decreased financial budgets for the elderly care, web based questionaaire was carried out through private internet survey agency. 627 of thousand responded individual data with the information of personal characteristics, income level, kind of LTC services using, as well as a location of care were analyzed by Logit and Multinomial Logit estimation.

Results: From the estimation, I found that 1) in case of those who have care needed elderly, no significant effect of the net income level on the withdrawal of saving, the job change, purchasing private insurance had been obtained, 2) younger generation tend to change their job as the tool for making their situation better, 3) the change of job is more significantly selected, in home care case, rather than saving withdrawal, 4) high premium-high reimbursement type of the private long-term care insurance would be favored among those who have no care needy, and 5)the plan in which the sufficient compensation and approval-related benefits scheme provide should be favored for the caregivers generally.

Conclusion: To prepare for the huge costs of long-term care by saving or changing job may be quite vague under the trend of economic uncertainty and income differences expansion. Therefore the role of the private long-term care insurance may be not so small. However, the market of the private long-term care insurance in Japan is so small and there may exist more rooms for improving that we look for, as first, the development of characteristics of public long-term care insurance by, for example, introducing the flexibility such as a family cash payment scheme.