<Articles>Long term Care Insurance for Better Aged Care Services : A New Chapter for Japanese Welfare System in 21^<st> Century

概要

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The implementation of Japan's Long Term Care Insurance Scheme in April 2000 was the culmination of some 30 years of policy deliberation on aged care, shaping many changes in service delivery, and much debate between service providers, different levels of government, academic analysts and major media interests. Understanding the policy development of the LTC Insurance scheme and its financing arrangements requires an appreciation not only of rapid demographic and social change, especially in family structures and attitudes to caring for aged parents, but the pressures that population aging and economic downturn are placing on Japan's pension and health insurance systems also need to be recognized. The later part of this paper specifies the major changes in organization of service delivery that have increased opportunities for private sector providers, including large corporations, and restructured contractual relationships between municipalities and providers in all sectors. New arrangements for client assessment, classification, care management and extended service types are then outlined. An interim assessment is then made of the likely consequences of the reform, with the concerns of welfare professionals that the public welfare system is under threat juxtaposed with bureaucratic goals of liberalising the provision of long term care.
関西学院大学の論文
2002-01-25