Public long-term care insurance in Japan.
A public long-term care (LTC) insurance program is likely to be introduced to Japan in the year 2000.
A consensus on the need for more LTC resources in the rapidly aging society and dissatisfaction with the current system are some of the factors that have contributed to its introduction.
Half the costs will be paid by premiums that will be levied on all those older than 40 years, and half will be covered by general taxation.
The insurer will be the municipalities with a pooling mechanism at the national level to balance the differences in their demographic structure.
The benefits will include institutional care, respite care, day care, home help, visiting nurses, and loan of devices.
Eligibility status will be classified into 6 levels that will be determined by assessment of functional and cognitive status.
However, there are few mechanisms to limit benefits and contain costs.
Problems also exist in the design of the eligibility classification and in the assessment instrument.
The proposed LTC insurance system highlights the need for defining what should be included in a « basic package » of LTC as an entitlement for every citizen, for an organizational mechanism and an assessment instrument to deliver services efficiently and equitably, and for physicians to work outside the traditional medical model.
To what degree the Japanese public in general, and physicians in particular, is willing to deal with these issues is a challenge for the 21st century.
Mots-clés Pascal : Soin, Assurance, Long terme, Programmation objectif, Communication information, Facteur prédictif, Aspect social, Coût, Critère sélection, Relation médecin malade, Aspect politique, Article synthèse, Japon, Asie, Homme, Organisation santé, Politique sanitaire
Mots-clés Pascal anglais : Care, Insurance, Long term, Goal programming, Information communication, Predictive factor, Social aspect, Costs, Selection criterion, Physician patient relation, Political aspect, Review, Japan, Asia, Human, Public health organization, Health policy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0543127
Code Inist : 002B30A03A. Création : 24/03/1998.