The Long Term Care Insuran The Long Term Care Insuran ce [Kaigo Hoken] and its I ce [Kaigo Hoken] and its I mpact on Society and Healt mpact on Society and Healt h Care System in Japan h Care System in Japan AtoZ OKAMOTO, MD, MPH National Institute of Pub lic Health
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The Long Term Care Insurance [Kaigo Hoken] and its Impact on Society and Health Care System in Japan AtoZ OKAMOTO, MD, MPH National Institute of Public.
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The Long Term Care Insurance [KaiThe Long Term Care Insurance [Kaigo Hoken] and its Impact on Society go Hoken] and its Impact on Society and Health Care System in Japanand Health Care System in Japan
Why was the LTCI developed?Why was the LTCI developed?Rapidly aging population and growing
need for LTC–Elderly population >65 will be 25%
of the populationStructural overhaul of the fragmented
health insurance systemEffective integration of medical and
non-medical services
Structural flaws of Japan’s heStructural flaws of Japan’s health insurance systemalth insurance system
Age distribution and health insurance stAge distribution and health insurance statusatus
Financial Redistribution Mechanism by the EldFinancial Redistribution Mechanism by the Elderly Health Care System [EHCS] since 1983erly Health Care System [EHCS] since 1983
Medical vs. Non-medical Services bMedical vs. Non-medical Services before the LTCIefore the LTCI
Medical---health insurance and EHCS financed by premium– Not restricted by budget -> cost inflation– Dictated by doctors’ prescription->not need-based
Non-medical---welfare system financed by tax– Restricted by budget -> frugal use of services– Restricted by income -> social stigma
Result: unusual shift of LTC toward medical services– Prolonged hospital length of stay (40 days)