A Preliminary Study of the Japanese Long-term Care Insurance Act: Lessons for Taiwan
Shu-Hsin Lin *
Abstract
With the change of population structure, marked by increases in the elderly and the disabled, the need for long-term care grows rapidly. In 2008, Taiwan launched the Ten-year Long-term Care Plan. However, the discussion of the plan centered on the system design, such as funding and distribution. Also, responsible authorities are spread among different government agencies. As a result, metropolitan areas have received better long-term care services than rural areas. It looks the Long-term Care Insurance Act is still at the planning stage. All these indicate that our long-term care system has much room for improvement.
The Japanese Long-term Care Insurance Act was first implemented in 2000, and has since been revised every 3 years. It is the first step to reforming the social insurance system. It is a “welfare system with choices”- a system that respects the elderly and emphasizes fair expenses, marketization of service provision, socialization of long-term care and liberalization of services choices.
This study identifies the following five lessons for Taiwan from the Japanese experience in seeking a good long-term care system: 1. Public-private partnership can be applied on the long-term care system; 2. Long-term care system is highly related to local autonomy; 3. Information transparency is essential to policy execution; 4. The services provided must be concise and localized; 5. Actual reimbursement is an act of proactive social welfare.
Keywords: long-term care insurance system, Japan, public-private partnership, marketization
* Professor, Department of Public Administration and Policy, National Taipei University, e-mail: susin@mail.ntpu.edu.tw.