National College of Nursing.
Department of Global Health, School of Health Sciences, Faculty of Medicine, University of the Ryukyus.
Biosci Trends. 2018 Mar 18;12(1):7-11. doi: 10.5582/bst.2017.01271. Epub 2018 Feb 26.
Elderly care is an emerging global issue threatening both developed and developing countries. The elderly in Japan increased to 26.7% of the population in 2015, and Japan is classified as a super-aged society. In this article, we introduce the financial aspects of the medical care and welfare services policy for the elderly in Japan. Japan's universal health insurance coverage system has been in place since 1961. Long-term care includes welfare services, which were separated from the medical care insurance scheme in 2000 when Japan was already recognized as an aging society. Since then, the percentage of the population over 65 has increased dramatically, with the productive-age population on the decrease. The Japanese government, therefore, is seeking to implement "The Community-based Integrated Care System" with the aim of building comprehensive up-to-the-end-of-life support services in each community. The system has four proposed elements: self-help (Ji-jo), mutual aid (Go-jo), social solidarity care (Kyo-jo), and government care (Ko-jo). From the financial perspective, as the government struggles against the financial burdens of an aging population, they are considering self-help and mutual aid. Based on Japan's present situation, both elements could lead to positive results. The Japanese government must also entrust the responsibility for implementing preventive support to municipalities through strongly required regional autonomy. As Japan has resolved this new challenge through several discussions over a long period of time, other aging countries could learn from the Japanese experience of solving barriers to healthcare policy for the elderly.
养老是一个全球性的新兴问题,威胁着发达国家和发展中国家。2015 年,日本 65 岁以上老年人口占总人口的 26.7%,被归类为超老龄社会。本文介绍了日本老年人医疗和福利服务政策的财政方面。日本的全民医疗保险制度自 1961 年开始实施。长期护理包括福利服务,2000 年,当日本已经被认为是一个老龄化社会时,福利服务从医疗保险计划中分离出来。从那时起,65 岁以上人口的比例急剧增加,而生产年龄人口却在减少。因此,日本政府正在寻求实施“社区综合护理系统”,旨在为每个社区建立全面的临终关怀服务。该系统有四个建议的要素:自助(自我帮助)、互助(相互帮助)、社会团结护理(社区关怀)和政府护理(国家关怀)。从财政角度来看,随着政府应对人口老龄化带来的财政负担,他们正在考虑自助和互助。基于日本的现状,这两个要素都可能带来积极的结果。日本政府还必须通过强烈要求的地方自治,将实施预防支持的责任委托给市政当局。由于日本通过长时间的多次讨论解决了这一新的挑战,其他老龄化国家可以借鉴日本解决老年人医疗保健政策障碍的经验。