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Long-Term Care Policy Update for Japan

Long-Term Care Policy Update for Japan

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By Ruru Ping and Nazak Salehi

Japan’s Long-Term Care System: Innovations and Workforce Challenges

In a Long-Term Care Policy Interest Group webinar, on the 26th February 2024, Ruru Ping from Hitotsubashi University shed light on the evolution and current state of Japan’s long-term care system. Established in 2000, this system aims to provide comprehensive support to Japan’s ageing population, separating long-term care from the traditional medical care system. Here is a summary of the key points from her presentation, as well an update on recent policy developments.

 

Historical Context and Structure

Japan’s long-term care insurance system was introduced to address a significant social issue in the 1980s: many older individuals remained in hospitals due to inadequate care options, creating a social and economic burden. The system, funded through general taxation and premiums, covers all citizens aged 65 and older, as well as those aged 40 to 64 with aging-related diseases. Local municipal governments act as insurers, conducting thorough needs assessments to determine eligibility for benefits, which do not include cash payments, unlike systems in Germany.

 

Current Challenges

Despite its advancements, Japan’s long-term care system faces several challenges:

  1. Ageing Population: As the population ages, there is an increased burden of chronic, non-curable diseases, necessitating a more integrated care approach.
  2. Emergency Services Overuse: A rising demand for ambulance services for non-urgent conditions has led to increased costs and pressure on emergency care.
  3. Workforce Shortages: There is a chronic shortage of care workers, exacerbated by a significant pay gap between care workers and the national average salary. Efforts to narrow this gap have been insufficient.

 

Policy Responses

To address these challenges, Japan has implemented several initiatives:

  • Community-Based Integrated Care: Since 2015, the government has promoted a community-based integrated care system. This approach emphasizes respecting community autonomy and leveraging local resources to enable older adults to age in place. It integrates medical care, long-term care, preventative care, daily living support, and housing services, supported by government and community solidarity.
  • Data Sharing and Infrastructure: In 2021, an amendment to the long-term care insurance act mandated the development of data infrastructure to facilitate information sharing between medical and social care systems. This aims to provide seamless care from acute to post-acute stages, reducing unnecessary emergency service use.
  • International Workforce and Technological Solutions: Japan has opened its labour market to international care workers and promotes new technologies to supplement human staff. However, retention of international workers remains low, partly due to economic factors. In June 2024, the central government drafted a plan to relax work restrictions for foreign workers in the care sector, which could take effect as early as the 2025 fiscal year.

 

Looking Ahead

While Japan’s long-term care system is one of the most developed globally, it continues to face significant hurdles. The government’s ongoing efforts to integrate care, improve workforce conditions, and adopt technology are critical steps toward addressing these challenges. Japan’s experience offers valuable lessons for other countries dealing with similar issues, particularly in terms of integrating data infrastructure and community-based care models.

As Ruru Ping concluded, Japan has yet to devise a fully effective long-term strategy for its workforce shortage, but it is experimenting with various policy initiatives to manage the evolving needs of its aging population. The continuous evaluation and adaptation of these policies will be essential in maintaining and improving the quality of care for Japan’s older citizens.

To read the full GOLTC LTC profile for Japan click here

Suggested citation:

Ping R.. and Salehi N. (2024, 5 September). Long-Term Care Policy Update for Japan: Japan’s Long-Term Care System: Innovations and Workforce Challenges. GOLTC Blog, Global Observatory of Long-Term Care, Care Policy and Evaluation Centre, London School of Economics and Political Science. https://goltc.org/publications/long-term-care-policy-update-for-japan/