Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108946

AtoZ(Etsuji) Okamoto, MD, Department of Management Sciences, National Institute of Public Health, 2-3-6, Minami, Wako-shi, Saitama, 351-0197, Japan, +81-48-458-6208, atoz@niph.go.jp

Fragmented social security systems produce both shortcomings and redundancy without proper coordination. Typical duplication includes pension and unemployment benefit, alimony and child allowances. The same duplication occur in institutional care. Japan's LTC insurance, started in April 2000, has seen a marked expansion: the number of elderly grew by 14%, the number of recipients of institutional care by 46% and home care by 138% (=2.38 times the number in 2000) for 4.3 years since its inception. The financial size of the LTCI is expected to reach $67 billion in 2005, 1.81 times that in 2000. Although premium of the LTCI (monthly average $33) is withheld from pension, effectively diverting a part of pension to the LTCI system, anticipation of increased premium burden inevitably called for more coordination between pension and the LTCI particularly in view of the median asset of elderly household was $150,000. In the process of policy debate, international examples were extensively studied on coordination of benefits, all of which had some kind of coordination between pension and “room and board” of nursing homes. Japan's LTCI requires 10% copayment of the per diem cost metered to the five levels of care need, but no room charge has been required except private rooms. Starting in October 2005, room charge will be levied on all rooms in addition to 10% copayment, to cover utility bills. The revision may solve some of the anecdotes that survived family inherit savings accumulated from pension after long nursing home stay.

Learning Objectives:

• Fiscal implications of sustaining the long-term care from "guns and butter" approach into the near future will be discussed

Keywords: International Health, Long-Term Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation