By Debbie le Quesne

Social care – Japan’s way of meeting the bill

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Radical reforms in Japan may provide a model for surviving the political promises or more deep cuts to funding, according to a new Nuffield Trust report.

Attempting to deal with the world’s highest level of public debt and oldest population, the Japanese government introduced a system of long term care insurance in 2000.

It gives automatic access to social care to all those over the age of 65 on a need alone basis.

The system is partly funded by a national insurance fund that all over-40s pay into and partly out of general and local taxation.

It appears that the system has helped many vulnerable elderly who were not receiving care get the support they need.

Dementia care homes support independence and social interaction while ensuring safety and security, and a national campaign has focused on eliminating the stigma previously linked to the condition.

A campaign to train dementia supporters exceeded expectations, attracting 1.5 million people in just four years.

The UK’s Government’s planned reforms in England will allegedly see the cost that individuals have to pay for care in their life-time capped at £72,000 in 2015/16.

Nuffield says this policy will protect those incurring the highest costs (about one in eight of those who need care) but still leave many paying significant sums out-of–pocket.

In the meantime, for those who cannot afford to pay for their own care, cuts to local authority budgets have led to more areas giving help only to those who have the most complex needs.

It’s interesting to note that Japan’s care reform has risen beyond its budget, something I’ve been concerned with over the UK approach.

In Japan those whose social care is funded by the insurance scheme are required to pay 10 per cent of fees, and there is a debate over whether the wealthy should pay more than this in order to address rising costs.

Quite what the way forward is in duplicating such a model in the UK I haven’t a clue, but the system does appear to have met critical needs and standardised a national approach. I doubt if it’s perfect and the prospect of greater national insurance cost outgoings is never good. However, I‘m sure there are some lessons to be learned here.


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