By Debbie le Quesne

Has Japan got funding for care right?

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Caring for the elderly in Japan was once the sole responsibility of family – but that’s changing as more buy in to long-term care insurance.

The costs of care in the UK for those who have resources are huge. Andrew Dilnot found that one in 10 will need to pay more than £100,000 from their own pockets.

Any alternative options are frankly unrealistic.

As the elderly population increases, so does the demand on an ever-shrinking pot of care money.

Sadly, what is emerging is a reduced number of people getting the social care they need as the bar for qualifying is set higher and higher.

The care bill, currently passing through Parliament, is the government’s response to the problems we all face. But what will it mean?

Holly Holder is a fellow in health policy at the Nuffield Trust wrote an interesting piece which was published in the Guardian online. In it she explores the Japanese model of modern care and how it could be funded.

She observes: ”Until 2000, publicly-funded social care was nonexistent in Japan; caring for the elderly was a family responsibility. There were two main consequences of this approach.

“First, there were many reports of neglect and abuse towards older people being looked after by family members. In a survey conducted by the Japanese government, a third of carers reported feeling ‘hatred’ towards the person they looked after. Caring also restricted the employment options of a growing number of Japanese women.”

A second issue was the development of a phenomenon known as “social hospitalisation”. Older people were being admitted to hospital for long periods – not for any medical reason, but simply because they could not be looked after anywhere else

A radical approach was needed and the Japanese government introduced long-term care insurance. It offers social care to those aged 65-plus on the basis of needs alone. The system is part-funded by compulsory premiums for all those over the age of 40, and part-funded by national and local taxation, says Holder.

I find it remarkable that the scheme is reported as being “popular”. Uptake of the services has far outstripped expectations.

In a nutshell, Japansese residents get access to a wide range of social care services  “with few of the barriers to access which exist in England.”

This all sounds great, doesn’t it?

Holder points out that one of the aspirations of the care bill is that setting a lifetime cap on care needs will allow for the creation of insurance products to cover against social care costs.

Holder adds: “The care bill is an attempt by government to redefine where the responsibility for caring lies; between the state, the family and the individual.

“Japan reminds us that while the balance between these three groups needs to be carefully struck, it is possible to introduce radical reform with public support. But Japan’s recent experiences should also remind us that we can expect the number of older people needing care to continue to grow. “


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