1. Beginning of elderly care insurance in Japan
Nowadays, many developed countries are all faced with a problem: aging of population, among which, Japanese is the country with the most serious aging in the world. The ones who were born during the baby boom in World War II will be 65 years old soon, so that the population of the elderly in Japan will increase rapidly. Meanwhile, the birth rate in Japan has continued to drop since from 1980s. The decreasing of birth rate and the increasing of elderly population give rise to the dropping of total population, and at the same time, the proportion of the population above 65 years old accounting for the total population goes up greatly. In the face of such problem, Japan attaches great importance to the coordination with the private enterprises on the infrastructure for home care and then carrying out expansion rapidly. Under such background, Care Insurance Law comes into being. 1.1 The road of elderly care insurance in Japan
Care Insurance Law was issued on November 17th, 1997, and took effect on April 1st, 2000. The materialization of care insurance is marked by the social insurance review conference held in July 4th, 1995.In this conference, a written advice, mainly aiming at the problem the welfare of the elderly should rely on the insurance benefit, was put forward for the first time since the system of “all nationals join the insurance” had been carried out for 33 years. On April 22nd of 1996, the review conference of health benefits for the elderly finally passed Proposal on Establishing Care Insurance for the Elderly, and proposed to establish social insurance method that half of the care insurance is undertaken by the public expense. In September of 1996, “Million Citizens Committee Boosting Care Socialization” was established, which was the first time to be discussed and modified on the care insurance among the citizens. In November of 1996, Care Insurance Law, Care Insurance Implementation Law, and Medical Service Modification Law, associated with care insurance, were put forward. During this period, Care Security Act for the elderly, established aiming at tax levy increasing, was unveiled. Therewith, as the main operation body, Municipalities of Japan required reviewing cautiously. After repeated discussion, Care Insurance Law was officially passed in December 9th of 1997, and took effect in 2000. 2. Reform of elderly care insurance in Japan
In order to adapt to the change of the times, the Japanese government reformed and improved Care Insurance Law in 2005. The main content of the reform is as follows: introducing prevention payment; reducing hospitalizing payment to facilitate the outpatient service payment; introducing new payment in the region; announcing information related to care facilities with Internet; enhancing the supervision on the city, towns and villages, so as to provide proper payment and legal protection for the care-needed patients; expanding premium grading. Among them, the most importance, i.e. the key point of this reform, is to introduce prevention payment. Through the reform of this time, the Japanese combines the care, medical treatment with the welfare, and then forms new care insurance system. Care Insurance Amendment began to come into force in April, 2006. From then on, the care insurance system of the new times came into being in Japan.
2. Content of elderly care insurance in Japan
2.1 Groups of care insurance
Japanese Care Insurance Law is operated by taking the Municipalities of Japan as the insurer. However, the ones who are above 40 years old and accept this service become the insured, who can be divided into No.1 insured and No.2 insured. The precondition for being insured is that the insured must dwell in the belonging Municipalities of Japan whatever No.1 insured or No. 2 insured, both of whom are different in age, payment object, premium levy and payment means. With regard to the age, No.1 insured...
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