A section of the health and welfare ministry’s Advisory Council on Social Welfare has started discussions to review the nursing care insurance system. The cost of nursing care services for the elderly will increase as senior citizens make up an increasingly large proportion of Japan’s population. We hope the council will come up with proposals that are fair regarding cost sharing between younger and older generations and between high- and low-income people. On the basis of the council’s discussions, the ministry is scheduled to announce a plan to reform the nursing care insurance system by the end of this year.

Council members will discuss three key issues — improvement of nursing care services provided in the private homes of elderly citizens, measures to cope with an increasing number of people suffering from senile dementia and stabilization of the funds needed to run the nursing care insurance system. These issues are difficult to solve because they are closely related to the rapid graying of Japan’s population and a shortage of funds. The council must present proposals that can gain widespread support.

The government hopes to shift from providing nursing care services at special facilities to providing such services in the residences of aged people because it will be far less costly.

In the fiscal 2012 budget, the cost for nursing care services for the aged — consisting of tax, insurance premiums and money paid by the elderly — hit ¥8.9 trillion. If no measures are taken to hold down costs, they will climb to ¥21 trillion in fiscal 2025. According to the health and welfare ministry, some 4.52 million people used nursing care services in fiscal 2012. If no reform efforts are made, the number will increase to some 6.75 million in fiscal 2025, when the youngest postwar baby boomers reach the age of 75.

If the central government wants to increase the weight of nursing care services given to elderly people who remain in their own homes, it will become necessary for local governments, medical institutions and nursing care companies to form a close network to ensure that their aged clients and their families will not feel isolated and can carry on with their lives without undue worries. This kind of network is especially critical for people with senile dementia and their families.

To this end, the central and local governments should begin concrete efforts to build an effective network so the transition from caring for the elderly in special nursing care facilities to caring for them in their own homes will go smoothly.

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