On Financing Retirement Health And Long Term Care In Japan

Japan faces the problem of how to finance retirement, health, and long-term care expenditures as the population ages. This paper analyzes the impact of policy options intended to address this problem by employing a dynamic general equilibrium overlapping generations model, specifically parameterized to match both the macroeconomic and microeconomic level data of Japan. We find that financing the costs of aging through gradual increases in the consumption tax rate delivers a better macroeconomic performance and higher welfare for most individuals than other financing options, including those of raising social security contributions, debt financing, and a uniform increase in health and long-term care copayments.

Ageing population poses a set of complex policy and dilemmas for social security systems, intensifying the concerns about rising expenditures in health care and long-term care for elderly. In this context, ageing societies has many valuable lessons to learn by studying Japan's experience dealing with its hyper-aged society and particularly from its strategies to ensure the financial sustainability of the Long-Term Care Insurance (LTCI) system. Based on an exhaustive literature review, and the results from six original researches on long-term care expenditures in Japan (LTCE) conducted during a doctoral program, the book provides a comprehensive view in analyzing trends and factors associated with increasing expenditures in the Long-Term Care Insurance system in Japan. The book address relevant topics such as; the main socio-demographic changes experienced by the Japanese society during the last three decades, predictors of the LTCE, measuring efficiency in nursing homes, the impact of the LTCI 2005-reform to contain expenditures, cost-effectiveness of the in-home and community based services and institutional LTCE in the last year of life. The book end with a discussion on futures challenges and strategies oriented to contribute with the sustainability of LTCI system in Japan.

This report aims to inform an approved Technical Product on Long-term care financing: lessons for low- and middle-income countries, which aims to share experiences globally to inform programs and policies in low- and middle-income countries. The report also aims to fulfil WKC’s objective for local engagement, by engaging researchers in the Kansai region to learn from and inform a global technical product. The report aims to describe the current system of financing long-term care (LTC) for older people focusing on long-term care insurance (LTCI) at the national and local levels. The report describes how a financially stable system is achieved and reviews the historical policy changes and evolution of the related data collection systems in the pursuit of LTC.

This book uses a revised version of Kingdon’s multiple-streams framework to examine health financing reforms in China, Hong Kong, Taiwan, and the Republic of Korea (ROK) as well as long-term care insurance (LTCI) reforms in Japan and Singapore. It shows that the explanatory power of the multiple-streams framework can be strengthened through enriching the concepts of policy entrepreneurs, ideas, and windows of opportunity in the original framework as well as bringing the theoretical lens of historical institutionalism into the framework.

This book examines the relationship between retirement and health of older people in Japan’s super-aging society and provides a key to understanding the remarkable longevity of the population. It also furnishes new evidence in this research field where the findings have been conflicting and the detailed causal mechanism has not been clarified for many years. For that purpose, a large-scale survey was used, “The Longitudinal Survey of Middle-Aged and Elderly Persons,” which was conducted in Japan from 2005 to 2015 with 34,240 respondents aged 50–59 years in the first sample. Using this longitudinal survey, which focused on people just before retirement, and rigorous causal inference including instrumental variable and panel estimation, several research questions were tested. Specifically, existing literature does not provide sufficient findings about the heterogeneity in the effect of retirement on health. Thus, we have questions which should be addressed: does retirement affect health immediately or with delay; does the lifestyle before retirement matter for post-retirement health; and which is better for health retiring early or late? The lack of this viewpoint is believed to have led to the conflicting previous findings. If we know the answers to the questions, we would be able to understand the mechanisms between retirement and health, and prepare more properly for better retirement life. Showing the results of the testing of these questions, this book provides readers, researchers, and policymakers a comprehensive understanding of the retirement–health relationship and a suggestion for an effective labor and health policy in an aging society.

Health spending has risen rapidly in Japan. We find two-thirds of the spending increase over 1990–2011 resulted from ageing, and the rest from excess cost growth. The spending level will rise further: ageing alone will raise it by 31⁄2 percentage points of GDP over 2010–30, and excess cost growth at the rate observed over 1990–2011 will lead to an additional increase of 2–3 percentage points of GDP. This will require a sizable increase in government transfers. Japan can introduce micro- and macro-reforms to contain health spending, and financing options should be designed to enhance equity.

Japanese and American economists assess the present economic status of the elderly in the United States and Japan, and consider the impact of an aging population on the economies of the two countries. With essays on labor force participation and retirement, housing equity and the economic status of the elderly, budget implications of an aging population, and financing social security and health care in the 1990s, this volume covers a broad spectrum of issues related to the economics of aging. Among the book's findings are that workers are retiring at an increasingly earlier age in both countries and that, as the populations age, baby boomers in the United States will face diminishing financial resources as the ratio of retirees to workers sharply increases. The result of a joint venture between the National Bureau of Economic Research and the Japan Center for Economic Research, this book complements Housing Markets in the United States and Japan (1994) by integrating research on housing markets with economic issues of the aged in the United States and Japan.

Thirty years ago, when compared to the U.S., England, France, and Sweden, Japan had the lowest life expectancy for males and females. Today, Japan has the highest life expectancy and is the world’s most rapidly aging society. Public Policy and the Old Age Revolution in Japan captures the vitality of Japanese policymakers and the challenges they face in shaping a modern society responding to its changing needs. The rapid transition to an aging society poses a set of complex policy and resource dilemmas; the responses taken in Japan are of great value to policymakers, professionals, and students in the fields of gerontology, Asian and Japanese studies, sociology, public policy, administration and management, and anthropology in other industrial aging societies. Readers of Public Policy and the Old Age Revolution in Japan will discover the array of social and economic implications that comes with an increasingly aged society. Such a change in demographics affects pension expenditures and pension contributions, capital formation and savings rates, health costs, service systems, tax bases, labor pools, career counseling, training, advertising, and marketing. This book does not stop with these topics, however. Readers also learn about: how older Japanese workers are staying employed and employable policies in Japan for a smooth transition from work to retirement Japan’s Silver Human Resource Centers the new direction of health services in Japan the Japanese financing system for elderly health care the expansion of formalized in-home services for Japan’s aged Japanese housing policy and the concept of universal design the Gold Plan, a comprehensive ten-year plan to promote health care and welfare for the aged the concept of ikigai--promoting feelings of purpose and self-worth in the aged Public Policy and the Old Age Revolution in Japan is one of only a handful of books prepared in English by American and Japanese authors for an international audience about aging and social policy in Japan. The book’s recent collection of articles by leading scholars on the subject makes it a unique and timely source of information. Above all, Public Policy and the Old Age Revolution in Japan makes it clear that the rest of the world has many valuable lessons to learn by studying Japan’s approach to its rapidly aging society.