Japanese nursing insurance

Fukuda’s grandmother, who lives in Osaka, Japan, was cured. After she was discharged from the hospital, she applied for home care. Some professionals regularly visit her to coach her rehabilitation training, and there are nursing staff to take care of her home and help her bathe. She only pays 10% of the cost of the care, and the rest is paid for by the care insurance.

In an aging society, no matter what kind of old-age care method the elderly choose, the demand for care is very large. To this end, some aging countries have introduced nursing insurance. Since 2000, Japan has implemented the Nursing Insurance Law, which has been continuously revised and improved to provide some funds and personnel protection for the daily care of the elderly, and has received widespread support from the elderly.

Source of care insurance funds
Nursing insurance financing mainly consists of two parts, some of which are undertaken by individuals, accounting for 50%; the other part is national taxation, accounting for 50%, of which the central government is responsible for 25%, the provincial government is responsible for 12.5%, and the municipal villages are responsible for 12.5%.

The Japanese Nursing Insurance System lists people over the age of 40 living in Japan as funding targets. Among them, the population aged 65 and above is the first insured, and the 40 to 65 years old is the second insured. The first insurer pays 20% of the insurance premium (90% of the pension is deducted, and the old pensioner does not pay the local government 10% of the premium). The second insurer is responsible for the remaining 30% and is directly deducted from the individual’s social insurance premium.

The special feature of Japanese nursing insurance is that it adopts the form of “tax + insurance” to ensure the stable acquisition of nursing insurance funds. From the perspective of the payment mechanism, most people’s contributions are directly deducted from pensions or social insurance. Therefore, they are not directly related to fees. Those who need to pay directly are those who have low income and no pension, accounting for 10%.

Service object of nursing insurance
According to the regulations, the nursing insurance service must wait until the age of 65 becomes the first insured. However, for the second insured who is enrolled in the nursing insurance but under the age of 65, such as early dementia, cerebrovascular disease, amyotrophic lateral sclerosis and other 15 diseases, you can enjoy the nursing insurance service.

Nursing insurance cost personal burden ratio
The cost burden of nursing care insurance is determined based on the income earned by the individual. At the beginning of the implementation of the nursing insurance system, the personal burden ratio is 10%, that is, if the nursing service used costs 100 yuan, the individual only needs to bear 10 yuan, and the remaining 90 yuan is paid by the government and insurance. However, after the revision of the nursing insurance system in August 2015, the personal burden ratio was raised, that is, the personal income must exceed 20% of the nursing service fee. In 2018, the personal burden ratio was further raised to 30%.

Type of care insurance service
The contents of the nursing insurance service can be roughly divided into three types: one is home service, the other is agency (facilities) service, and the third is regional service (the service target is limited to the elderly in the administrative area where the facility is located).

Home-based care services include: home visits, visits to baths, visits to nurses (nurses), visits to rehabilitation training, home care management guidance, day care, day care rehabilitation, short stays, short stays, designated facilities, life care, Welfare tools are rented, and 12 types of services are sold for specific welfare equipment.

On-site visit care: Access care is divided into two categories: body care and life support. Body care includes direct contact with the body such as bathing, defecation, feeding, changing clothes, etc. The level of care can be received multiple times a day. Life support includes household services such as cooking, laundry, and shopping.

Access to the bath: provide home-care bathing services for those who cannot take care of themselves.

Visiting Nursing: A nurse or health care professional visits a professional medical care service.

Access to rehabilitation training: Professionals come to the door to perform rehabilitation training for those in need of care. Visiting rehabilitation training implementation units can only be hospitals, clinics, nursing elderly health centers, and without the above-mentioned units, access rehabilitation services can be used in the form of visits and care.

Home care management guidance: For the elderly who have difficulty in moving to the hospital, doctors, dentists, dental hygienists, pharmacists, management nutritionists come to the door to provide medication, oral hygiene, nutritional intake and other related guidance.

Day Care: You can receive non-occupancy services at the center, including routine care such as bathing, excretion, feeding, and functional training.

Day Care Rehabilitation Training: People in need of care can receive necessary rehabilitation training services such as physical therapy and occupational therapy in elderly health centers, hospitals, clinics and other medical institutions.

Short stay: Short-term care is available at short-term check-in institutions.

Short-term stay: Provide short-term care and check-in at an elderly health facility or a nursing facility.

Designated facility life care: People in need of assistance can use the care prevention designated facility to receive life care.

Welfare equipment rental: According to the level of care recognition, the elderly can borrow the appropriate care and welfare equipment.

Sales of specific welfare equipment: You can use the care insurance to purchase the designated care equipment, only for bathing and excretion related items.