Introduction to the Special Issue

Review and Evaluation of Twenty-Five Years of the Long-Term Care Insurance Program

Abstract

At the Plenary Session of the JASPS 151st Conference, four presentations and general discussions were held on the financing of the Long-Term Care Insurance （LTCI） program, its reforms, comparison with similar programs in other countries, the Disability Welfare Program in Japan, and other related issues. Based on these presentations and discussions, this article examines the challenges it faces and other issues yet to be discussed. From these perspectives, an important theme is the long-standing problem of achieving sufficiency in the care workforce. Their wage level is still relatively low. The government has accepted an increasing number of foreign care workers but lacks a long-term perspective. In addition, the reforms conducted on the LTCI program with the aim of ensuring its financial sustainability and introducing policy innovations have produced new challenges for this program, such as its expansion and complications, as well as the coexistence of subsystems with different principles of operations. Further examination is needed to address issues such as care security for low-income elderly individuals, and other policy and environmental factors that affect the effectiveness of this program.