Because there has been a severe shortage of long-term care facilities for the elderly, the overwhelming majority of old inpatients receive medical care at general hospitals, thus substantially increasing the average duration of hospitalization; data gathered in 1993 show that the average length of hospitalization for those aged 65 and over is 71 days, as opposed to 10 days for those at ages 0-14 (Health and Welfare Statistics Association, 1995). Institutions for long-term care for the elderly are a relatively recent development; the establishment of such institutions was officially approved by the government in 1983.
Because institution-building is a slow process, and Japan's population aging is expected to accelerate in the next few decades, it is highly probable that the long period of hospitalization will continue to be the main source of the growth of public medical expenditure in the years to come.In order to avoid this future development, the government emphasized in its 1987 White Paper on Health and Welfare that the responsibility for looking after elderly patients should be shifted from hospitals to family caregivers, who are usually middle-aged women. To facilitate this transfer process, the government started in 1990 to increase substantially, through its 10-year project called "the Golden Plan," its budgetary allocation for the social service programs for elderly patients (Ogawa and Retherford,1996).
C. Bridging Pensionable and Retirement Ages
It is anticipated among government pension planners that the discrepancy of pensionable ages among the various pension schemes will be eliminated by gradually raising the pensionable age to 65 in all public pension plans by the year 2013. Since the majority of older employees are required to retire from their firms before they reach the age of 60, however, this pensionable age may pose serious difficulties unless the mandatory retirement age is raised accordingly and/or the employment opportunities for work after mandatory retirement are considerably expanded.
In an initiative that is consistent with these policy goals, the government of Japan has been implementing a variety of programs and measures aimed at facilitating the increase in mandatory retirement ages since the latter half of the 1980s. In 1986, it implemented the comprehensive Law Concerning Stabilization of Employment for Older Persons. This legislation established the goal of raising the mandatory retirement age at least to age 60 in every Japanese company. The law, however, does not include
