As described in the previous section, Japan has a wide variety of programs and services for the welfare of the elderly. Most of the important services, however, have yet to be fully developed. Especially in the field of long-term care, the shortage of service resources is very serious. In order to cope with this situation, the National Government started the TenYear Gold Plan in 1990 and revised it in 1994. The problem is, however, that the population aging will continue at an accelerated pace in the next century, and the various needs of older persons, especially the needs for long-term care, will grow very rapidly.
In order to meet the expanding needs for long-term care and secure a decent level of care services for every senior citizen, we shall have to start another Ten-year Gold Plan in the year 2000. The budget needed for it will be much greater than that for the present New Ten-year Gold Plan. Thus, securing the necessary amount of revenue for the second Plan to be started soon is one of the most important issues for the National Government.
The answer from the National Government is the establishment of a public long-term care insurance program. In May, 1996, the Ministry of Health and Welfare finished its first draft and presented it to the National Advisory Council on the Health and Welfare Services for the Elderly. According to the draft, the public long-term care insurance program will be started in 1999. At first, it will only cover the care services to older and middle-aged persons aged 40 and over living in the community. In the case of middle-aged persons between age 40 and 64, the insurance will only cover the care services to those who suffer from such age-related illnesses as stroke, or dementia. institutional care services will be covered several years later.
Contributions to the program will be collected from persons aged 40 and over. This means that retired older persons will also be obliged to contribute. According to the draft, the contributions of retired older persons are to be deducted from the payment of the public pension. The contribution of middle-aged persons is to be collected along with their contribution to public sickness insurance programs.
The proposed long-term care insurance is to be financed with insurance contributions (1/2) and general revenue (1/2). Therefore, in order to cope with the predicted conspicuous increase in the amount of general revenue, the National Government intends to raise the rate of the consump
