The Challenge of Sustaining Long-term Care in Aging Societies: Lessons From Japan and Spain Comment on "Financing Long-term Care: Lessons From Japan"

Abstract

This article compares the provision of long-term care (LTC) in Japan and Spain, two countries with similar demographic structures but which address the provision of LTCs in very different ways. Both countries provide universal LTC. However, Japan has developed a generous benefit package of formal services for dependents to alleviate the care burden on the family, but provides no cash benefits. In Spain, on the other hand, cash allowances are the norm rather than the exception in the practical implementation of LTC services. After discussing the necessary delineation of LTC in response to future sociodemographic challenges, we discuss LTC system characteristics and the recent cost containment reforms implemented in Japan and Spain. Finally, we consider the lessons that may be drawn from each country’s experience and the reforms that must be undertaken in order ensure the sustainability of LTC provision in other countries with incipient or more developed LTC systems. In addition, since Japan and Spain are both faced with challenging demographic projections, it is important for each country to learn from the other’s initiatives and reforms.

Cost-containment long-term care policies for older people across the Organisation for Economic Co-operation and Development (OECD): a scoping review

“…These beneficiaries are therefore included in a category of people with a lower level of disability who receive a more moderate amount of benefit (Janssen et al, 2016). Similar approaches have been reported in Japan and Spain (Tsutsui and Muramatsu, 2007;Waldhausen, 2014;Pozo-Rubio and Jiménez-Rubio, 2020).…”

Key Issues in Designing Long-term Care Systems: A Response to Recent Commentaries

“…This stable status contrasts with the drastic cuts made in Spain's tax-based program described by Pozo-Rubio and Jimenez-Rubio although the economic crisis must also be taken into consideration. 7 There are other ways to finance LTC such as the Swiss individual capital-funded occupational retirement fund as described by Eling. 8 However, this method would not be feasible in countries where pensions are funded on a pay-go basis.…”

“…This stable status contrasts with the drastic cuts made in Spain’s tax-based program described by Pozo-Rubio and Jimenez-Rubio although the economic crisis must also be taken into consideration. 7 …”