Discussions to review the long-term care insurance system have begun at an expert subcommittee of the Ministry of Health, Labor and Welfare.


What should we do about the increasing cost of nursing care due to the rapid aging of the population?


The focus will be on discussions that will lead to an increase in the burden of elderly people aged 65 and over, such as "reviewing the burden of long-term care insurance premiums" and "increasing the co-payment of long-term care services."

Q. Will the burden increase?

going down?

Full-scale discussions have just started on October 31, so the conclusion is not yet known.



On the other hand, the agenda presented by the Ministry of Health, Labor and Welfare on the 31st includes content that asks the elderly to bear the burden, such as `` reviewing the burden of long-term care insurance premiums '' and `` raising the self-pay of nursing care services ''.

Considering the current situation, a review is unavoidable, and discussions are expected to advance in the direction of asking some elderly people to increase the burden.



The Ministry of Health, Labor and Welfare plans to compile a policy by the end of the year.

Q. Why do we have to think about revising?

This is because the number of elderly people who need nursing care is increasing year by year due to aging, and the cost of nursing care continues to increase accordingly.



As of the end of March 2022, the number of elderly people requiring nursing care has increased to approximately 6.9 million, 3.2 times the number at the end of April 2000 when the nursing care insurance system began.



In addition, the number of elderly people aged 75 and over is estimated to be 19.4 million in October 2022, but it will reach 21.8 million in 2025, when all the baby boomers will be over 75, accounting for nearly 20% of the population. It is estimated that



Along with this, the cost of nursing care services is increasing year by year, and the total budget for this year is 13.3 trillion yen. It is estimated to reach 1 trillion yen.

On the other hand, the number of people between the ages of 40 and 64 who pay premiums to support the system is on the decline. The challenge is how to deal with it.

Q. What kind of content is subject to review?

The subject of the review is the "benefits and burdens" of the long-term care insurance system.



▽ “Benefits”: Contents and scope of long-term care insurance services.


▽ "Burden": Self-pay when using insurance premiums and services.



Specifically, the following seven items were presented as agenda items.

1Review of the scope of insured persons and beneficiaries Under the long-term


care insurance system, premium payments begin at the age of 40, and services are available from the age of 65 in principle. ” and whether to review the target age of “beneficiaries” who receive the benefits of the service.



2 “Review of Supplementary Benefits”


“Supplementary benefits” are benefits for living expenses and food expenses when people whose income is below a certain amount use facilities covered by long-term care insurance. increase.



3. Burden of room charges for multi-bed rooms


Currently, in special nursing homes for the elderly, users are required to pay the room charges not only for private rooms, but also for multi-bed rooms where multiple people live in one room. .



On the other hand, as long-term care health facilities for the elderly do not require users of multi-bed rooms to bear the room charges, the issue is whether or not to ask them to do so in the same way.



4 "Self-pay for care management"


When receiving nursing care at home, "care management" such as the care manager creating a service usage plan is free, but whether or not to ask the user to bear the burden is an issue. becomes.

5 Municipal transition of livelihood support services, etc. for people


requiring long-term care 1 and 2 Currently, living support services such as cleaning, laundry, shopping, etc. received by people with low levels of long-term care 1 and 2 according to national standards ” is provided as “home-visit care” as part of long-term care insurance services.



In this subcommittee, we will discuss whether or not to separate "life support services" for people requiring long-term care 1 or 2 from long-term care insurance services and shift them to municipal-led projects.



6.Review of those eligible for 20%/30% co


-payment: Currently, the co-payment rate for receiving nursing care services is 10% in principle, and 20% or 30% for people with high incomes.


Whether to increase this 20% or 30% target audience will be an issue.



7 "Regarding the review of long-term care insurance premiums" Regarding


the long-term care insurance premiums borne by the elderly aged 65 and over, in order to review the burden according to the ability to pay, the insurance premiums for elderly people with income above a certain level will be raised. , and whether or not to reduce the income of elderly people below a certain level will be an issue.

Q. The burden may increase…for the elderly

Elderly people who use nursing care services have voiced their concerns.



Koichi Koyama (81), who lives with his wife Teruko (79) in Tokyo, has been certified as requiring nursing care 2.

I need a cane to walk, and I use a day care service once a week to move my body through gymnastics. I'm here.



Since the decline in cognitive function is also seen, the day service office asked me if I should increase the number of times I use it to twice a week. It means that we are holding back.



Under these circumstances, the burden of medical expenses has increased since October this month.



The co-payment of medical expenses for elderly people in the later stages of life was partially raised from 10% to 20%, and they became eligible.



The two of them have been paying about 15,000 yen each month due to their chronic diseases, and they have to pay rent, etc., so when medical expenses increased, they withdrew their savings, but the burden of medical expenses increased. Furthermore, if the burden of nursing care services increases, he is worried about how he will be able to maintain his household budget in the future.

Mr. Koichi said, "If medical expenses increase and nursing care costs increase, I'm worried about how much my wife and I will be able to use nursing care services when we get older and our health is worse than now." rice field.



His wife, Teruko, said, "If nursing care costs go up, I think I'll have to take care of my husband at home, but I'm worried because I don't know how long I'll be fine. We have been paying taxes and supporting the country since we were young. However, when I become an elderly person, I feel lonely because I feel like I'm being pushed to a corner of society."

Q. We asked Professor Yasuhiro Yuki of Shukutoku University who is familiar with the long-term care insurance system.

(Professor Yuki)


“In a situation where the number of elderly people is increasing and the working-age population is declining, it is unavoidable to ask the elderly to shoulder a certain amount of the burden. It would be putting the cart before the horse, so we should carefully discuss what kind of elderly people should bear the burden and how much.”

“Long-term care insurance is a system that supports society as a whole in the sense that it supports the elderly, so instead of considering the burden only within the financial framework of long-term care insurance, is there any other tax revenue source? We should also consider considering whether there really is no such thing within the framework of the social security system as a whole.”