Controversial Issues and Reforms in the Long-term Care Insurance Scheme

ABSTRACT

Recently, The Ministry of Health and Welfare(MOHW) introduced a new bill called the Law of Personal Care for the Elderly People(LPCEP). The bill has several important problems. First, the bill of LPCEP contains no comprehensive care but only personal care. Basically, the elderly would be in need of comprehensive care because they are weakened or in ill-health and must always be provided with medical treatment and personal care. However, MOHW has reduced the basic concept of services for the elderly from comprehensive care to personal care. Second, the design of the longterm care insurance scheme is distorted. Principles of insurance are not adopted making eligibility equal to the burden of insurance contribution. In addition, the burden of the nation is insufficient compared with that of Japan. Third, medical longterm care facilities(LTCF) are no longer provided for the elderly. It is inadequate for the elderly to be provided only non-medical LTCF. Fourth, in the beginning, the National Health Insurance Corporation would manage the LTC system, but in the long run, local government should manage it. Fifth, the assessment of eligibility scale is not estimated by professional medical man power. Half of the estimation committee is composed of public officers who have no professional knowledge or skills in simulative demonstration of long-term care insurance. Sixth, care management of core man power for LTC is not designed to adequately supply for the elderly. A personal caregiver only would be supplied. Therefore, the bill has to be put on hold. In case of a revision, the bill, which is designed inappropriately, should be reformed fully.