Political and Cultural Foundations of Long-term Care Reform; Comment on “Financing Long-term Care: Lessons From Japan”

Document Type : Commentary

Author

Department of Health Policy and Management, Emory University, Atlanta, GA, USA

Abstract

This paper comments on Naoki Ikegami’s editorial entitled “Financing long-term care: lessons from Japan.” Adding to the editorial, this paper focuses on analyzing the political and cultural foundations of long-term care (LTC) reform. Intergenerational solidarity and inclusive, prudential public deliberation are needed for the establishment or reform of LTC systems. Among various lines of ethical reasoning related to LTC, Confucian ethics and other familist ethics are specifically important in the societies that share these values. The core issue in the debates around LTC reform is how to (re-)define the scope of social entitlements and accordingly to allocate the responsibility for care between states and families, between social groups, and between generations with limited resources.

Keywords

Main Subjects

References

  1. Ikegami N. Financing long-term care: lessons from Japan. Int J Health Policy Manag. 2019;8(8):462-466. doi:10.15171/ijhpm.2019.35
  2. Kim JW, Choi YJ. Farewell to old legacies? the introduction of long-term care insurance in South Korea. Ageing Soc. 2013;33(5):871-887. doi:10.1017/S0144686X12000335
  3. Hsu HC, Chen CF. LTC 2.0: The 2017 reform of home- and community-based long-term care in Taiwan. Health Policy. 2019;123(10):912-916. doi:10.1016/j.healthpol.2019.08.004
  4. Saltman RB. The role of comparative health studies for policy learning. Health Econ Policy Law. 2012;7(1):11-13. doi:10.1017/S1744133111000259
  5. Seo Y. Democracy in the ageing society: quest for political equilibrium between generations. Futures. 2017;85:42-57. doi:10.1016/j.futures.2016.11.002
  6. Thompson DF. Representing future generations: political presentism and democratic trusteeship. Critical Review of International Social and Political Philosophy. 2010;13(1):17-37. doi:10.1080/13698230903326232
  7. Kotlikoff LJ, Burns S. The Clash of Generations: Saving Ourselves, Our Kids, and Our Economy. Cambridge, MA: The MIT Press; 2014.
  8. Kawai N, Kubo K, Kubo-Kawai N. “Granny dumping”: Acceptability of sacrificing the elderly in a simulated moral dilemma. Jpn Psychol Res. 2014;56(3):254-262. doi:10.1111/jpr.12049
  9. Goerres A, Tepe M. Age-based self-interest, intergenerational solidarity and the welfare state: a comparative analysis of older people's attitudes towards public childcare in 12 OECD countries. Eur J Polit Res. 2010;49(6):818-851. doi:10.1111/j.1475-6765.2010.01920.x
  10. Young IM. Inclusion and Democracy. New York, NY: Oxford University Press; 2000.
  11. Kyodo J. Government backpedals on report that said elderly couples will need ¥20 million in savings. The Japan Times. June 11, 2019. https://www.japantimes.co.jp/news/2019/06/11/national/abe-apologizes-report-aging-said-elderly-couple-will-need-%C2%A520-million-savings/#.XaWFwEgvxPY.
  12. Deng CY, Wu CL. An innovative participatory method for newly democratic societies: the "civic groups forum" on national health insurance reform in Taiwan. Soc Sci Med. 2010;70(6):896-903. doi:10.1016/j.socscimed.2009.10.053
  13. Lin KM, Chen DS. Citizen Conference and Deliberative Democracy: Citizen Participation in Taiwan's National Health Insurance Policies. Taiwanese Sociology. 2003(6):62-118.
  14. Nakagawa Y, Kotani K, Matsumoto M, Saijo T. Intergenerational retrospective viewpoints and individual policy preferences for future: a deliberative experiment for forest management. Futures. 2019;105:40-53. doi:10.1016/j.futures.2018.06.013
  15. Kingdon JW, Thurber JA. Agendas, Alternatives, and Public Policies. Vol 45. Boston, MA: Little, Brown and Company; 1984.
  16. Rachel Lu JF, Chiang TL. Evolution of Taiwan's health care system. Health Econ Policy Law. 2011;6(1):85-107. doi:10.1017/s1744133109990351
  17. Zhang E. Community, the common good, and public healthcare—Confucianism and its relevance to contemporary China. Public Health Ethics. 2010;3(3):259-266. doi:10.1093/phe/phq030
  18. Park M, Chesla C. Revisiting Confucianism as a conceptual framework for Asian family study. J Fam Nurs. 2007;13(3):293-311. doi:10.1177/1074840707304400
  19. Yeh MJ. Long-term care system in Taiwan: the 2017 major reform and its challenges. Ageing Soc. 2019:1-18. doi:10.1017/S0144686X18001745
  20. Ranci C, Pavolini E. Not all that glitters is gold: long-term care reforms in the last two decades in Europe. J Eur Soc Policy. 2015;25(3):270-285. doi:10.1177/0958928715588704
  21. Saraceno C, Keck W. Can we identify intergenerational policy regimes in Europe? European Societies. 2010;12(5):675-696. doi:10.1080/14616696.2010.483006
  22. Graham Wck, Bilger M. Financing Long-Term Services and Supports: Ideas From Singapore. Milbank Q. 2017;95(2):358-407. doi:10.1111/1468-0009.12264
  23. Imamura S. The Ballad of Narayama (a film based on the novel written by Fukazawa Shichiro). Toei Co. Ltd. and Umbrella Entertainment; 1983.
  24. Danely JA. Art, aging, and abandonment in Japan. Journal of Aging, Humanities, and the Arts. 2010;4(1):4-17. doi:10.1080/19325610903419350
  25. Lee WH, Shaw Y. Revisiting the Tale of Obasute in the Japanese Imagination. Asian Cinema. 2009;20(1):98-126. doi:10.1386/ac.20.1.98_1
  26. Yeh MJ. Long Term Care at the Crossroads: Institutional Designs and Social Values. Taiwan J Public Health. 2017;36(3):197-203.
  27. Cylus J, Normand C, Figueras J. Will population ageing spell the end of the welfare state? a review of evidence and policy options. Copenhagen: European Observatory on Health Systems and Policies; 2018.
  28. Reis AA. Universal Health Coverage - The Critical Importance of Global Solidarity and Good Governance: Comment on "Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage." Int J Health Policy Manag. 2016;5(9):557-559. doi:10.15171/ijhpm.2016.61
  29. World Health Organization (WHO). World report on ageing and health 2015. Geneva: WHO; 2015.
International Journal of Health Policy and Management
Volume 9, Issue 2
February 2020
Pages 83-86

Files

History

  • Receive Date: 16 August 2019
  • Revise Date: 09 October 2019
  • Accept Date: 12 October 2019
  • First Publish Date: 01 February 2020

Share

How to cite

Statistics