Discussion
On November 30, 2021, the 259th Japanese Expert Invitation Seminar was held as a webinar. In the presence of about 30 participants, Mie Owa, a professor at the Department of Human Welfare and Human Welfare at Kansei Gakuin University, gave a presentation on the topic of “The present and challenges of welfare of the elderly in a super-aged society.” The contents of the presentation are as follows.
Currently, Japan is entering the world's most aging super-aged society, with the proportion of people aged 65 and over exceeding 28.8%. The elderly population will peak in 2040, and the aging rate will continue to increase, reaching 40% in 2065. As the average life expectancy increases, the age of 100 years is approaching reality, but even if the average life expectancy increases, there is an 'unhealthy period' of about 10 years. What you need at this time is long-term care insurance.
Japan's long-term care insurance system, launched in 2000, is mandatory for those over the age of 40 and pays an insurance premium of 1-3% of the cost of long-term care services depending on income. However, there are concerns about the impact on the economy due to the aging and declining labor force mentioned above, so maintaining the long-term care insurance system is becoming a challenge. Currently, the number of certified long-term care recipients accounts for 18% of the elderly population, and as the number of certified long-term care recipients continues to increase, the number of recipients of long-term care insurance is increasing. Accordingly, the total cost of long-term care benefits has steadily increased from 3.6 trillion yen in 2000 to about 12 trillion yen now, and the monthly insurance premiums paid by individuals have also steadily increased, suppressing the increase, but reaching about 6,000 yen as of 2021.
In addition, among the elderly in Japan, the ratio of elderly people with dementia and elderly living alone is high, and there are many elderly people suffering from social isolation. In response, the Japanese Cabinet established the Office of Solitude and Isolation Countermeasures in February 2021, and is actively promoting the regional comprehensive care system as a specific system. The regional comprehensive care system is being promoted with the goal of maintaining the dignity of the elderly and living in the local area until the end, that is, 'Aging in Place'. However, since there is a large difference in the progress of aging in each region, the goal is to establish a regional comprehensive care system tailored to the characteristics of each region.
However, the demand for nursing talents increases sharply every year, and although the demand for 2.45 million people is predicted in 2025, the supply does not meet the demand. For example, it is predicted that there will be a shortage of 340,000 nursing talents in 2025. Accordingly, the Japanese government has recently started to more actively promote the importation of foreign nursing personnel. The number of foreign care workers was confirmed to be about 1.27 million in 2017, and it is confirmed that the number is steadily increasing. The proportion of elderly welfare facilities that still employ foreign nursing staff is about 30%, but it is expected to increase further in the future. However, due to the current COVID-19 pandemic, the working and hiring situation of foreign nursing talents is not as smooth as before.
In other words, Japan is currently facing a situation in which not only the aging population is progressing, but the nursing care rate is increasing, the elderly living alone, and the elderly suffering from social isolation or poverty are increasing. In this regard, securing the sustainability of social security systems, including long-term care insurance, and changing society's consciousness toward the elderly are being raised as tasks for the welfare of the elderly, requiring continuous consideration.
After the presentation, a question-and-answer session followed. There was a question about the actual utilization of the social insurance system or regional comprehensive care system introduced in today's presentation. The presenter first introduced the point that although certified long-term care recipients make up about 18% of the elderly population, just because they receive certification for long-term care does not necessarily mean they use long-term care services. However, in Japan, where nursing care was often carried out by families due to the Confucian culture, “socialization of nursing care” is gradually taking place. was expected to be mentioned. Even in the case of the regional inclusive system, although there are still some people who do not know it even after 15 years have passed since it was created, it is working very hard as the lowest or the most local administrative agency. He replied that he expected to do so. He also added that the members of the People's Livelihood Committee have a close cooperative relationship with the regional center.
In addition, questions such as the level of nursing care education of foreign nurses working in Japan and their evaluation of their work, discrimination in nursing care workers in Japan, young careers, youth job problems due to the extension of the retirement age, and decentralization related to regional disparities will be discussed will be discussed. After that, the seminar ended.
