Since the nursing care insurance system was established, 20 years have passed and it can be said to have reached a major turning point.
In the past, nursing care was carried out by family members, but care dependent on relatives has reached its limit as the tendency to form nuclear families continues. Therefore, the nursing care insurance system was introduced in fiscal 2000 for society to support nursing care.
After individuals are certified as needing nursing care, patients are provided services depending on their condition, such as help with bathing and meals. The funding is provided by insurance premiums and public funds, and the service usage fees paid by patients are kept low.
It is commendable that the system has taken root and many people have become able to receive various support.
However, with the rapid progress in the aging of the population, the number of people who need nursing care has tripled in the past 20 years. Securing human resources to provide nursing care services cannot keep up with growing need.
According to a survey by The Yomiuri Shimbun, about 90% of the heads of major local governments responded that it would be difficult to maintain the system in the next 10 years. Many of them cited the shortage of human resources as the reason.
At nursing care workplaces where staffing is insufficient, the burden of each worker tends to become heavy. As a result, there are many cases where those workers leave their jobs, and the situation is falling into a vicious circle, with the quality of services deteriorating. It is an urgent task to increase the number of caregivers.
No time for delay
Improving treatment, such as raising salaries that are comparatively lower than in other industries, is essential. It is necessary to create an environment in which it is easier to work, through labor-saving measures such as recording patients' conditions on smartphones.
The burden of insurance premiums is ever increasing as the need for nursing care grows. Monthly insurance premiums for those aged 65 or older have increased from 2,911 yen initially to 5,869 yen. If it continues to increase, some people will become unable to pay insurance premiums.
Reexamining service content is indispensable to reduce the burdens.
Currently, nursing care insurance provides housework assistance service even for those who only need low levels of care. It is necessary to transfer such services to municipal governments.
If volunteers are used to help with household work, it can be expected to reduce costs. It is important to enhance the power of mutual assistance among local residents.
What is concerning is that the government's reform of nursing care insurance system is slow. One option is to request elderly people who have economic leeway to pay for the use of nursing care services according to their financial abilities. However, there is no prospect of realizing such a reform.
In order to maintain the system and continue to support the security of life after retirement, postponement of discussing the issues surrounding the nursing care insurance system cannot be permitted.
-- The original Japanese article appeared in The Yomiuri Shimbun on April 5, 2020.
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