Research On The Rule Of Insurance Benefits Payment In The Japanese Long-term Care Insurance Law And Implications For China

Although China and Japan are at different stages of aging,they face similar challenges such as expanding demand for care and a shortage of medical resources.The establishment of the care payment rules in Japan’s Long-term Care Insurance Law,including the background,specific content,and legal evaluation,has strong reference significance for the construction of China’s long-term care insurance system.Japan’s Long-term Care Insurance System was established through legislation in 1997 and has undergone several revisions,providing Japan with rich experience in dealing with care issues.When Japan established the care payment rules in the Long-term Care Insurance Law,it was in the midst of a deepening aging society,with an increasing number of elderly people living longer and suffering from chronic diseases.In traditional Japanese society,families were responsible for caregiving.However,with the acceleration of urbanization,changes in family structures,and the rise in the status of women,the caregiving capacity of families gradually weakened.At the same time,medical institutions were overcrowded,and medical resources were scarce,posing significant challenges to the healthcare system.These societal needs led Japan to change its previous practice of providing care solely through administrative agencies and establish a connection between the government and care demanders through insurance contracts.With the continuous revision of the Long-term Care Insurance Law,the care payment rules have been continuously optimized.The care payment rules in Japan’s Long-term Care Insurance Law consist of four stages,including assessment,planning,care provision,and content evaluation.The care services provided include home care,community care,and institutional care.If the insured person has not yet lost their self-care ability or has been assessed as "requiring support level 1-2," preventive care measures are used to intervene in disability risks and prevent further deterioration.In addition to the specific implementation,supervision methods for third-party service providers are also specified.The subject of Japan’s Long-term Care Insurance System is jointly supported and maintained by the parties involved in the system.Insured persons who pay their premiums on time apply to their local governments for care level certification,and based on their level of care,they receive corresponding physical payments from designated or permitted service providers.Japan’s Long-term Care Insurance System includes both care insurance contracts and care service contracts,both of which have multiple contractual properties.The care insurance contract is both an insurance and welfare contract,while the care service contract is a quasi-appointment,sales,continuous,and service contract.The connection between the adult guardianship system and the Long-term Care Insurance Law can remove barriers to the insured person’s ability to act.Through studying the benefit payment rules in Japan’s "Long-term Care Insurance Law" and combining it with China’s experience in constructing long-term care insurance systems,it is necessary to promote the integration of the long-term care insurance system at the legislative level,establish a service pattern where community-based care is the main focus and institutional care is supplementary,establish a nursing prevention system as soon as possible,encourage service marketization,strengthen nursing management and supervision,and promote the construction of China’s long-term care insurance system.