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mahatmakanejeeves

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Mon Jul 13, 2020, 10:19 AM Jul 2020

Could a Japanese-style elder care insurance program work in Montana?

https://twitter.com/David__Erickson

Could a Japanese-style elder care insurance program work in Montana?

DAVID ERICKSON david.erickson@missoulian.com Jul 12, 2020

Last week in Graying Pains, the Missoulian’s David Erickson examined the introduction and implementation of Kaigo Hoken, or care insurance, in Japan, the world’s demographically oldest country. This week’s conclusion of that story explores how a similar policy might translate to Montana, the oldest state in the American West.

A full 13% of Montanans are in their 60s, and the “baby boomer” generation is nearing or entering retirement age. Care for the elderly will become an increasingly pressing issue in Montana as larger and larger numbers of voters enter the older brackets of the state’s demographics.

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There’s no doubt that Montana is facing a crisis. According to Melissa Favreault of the Urban Institute and Judith Dey of the U.S. Department of Health and Human Services, Americans who need long-term care can expect to incur costs of $138,000, on average. They say that about half of Americans turning 65 today will eventually need assistance with bathing, dressing and other personal activities. Yet people ages 55 to 64 with retirement savings accounts have a median balance of $104,000, according to the National Institute on Retirement Security.

“If you look at the population pyramids of Montana counties, you’ll see a big hole in the 18-to-25 age bracket,” he said. “The young people are gone and they’re not coming back. And that’s what’s happening in Japan. The young people in Japan move to three or four big cities, and they’re the only places that have a large number of youth. Montana has two counties, Gallatin and Missoula, that have lots of young people. Everywhere else they’re just gone.”

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This article originally ran on helenair.com.

Last week:

Graying Pains: Japan: A glimpse at Montana’s future?

David Erickson Missoulian Jul 3, 2020

About this series

Montana is the oldest state west of the Mississippi, and demographic projections show the state growing collectively older as more Montanans enter their senior years. The economic, cultural, and personal impacts of that trend present the state and its residents with new challenges and, with those challenges, opportunities.

Graying Pains is a series of weekly stories and broadcasts exploring those challenges and opportunities in communities statewide. By investigating how other communities have responded to the issues raised by aging, Graying Pains hopes to point the way toward policies and innovations that can help Montana, and Montanans, improve with age.

The series is produced by the Montana Fourth Estate Project, a collaboration among 13 Montana newsrooms and the University of Montana School of Journalism coordinated by Montana Free Press under the auspices of the Montana Newspaper Association and the Solutions Journalism Network. See montanafourthestate.org for the collected Graying Pains stories and more information.

This is part 1 of a two-part story about financing elder care in aging populations. Part 2 — what new strategies could Montana explore? — will be published next week.

Montana, the oldest state in the western United States, faces many of the same problems as Japan, the world’s oldest country. Might there be solutions for Montana from what looks to be a successful experiment enacted two decades ago to help pay for elder care in Japan?

On April 1, 2000, a new law in Japan began the world’s largest and most radical long-term care program for the elderly.

It was a surprising development to many outsiders, because although it was well-known that Japan was, and remains, the world’s oldest country, the government had a reputation for not doing much about the issues raised by that demographic fact. In Japanese society, the burden of caring for the elderly has historically fallen on the shoulders of family members, especially women. For example, the wife of any given family’s eldest son often takes care of his parents. Elderly people often live in the same home as the eldest son or one of the daughters.

The program, called Kaigo Hoken (care insurance), is essentially a socialization of elder care through mandatory social insurance. Every citizen over the age of 40 with an income must contribute a monthly premium of $30-$50, depending on income. Then, everyone over the age of 65 is eligible for benefits in the form of care. The range of available services depends on a recipient’s level of disability, but the law pays for trips to adult day care centers, hospice care, medical care and in-home care such as cooking and cleaning.

After two decades, the $100 billion program has become "very popular,” said Naoki Ikegami, a professor in the School of Public Health at St. Luke’s International University’s Center for Clinical Academia in Tokyo. “For both the middle-aged and the young, it’s very popular because it has taken care of their parents. Japanese society can’t exist without [the law] now.”

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Next week: Could a mandatory elder care insurance program work in Montana?
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