By: Madeleine Elser
Providing long-term-care services for the world’s elderly population will soon become one of the world’s largest and most crucial health care policy issues. The increasing number of aging individuals will soon affect many countries in areas such as providing these long-term-care services as well as a decreasing work force. As of 2015, the percentage of the world’s population aged 65 years and over was 9%. By 2030 this number is projected to reach 12% and by 2050, it is projected to reach nearly 17%. The global population of individuals aged 80 years and over is expected to triple by 2050. Certain countries, such as the United States, have implemented little to no policy in response, while other countries, such as Japan, have created drastic changes to deal with current demand as well as in anticipation of future growth.
Currently, The United States does not have a plan of action to combat the increasingly significant problem of financing the long-term-care of the elderly population. Nearly 48 million people in the United States are aged 65 years or over, constituting about 15% of the country’s total population. In 2010, Congress instituted the CLASS Act, which would create a voluntary long-term-care insurance program, but the Act was quickly repealed after the Obama Administration determined it was not financially possible to sustain. Many Americans are not engaged with the issue because they expect Medicaid to be available to them when they don’t proactively make plans for long-term-care. Bruce Chernof, President of the SCAN Foundation, has stated that the public has not concerned itself with the issue because it “sounds expensive and insurmountable.” With the baby boomer generation moving past the ages of early retirement, and into the ages of becoming frail, ill, and diseased, the crisis will rapidly worsen. Some policy considerations that have been made include providing a tax incentive for the purchase of private insurance, and the creation of a required system of social insurance for the kinds of services that will be demanded by the elderly population. By 2050, the Department of Health and Human Services predicts that 27 million elderly Americans will need some type of caregiving aid. At a time where Medicare and Medicaid programs have been the focus of spending cutbacks, a resolution to this problem does not appear imminent. However, the National Bureau for Economic Research reports that long-term-care expenditures have been increasing more rapidly than any other health care expenditure and should continue to increase for decades to come.
Japan faces a much more urgent crisis, with 25% of its population currently aged over 65 years amidst a world average of about 9%. Additionally, Japan has the longest life expectancy rate in the world at 83.4 years, creating a need for longer terms of care per individual than many other countries. However, unlike many other nations, the Japanese government has made bold changes to their health care system in recent years. As of 2000, the government implemented a national long-term-care insurance plan, which is generous in coverage and benefits, offering each recipient up to $2,900 a month in services, although it does require co-payment from the patients utilizing the services. In 2011, the government created new reforms to assimilate health care, prevention, and long-term-care, which demonstrated to the world the effectiveness of changing health care policy proactively. With regards to the decreasing number of people in the work force, many Japanese companies have also experimented with raising maximum age limits, as well as decreasing hours and giving more limited responsibilities for senior employees.
While the United States and other countries may not presently be experiencing the extreme effects of the growth of the elderly population and the pressing need for long-term-care services, preparations are needed, along with a willingness by lawmakers to bring about change in healthcare policy. Legislators should look to policies from countries, such as Japan, that are currently experiencing the pressing need to provide care for a largely increasing elderly population and are responding accordingly. While the Japanese system is not perfect, it is a notable example of a nation that has attempted to provide access to care and proactively prepared for even more growth in years to come. The United States should look to such policy to determine what courses of action were successful and which left room for improvement. It will be crucial for future generations that policy makers develop a plan of action now, so that the dramatic increase in the elderly population will not result in a lack of access to long-term-care when it is needed most.