日本介護保險改革及其展望（譯文）

Abstract

日本介護保險制度自二○○○年四月施行以來，迄今已有十六年。著者伊藤周平教授在概述日本介護保險制度及其現況後，除檢討自二○一五年四月起施行之新修正介護保險法的問題點外，也針對現行介護保險制度提出因應之道，並論及日本介護保險制度的未來方向。文中在逐一檢討安倍政權在社會保障改革下強化給付限制及利用者負擔、調降介護報酬等措施所衍生問題後，並直指現行制度在收支連動構造下，因實際上難以調高保險費，致使改革僅能趨向節制給付一途；而此亦正是日本介護保險制度之困境。 It has been over 16 years since long-term care insurance started in Japan in April,2000. Prof. Itou stated Japan’s Legal system of Long-term Care Insurance (LTCI) and its current situation. Besides discussing the problems faced in enforcing the newly reformed long-term care insurance law from 2015, he also offered some solutions for the LTCI system and discussed the trend in the future of Japan’s long-term care insurance law. In the article, he discussed about the social security reform under ABEs administration. It brought up the problems arose from the reform such as benefit limitation, burden on users, and from lowering the compensation for long-term care. Prof. ITOH pointed out the relationship between revenue and expenditure under the financial structure of LTCI. Under the current situation, it is difficult to increase the insurance premium. Therefore the only way for the reform is to limit the benefit. That is the difficult situation in Japan’s LTCI.