Rising costs of nursing care insurance (in Fukushima)

May 22, 2018

Nursing care insurance premium rises to average 5,869 yen for FY2018-2020

https://mainichi.jp/english/articles/20180522/p2a/00m/0na/015000c

TOKYO -- The Ministry of Health, Labor and Welfare announced on May 21 that the average monthly premium for nursing care insurance that elderly people will pay for fiscal 2018 through 2020 is 5,869 yen, up 6.4 percent from the previous period and doubling from when the program was introduced.

The rise in the long-term care insurance premium comes amid the ever-increasing use of nursing care services in a rapidly aging society.

According to the ministry, those aged 65 or older are to pay a monthly national average of 5,869 yen for nursing care insurance premiums in fiscal 2018-2020, up 355 yen from the previous FY2015-2017 period.

Municipalities across the country review the insurance premiums every three years based on the projected volumes of nursing care services to be provided, which are then tallied by the health ministry. While the number of people recognized to require nursing care or assistance stood at 2.56 million in fiscal 2000 when the nursing care insurance system was introduced, the figure for such people shot up to 6.4 million by February this year. Accordingly, the national average monthly nursing care insurance premium has doubled from the initial 2,911 yen in FY2000.

The nursing care insurance premium is expected to further rise over the coming years, to somewhere between 6,800 yen and 7,200 yen in fiscal 2025 and between 8,600 yen and 9,200 yen in fiscal 2040, according to the ministry's estimate.

By municipality, 1,224 local bodies (78 percent) raised the insurance premium from that for the previous three-year period, while 256 other bodies (16.3 percent) kept the fees unchanged and 90 bodies (5.7 percent) lowered the premium.

The village of Katsurao in nuclear disaster-hit Fukushima Prefecture stood out for its highest premium at 9,800 yen a month. Among the 11 towns and villages ranked in the top 10 for their high nursing care insurance premiums, seven are situated in Fukushima Prefecture. The other six Fukushima municipalities in the top 10 are: the town of Futaba (8,976 yen), the town of Okuma (8,500 yen), the town of Namie (8,400 yen), the village of Iitate (8,297 yen), the town of Mishima (8,000 yen) and the village of Kawauchi (8,000 yen).

Meanwhile, the village of Otoineppu in the northernmost prefecture of Hokkaido ranked at the bottom for its lowest premium of 3,000 yen. In 1,150 municipalities (about 70 percent), insurance premiums stood within the range of 5,001 yen to 6,500 yen.

Among the seven Fukushima Prefecture municipalities that ranked in the top 10 for their high insurance premiums, six were subject to evacuation orders in the wake of the Fukushima No. 1 Nuclear Power Plant disaster. The high premiums in those local bodies are believed to have been triggered by deteriorating health conditions among elderly residents due to the prolonged evacuations, among other factors. While residents in those areas are exempt from insurance premium payments in principle under the national government's special measure, local municipalities are growing wary of how long the exemption will continue.

The evacuation order was lifted in June 2016 for most parts of the village of Katsurao, whose insurance premium stood the highest among all municipalities. As of May 1 this year, there were 530 people aged 65 or older in the village, accounting for nearly 40 percent of the 1,430 registered population. Among them, 157 people have been recognized to require nursing care or assistance.

"Due to the prolonged evacuations, residents tend to develop poor health conditions more often than before," said a representative of the Katsurao Municipal Government's resident life division. "Over the course of their evacuation, the trend toward nuclear families progressed and elderly households increased, forcing them to have no choice but to rely on nursing care services."

The Fukushima Prefecture village of Iitate ranked eighth with a monthly insurance premium of 8,297 yen, down from the second place it took in the previous period. While the evacuation order was lifted for most parts of the village in March last year, only about 14 percent of its registered residents, or 794 people, have returned to the village to live, with over half of them aged 65 or older. "If the insurance premium becomes more expensive while the special exemption is abolished, our nursing care services could collapse," lamented a representative of the Iitate Municipal Government's health and welfare division.

Hideo Takahashi, a 68-year-old local farmer, said, "Even if the national government's assistance is terminated, I can get by with my income, but other elderly people who cannot work would be in hell. Unless the Fukushima Prefectural Government and the Iitate Municipal Government provide assistance, the weak will just be discarded."

The Fukushima Prefectural Government is set to request the central government to continue the insurance premium exemption system for elderly residents and aims to curb insurance fees by stepping up efforts to prevent residents from requiring nursing care in collaboration with municipalities hosting nuclear evacuees.

"We will strive to make sure that those in need can properly receive nursing care services," said an official of the prefectural government.

The health ministry is set to release its tallies of nursing care insurance premiums by municipality and other related information on its website.

(Japanese original by Hiroyuki Harada, Medical Welfare News Department, Toshiki Miyazaki and Hideyuki Kakinuma, Fukushima Bureau)