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The ProgramThe new LTCI program departs from past Japanese practices inseveral important respects. It aims to (1) shift a major responsibilityfor caregiving from the family to the state; (2) integrate medical careand social services via unified financing; (3) enhance consumerchoice and competition by allowing free choice of providers, includingeven for-profit companies; (4) require older persons themselvesto share the costs via insurance premiums as well as copayments;and (5) expand local government autonomy and management capacityin social policy. The government plans to expand the newprogram gradually over ten years, leading to a major expansion ofcommunity-based care, a fundamental reform of financing and regulationof institutional care, and, more generally, a flexible approachto social policy based on individual entitlement and choice
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