Lessons from public long-term care insurance in Germany and Japan

John Creighton Campbell, Naoki Ikegami, Mary Jo Gibson

Research output: Contribution to journalReview articlepeer-review

111 Citations (Scopus)


The U.S. Congress is considering the Community Living Assistance Services and Supports (CLASS) Act, a voluntary insurance program that would help pay for long-term services and supports to disabled Americans. In Germany and Japan, social insurance programs are universal, support family caregivers, and allow individuals considerable flexibility in securing the services they require. We explored differences between Germany and Japan in program goals, eligibility process, scope, size, and sustainability for possible applications in the United States. Moreover, when we compared public spending on longterm care, we found that spending in the United States is actually higher than in Germany even now, prior to enactment of the CLASS Act, and is only slightly lower than in Japan.

Original languageEnglish
Pages (from-to)87-95
Number of pages9
JournalHealth Affairs
Issue number1
Publication statusPublished - 2010 Jan
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine


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