But it is expected that the quality of services under Kaigo Hoken (the mandatory public long-term care social insurance system) will improve further and that older people's attitudes toward service utilization will change for the better.
In France the obligatory social insurance system, called Social Security, reimburses most medical expenses for 99% of the population.
Germany enabled public long-term care insurance (LTCI), a social insurance system, in 1995.
When high- and low-risk individuals can be identified second-best social insurance system entails cross-subsidies from the low-risk group to the high-risk group.
For both systems we examine the size of the social insurance system in a political equilibrium, and we compare the results in particular with respect to their distributional effects.