Fiscal Panel Calls for Ability-Based Fees for Care Services

From Jiji

November 11 2025

TOKYO – A panel under Japan’s Fiscal System Council, which advises the finance minister, proposed Tuesday that nursing care service fees be charged to users based on their ability to pay, as part of reform on the country’s nursing care insurance program. 
   The proposal comes as nursing care costs are estimated to total 14.3 trillion yen in fiscal 2025, about four times the level in 2000, when the program was established. These costs are projected to reach 27.6 trillion yen in fiscal 2040.
   While the program’s premiums have increased about two to three times, fees paid by users have remained largely unchanged.
   Currently, users cover 10 to 30 pct of nursing care service fees, depending on their income levels, but over 90 pct, or 5.41 million people, pay only 10 pct.
   Given that the top 30 pct income layer of Japan’s elderly households have at least 10 million yen in savings on average, the panel called for expanding the scope of users who pay 20 pct, while setting a ceiling on their payments.