IB Geography

hospital's long-term-care ward

Japanese leaders have made radical changes to the way health care is delivered in recent decades, most notably with the introduction of long-term-care insurance in 2000. The system is far from perfect, but Japan has been unafraid to improve the system as they learned its faults, and as an economic boom gave way to zero growth.

ut Japan's government, businesses and society are facing these challenges earlier than others, allowing the world to learn and benefit from their stumbles, innovations and experiments.

5 per cent of Japan's population is currently over the age of 65,

where the hospital says there are no trainee nurses.

this demographic is forecast to make up a full 40 per cent of the country's population by 2060

2010 and 2060, the percentage of Japanese citizens over the age of 75 will more than double from 11 per cent to 27 per cent

he absolute number of old people will soon level off in Japan, but the proportion of the population who are young is declining rapidly: The percentage of Japanese younger than 19 years old, who constituted 40 per cent of the population in 1960, will decline to just 13 per cent in 2060.

apan's total population peaked in 2010 at around 127 million people and has already begun to decline. In 2014, the country lost a record 268,000 people, as deaths continued to outstrip births.

ging society is a reality, as well as a business opportunity.

Lawson Inc.,

"seniors' salon" with a blood pressure monitor, pamphlets on municipal health care services and nursing homes, and on-staff social workers.

he store also has a special section featuring adult diapers, special wipes for bathing the elderly, straw cups, a gargling basin and detergent that is tough on urine and perfect for bed mats and wheelchair coverings. Staff will also deliver heavier items, such as bags of rice or water, to local residents.

Prime Minister Shinzo Abe's administration is concerned about how Japan's aging and shrinking work force will slow down the national economy. One piece of Mr. Abe's so-called Abenomics revival program – which also includes getting more women in the workplace – is an emphasis on new medical technologies, including experimental regenerative medicine and cell therapy. The hope is that with two new acts governing regenerative medicine to help commercialize technologies more quickly, the Japanese government can save money on future health care costs while spurring the creation of a valuable new industry – particularly in bio-medical hubs such as the one in Kobe, which features a gleaming new mini-city of medical buildings, research centres and hospitals on a man-made island near the port city's airport.

macro level, Japan's predicament is prosperity, which is always followed by lower fertility rates and higher life expectancy. At 83.4 years, Japan has the longest life expectancy at birth in the world, according to the Organisation for Economic Co-operation and Development (OECD). Many Japanese people are also fearful of the type of immigration that has sustained slow population growth in the industrialized West.

The elderly in Japan, similar to seniors across Asia, are less likely to live with their children

women, after decades of opting out of a career after giving birth, are also being encouraged by the government to re-enter the work force, something that may eventually help boost Japan's declining labour numbers, as the government hopes, but also prevents women from acting as caregivers.

small baby boom "echo" took place between 1971 and 1974

Liberal Democratic Party to expand the country's health care system as Japan aged, but by the 1990s, the enormous price tag raised the spectre of tax hikes.

Japan chose to supplement its national pension plan with long-term-care insurance (LTCI), which was implemented in 2000.

one of the most generous long-term-care systems in the world in terms of coverage and benefits."

People pay into the system starting in their 40s and are eligible to receive benefits starting at 65, or earlier in the case of illness.

assigns the person a care level.

allowing the patient to choose between competing institutions and service providers offering everything from home visits, bathing and help getting groceries to paying for short stays in hospitals or long-term residence in nursing homes and specialized group homes for dementia patients.

The LTCI system covers up to $2,900 a month in services, as opposed to cash payment, and does require "co-payments" from patients. LTCI co-payments are capped or waived for low-income individuals, and the system saves money by providing options other than full-on institutionalization.

has demonstrated to other governments around the world that it pays to adjust programs before problems become systemic.

The LTCI system was originally designed to alleviate the strain on family caregivers, but that hasn't entirely happened. Research shows that LTCI, in terms of freeing up family carers to work and have more free time for themselves, has only marginally benefited caregivers, and only then from wealthier families.

disapproval of children born to unmarried mothers

the decline in the number of young Japanese people has implications for high schools and universities as well as for industry and commerce. It also means that it will become more and more difficult to fund pensions for old people and to find carers for them.

One way of coping with the declining number of young workers is to increase imports of finished goods from countries where wages are relatively low. Japan’s balance of payments is likely to allow this for some time to come.Another way to deal with the likely shortage of labor is by increased use of robots. This is already happening and will certainly lead to a phasing out of certain white- and blue-collar jobs although the prognostications of SoftBank’s Masayoshi Son on this score seem overblown.

Ultimately, Japan will only survive and prosper if it alters its deep-seated prejudice against immigration

he Korean and Chinese minorities have been painted over, as have regional cultures such as those of the Ryukyu Islands and Hokkaido. It also ignores the existence of the Japanese diaspora in North and South America.

Does any Japanese leader have the courage to start arguing publicly and loudly for a relaxation of Japan’s at best illiberal immigration policies that are damaging to the nation’s economic and ultimately national interests? Some nurses have been admitted from the Philippines, but the stringent language tests have been a deterrent and Japan’s welcome mat for such necessary workers is restricted.

Japan has shamefully taken very few refugees despite the huge numbers living on a pittance in refugee camps throughout the world.

For Japan the immediate requirement is to confront vigorously Japanese male and ethnic chauvinism and traditional prejudices.