In April 2000, the new long-term care insurance (LTCI) program was implemented in Japan. This program represents a major policy change and system redesign. This article briefly describes the factors leading to the development of LTCI and explains the philosophy and mechanism of LTCI, including patients' access to the system, its financial cost, changes in long-term care (LTC) system patterns, and the impact on institutional care and home care after its implementation. By presenting the current situation of LTCI, the authors want to share with readers outside Japan how this experience brought remarkable change in the delivery of LTC in the country. The experience of seeing what happened should be shared by all to keep the positive opportunities alive and to mitigate the negative experiences. Home care professionals firmly believe that it is essential to encourage further development relevant to the needs of families and society.
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