Could a Japanese-style elder care program work in Montana? – Health News Today

Last week in Graying Pains, the Missoulian’s David Erickson examined the introduction and implementation of Kaigo Hoken, or care insurance, in Japan, the world’s demographically oldest country. This week’s conclusion of that story explores how a similar policy might translate to Montana, the oldest state in the American West.


A full 13% of Montanans are in their 60s, and the “baby boomer” generation is nearing or entering retirement age. Care for the elderly will become an increasingly pressing issue in Montana as larger and larger numbers of voters enter the older brackets of the state’s demographics.

In an interview with the Missoulian, Montana Gov. Steve Bullock said he believes the state’s voters prioritize allocating resources toward the elderly in many cases. He pointed to the fact that Montana is one of just a handful of states without publicly funded preschool, despite his administration’s concerted efforts to win funding from the state Legislature.

“Not in my experience,” Bullock said, when asked if Montana voters would generally rather spend money on policies that mainly benefit young people rather than those of advanced age. “Our legacy citizens have so much more voting power. It’s an interesting dynamic.”

Without any knowledge of Japan’s policies, Bullock said he was doubtful that Montana voters would approve a statewide mandatory nursing care insurance law in any form.

“When you’re talking about a whole new tax structure, I think it would be pretty doubtful,” he said.

However, voters here are highly protective of health care programs like Medicare and Medicaid that overwhelmingly benefit older people, he acknowledged.

Dr. Yoshi Colclough is an associate professor of nursing at Montana State University. She grew up in Japan and remembers how her mother took care of her grandmother.

“There’s a complete family responsibility to take care of elders,” she explained. “When I was born, [my grandmother] was already living with us.”

In Kobe, Japan, a city with a population of 1.5 million, Colclough said, there were only three nursing homes when she was living there. For many Japanese women, taking care of the elderly is a way of life and can get in the way of a career.

“My mother’s generation didn’t need to work outside the home,” Colclough said. “That’s more a man’s responsibility. The woman takes care of the family. For people educated before World War II, there’s a separate male and female role. It’s pretty much old traditional.”

She said some older people, like her father, didn’t like outsiders coming into the home to cook and clean. However, when her mother lost her eyesight, Colclough, said the law paid for a helper to be there for an hour and a half every day. That also means good jobs for Japanese people, many of them women.

“I don’t think we could have afforded…