The Relationship between the Support Service Payment System for Persons with Disabilities and the Long-term Care Insurance System: their Present Situations and the Issues Concerned with their Integration

超高齢化社会、急速な人口減社会を背景として、介護保険制度が2000年4月に開始され、障害者福祉施策を基本的に変えた支援費制度が2003年4月に実施された。 しかし、介護サービスの利用者が飛躍的に伸び、また支援費制度の利用は当初の予定を大幅に超えて、国および地方自治体の財政を圧迫するなかで、主に財源確保の視点から、両制度の統合問題が急浮上してきている。 支援費制度と介護保険制度の経過と社会的な背景は共通性があっても、両制度の個々の内容の相違性や、障害者の支援と高齢者の介護の内容はかなり異なる。介護保険制度の見直し時期の2005年度の統合では性急過ぎるので、次の時期を目途に、障害者自身の参加を得て、慎重な検討が行なわれることが望まれる。The Long-term Care Insurance System for Elderly People was introduced in April 2000 to deal with the Japanese typical condition which have been undergoing extremely advanced aging and rapidly decreasing population. The Support Service Payment System for Persons with Disabilities was implemented in April 2003, which caused drastic changes of social welfare programs for persons with disabilities. However, due to the fact that the number of users of the Long-term Care Insurance System has been increasing with rapidity, and that of users of the Support Service Payment System has been far greater than what was expected in the beginning, the integration issues of both systems has been swiftly emerging. These issues has come from the viewpoint of securing their financial resources as both central and local governments have been suffering from serious financial constraints. Though the Support Service Payment System and the Long-term Care Insurance System have circumstances and social background in common, the contents of support services for persons with disabilities and long-term care services for elderly people are quite different. As it might be too early to integrate both systems in 2005 when the Long-term Care Insurance System is to be reviewed, based on the relevant law, it would be desirable to carefully study their integration issues in time for the next regular review in 2010, with the active participation of representatives of persons with disabilities