Eco-Economy: Japanese Health Care Currency

When Finance Minister Michael Cullen delivered his Budget Speech the other day I couldn't help thinking how we could so effortlessly introduce a scheme like the Japanese Health Care Currency thus alleviating a very bleak health expenditure situation. There was little for health in the Budget, and whether it was because of that or not, certainly the Health Minister was looking very forlorn during the Budget speech.

In Japan there are already 800,000 retired people needing periodic help and another one million handicapped people, and, as with other countries, the Japanese Ministry of Health forecasts a vast increase in these numbers for the foreseeable future.

In order to face this rapidly rising problem, the Japanese have implemented a new type of Health Care Currency. In Japanese, the currency is called Hureai Kippu, which translates literally as "Caring Relationship Tickets."

It began in 1991, and by 1999 researcher Bernard Lietaer found there were around 300 systems in operation. In this system, the hours that a volunteer spends helping older or handicapped persons in their daily routines is credited to that volunteer's "Time Account." This Time Account is managed exactly as a savings account, except that the unit of account is hours of service instead of Yen.

Different values apply to different kinds of tasks. For instance, a meal served between 9 a.m. and 5 p.m. has a lower credit value than those served outside that time slot; household chores and shopping have a lower credit value than personal body care.

These Health Care Credits are guaranteed to be available to the volunteers themselves, or to someone else of their choice, within or outside of the family, whenever they may need similar help. The local and national government has set up a nation-wide electronic clearing network, so that someone can provide help in Tokyo, while the time credits become available to his parents anywhere else in the country.

Many people just volunteer the work and hope they will never need it. Their Time Account Credits complement their normal health insurance programs. Others not only volunteer, but also give their Time Credits away to people who they think need them. To them, it amounts to doubling their time. It works like a matching grant: for every credit hour of service, the amount of care provided to society is two hours.

Most significantly, Lietaer suggests this type of service is also preferred by the elderly themselves, because the caring quality of the service turns out to be higher than those obtained from Yen-paid social service workers. It also provides a more comfortable emotional space for the elderly, who would otherwise be embarrassed to ask for free services.

The Japanese also report a significant increase in volunteer help, even by people who do not bother to open their own Time Accounts. The reason may be that there is a better overall community atmosphere, which promotes the idea of taking care of each other.

Maybe with this system, all volunteers feel more acknowledged. Whatever the reason, this precedent should put to rest concerns that paying volunteers with complementary currency might inhibit those not getting paid in national currency from volunteering.

The Japanese Health Care Currency has proven both more cost effective and compassionate than the system which prevails in the West. As New Zealand embarks on an identical trend of an aging population, why not learn from the Japanese experience? It is legal, it is easy to copy and we should do it.

In the age of the Internet, good interpreters and cheap air-travel there is no excuse to be limited to using the precious national currency when we can supplement it with legal and abundant time dollars. Globalisation can help us solve our problems.

- Feedback to Deidre Kent - EMAIL: deirdrek@paradise.net.nz

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