To help with this, the government is introducing a new Public Nursing Insurance system, scheduled to go into effect in two years' time, to train more home helpers and provide other services.

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The total is JPY 220 trillion of which an astonishing JPY 82 trillion is interest and principal payment on the national debt and JPY 63 trillion the cost of the state pension, health care, and nursing care system.

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However, Bev Clarke of the Royal College of Nursing said the system was poorly suited to hospital rotas.

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Questioning the Prime Minister David Cameron in the Commons on Wednesday, she said she was committed to an NHS free at the point of use but said there were increasing complaints about nursing in parts of the system.

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His attention is focused on the old age welfare system, comprising pensions, health care, and nursing care.

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Hospitals and nursing homes are experts at gaming the system so that they can maximize the reimbursements that they get from these two poorly-paying programs.

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But someone will still have to pay for all the extra health care and nursing-home beds, and America's system of provision is both costly and dysfunctional.

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Now, the HSL system is expanding this program to residents of its long-stay nursing home.

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Director of the Royal College of Nursing NI Janice Smyth said fundamental reform of the health system in Northern Ireland was needed.

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More daunting, though, is converting nursing-home operators who would prefer to roll out a new system all at once.

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