 This paper examines the differences between the Japanese and Spanish approaches to providing long-term care, LTC. The authors argue that both countries have similar demographics, yet their approaches to LTC differ significantly. Japan offers universal coverage through a combination of formal services and cash payments, while Spain focuses primarily on cash payments. The authors then discuss how these differences can inform future policy decisions in both countries as they face increasing demand for LTC services. They also suggest that the two countries could learn from each other's experiences and reforms. This article was authored by Roald Del Posa Rubio and Dolores Jimenez Rubio.