社会保障の視点から： 高齢者介護保障法政策を中心に

抄録

This article examines the influence of declining family functions on the long-term care policy for the elderly in the super-aged Japanese society including a comparison with the case in the Netherlands. The reduction of family size and increasing independent life-style of the elderly, who have traditionally been cared for by their families, has made it difficult for them to rely on family members to provide care at home. Consequently, social security and social welfare reform has been implemented since the 1990s, and the public long-term care insurance scheme was finally established in 2000 which aimed at socialisation of elderly care. However, the public opinion poll held by the Cabinet Office every year suggests that anxiety is high among the respondents for their future lives, and this indicates the need for welfare policy concerned with elderly living. Moreover, the recent reform of the long-term care insurance scheme encourages the elderly to be self-reliant and use private capabilities based on ‘community’. What is interesting is that this trend can be found not only in Japan, but also in the Netherlands where the advanced welfare state has highly developed professional long-term care services for the elderly. In other words, it is a reform that has expanded municipal discretion in the Netherlands based on the ‘Social Support Act’. Furthermore, in the background to this, there is a ‘participatory society’, a key word in the transformation of the Dutch welfare state, which has been underway while reassessing family care. In the recent reform policies of the two countries aiming for fiscal restraint and efficiency, we find a minimum social security perspective of Anglo-Saxon type of policy there. However, rather than accepting such a reduction reform immediately in each country, we should first more carefully analyse elderly care policies in the two countries through comparative research work, and learn from each other to resolve any future anxiety of the residents.