Toward the Anthropological Study of Public Welfare Systems

An Analysis of the Concept of "JIRITSU" in the Japanese Long-Term Care Insurance System

Abstract

The purpose of this paper is to analyze the process by which the concept of "JIRITSU (independence/autonomy)" became an ideology in the Japanese Long-Term Care Insurance System. The concept of "JIRITSU" was born out of the collaboration among frontline care service workers, members of the expert panel who devised the system, and Ministry of Health and Welfare bureaucrats who sympathized with this idea. On the other hand, the concept of "JIRITSU" was also used in the logic of the attempt to limit the number of people eligible for care service. This paper analyzes these processes based on Annemarie Mol's discussion of the "Logic of Choice/Care," and points out that the two different meanings of "JIRITSU" were compatible because they were both based on the "Logic of Choice," which emphasized the will and choices of the elderly people receiving the care service.