The Evolution of Japan’s Elderly Welfare Policies and “Welfare Marketization”

: The Fundamental Problems of the Long Term Care Insurance （LTCI） System.

Abstract

The aim of this paper is to revisit―through the perspective of ‘welfare marketization’―the evolution of Japan’s welfare policies for the elderly, and to present the Long Term Care Insurance （LTCI） system’s current situation and fundamental problems. The findings of the paper are four―fold. Firstly, the ‘welfare marketization’ of Japan’s welfare policies for the elderly were undertaken in two phases : through the emergence of the ‘silver business’ sector and the implementation of contracting―out to private care providers under the means―tested system from the mid―1980s, and the introduction of the LTCI system from 2000. Secondly, due to the introduction of the LTCI system, ‘welfare marketization’ is expanding through private organisations to provide not only LTCI services but also to deliver care planning, conduct visiting assessments, and to provide other core care services, such as ‘advice and guidance consultancy’, which were once the responsibility of local authorities. Thirdly, under the LTCI system, service users’ livelihood security is no longer guaranteed as a public responsibility. Fourthly, the 2014 LTCI reforms call for the deployment of community resources and private organisations and for social participation by older people, posing the potential danger of a return to the ‘Japanese―style welfare society’ discourse.