3 高齢者ケアのウェルフェアミックス : 介護・医療システムの再編成(テーマ別分科会4=政策分析・政策評価-福祉・保健医療領域を中心に,II テーマ別分科会=報告論文と座長報告)

抄録

This paper attempts to broaden the understanding of the status quo in the Japanese welfare system by highlighting how unique policies ensure that the state plays only a marginal role in providing and financing care services. The care of older people is used as a case study to explore how this residual system has been developed and how it operates in practice. This study outlines the production of care in each welfare sector and shows the recent trends in the welfare mix. Due to the process of modernization, some important family functions have been removed from the family system and have been taken on by other sectors. The increase in care needs and the decrease in the capacity for informal care is an outcome of modernization in Japan. In theory, therefore, family care work in the future will be further externalized, and responsibilities of care provision will be shifted to other sectors. However, the direction of this shift is affected to a great extent by political intentions. Under the present welfare reforms, the private sector will play a larger role as one that assumes externalized family care work. However, a large proportion of care responsibilities continuously lie with family members, and the significance of self-help is projected to increase in the Japanese welfare mix. This paper reveals the residual nature of long-term care policies and the various strategies aimed at minimizing the role of the public sector. It explores the recent development of several schemes that have encouraged private and informal activities in the field of care for older people.