At the Plenary Session of the JASPS 151st Conference, four presentations and general discussions were held on the financing of the Long-Term Care Insurance （LTCI） program, its reforms, comparison with similar programs in other countries, the Disability Welfare Program in Japan, and other related issues. Based on these presentations and discussions, this article examines the challenges it faces and other issues yet to be discussed. From these perspectives, an important theme is the long-standing problem of achieving sufficiency in the care workforce. Their wage level is still relatively low. The government has accepted an increasing number of foreign care workers but lacks a long-term perspective. In addition, the reforms conducted on the LTCI program with the aim of ensuring its financial sustainability and introducing policy innovations have produced new challenges for this program, such as its expansion and complications, as well as the coexistence of subsystems with different principles of operations. Further examination is needed to address issues such as care security for low-income elderly individuals, and other policy and environmental factors that affect the effectiveness of this program.

This study examines the transformation of Japan’s Long-Term Care Insurance （LTCI） system and the evolution of support frameworks for elderly care, with the aim of clarifying the achievement of the LTCI system since its introduction. Through successive institutional reforms, the LTCI system has made progress, in emphasizing the importance of comprehensive care that supports the overall lives of older adults and in promoting the development of community-based support systems. These reforms have contributed to a broader recognition that elderly care should not be limited to the provision of specific services but should instead be organized as integrated support for daily living within local communities.

However, several structural challenges remain unresolved. These include instability in service provision, regional disparities in access to care, a persistent shortages of care workers, and continued reliance on family-based caregiving. The recent initiative to establish the Comprehensive Support System Development Program represents an important step toward institutional restructuring, but also highlights the need to reconsider the relationship between social insurance and public financing, including insurance premiums and financial resources.

Future policy discussions should move beyond incremental institutional adjustments and consider the fundamental redesign of the broader social security and social welfare systems.

This paper focuses on three reform trends aimed at controlling long-term care costs : the expansion of community-based care services ; the increase in “specified facility residential care” ; and the introduction of “prevention and life-support comprehensive program”. These efforts were intended to reduce long-term care costs by deregulating facilities and staffing standards, introducing self-payment for housing costs, and excluding preventive services from insurance coverage. This paper refers to this ironic phenomenon of reducing insurance coverage in order to maintain insurance finances as “de-insurance”. This “de-insurance” initiative expands the range of uninsured services provided by local governments, but at the same time it also forces local governments to strengthen their “insurer functions.” This is intended to achieve a balance between the costs and benefits within a local area. In contrast to the National Health Insurance system, which chose to shift to a broad-area insurer, long-term care insurance focus on a narrow-area insurer, because of excessive regional disparities in services that have been exacerbated by marketization. Ultimately, this is nothing more than a departure from the insurance principle of risk diversification.

Through an analysis of the policy process, this study examines the interface between the Long-Term Care Insurance System and the Welfare System for Persons with Disabilities, two institutional arrangements grounded in distinct normative structures and governing principles. It argues that these systems are simultaneously experiencing the advancement of institutional integration and the intensification of normative divergence.

While the Long-Term Care Insurance System has evolved under a policy rationality centered on “support for independence” and fiscal sustainability, the Welfare System for Persons with Disabilities has been shaped by domestic disability movements and international human rights norms, institutionalizing the principles of “independent living” and “rights protection.”

By clarifying the structural differences in the normative foundations of the two systems, this study highlights the growing tension embedded in their interface and underscores the need for the normative reconstruction of elderly care in later life.

Long-term care in Sweden is characterized by public provision funded by local taxes. However, the share of care provided by for-profit providers has increased with the introduction of competitive bidding and a voucher system, particularly in urban areas. In Germany, reforms in the long-term care insurance system in the 2010s strengthened family support while clarifying family responsibilities. Meanwhile, immigrant care workers from neighboring countries tends to use cash benefits. The long-term care insurance system remains a partial insurance system, chat links social assistance, health insurance, municipal elderly policies, and support activities by welfare organizations to provide comprehensive support to people in need of care and support, regardless of age. This article compares and discusses the transformations and characteristics of long-term care regimes in Sweden and Germany, clarifying the characteristics of Japan’s current long-term care insurance system and the direction of long-term care regimes.

Support for “Continuation of Employment of Persons with Disabilities in Type A Workplaces” （workplaces that hire the disabled as normal employees）, is necessary in order to allow employment of people with disabilities, and others who have difficulty finding jobs, especially in a society with an insufficient labor force. The author conducted a survey in an interview format of Type A employers working with support centers for continuous employment of the disabled in rural and urban areas that meet the designation criteria under the “Act on Comprehensive Support for Persons with Disabilities”. The survey results clarify the current status of the operations of these businesses and the supported provided, as well as the position of persons with disabilities in the labor system, and the effectiveness of the operations of support centers for Type A employers.

This paper will report the result of an analysis of survey results for urban areas, which reveal that the support centers for Type A employment are playing complementary roles to the insufficient government employment policies for persons with disabilities. In addition, we will discuss the current status of employment for persons with disabilities in urban areas, and how such employment can be improved in the future.

The U. N. Convention on the Rights of Persons with Disabilities （hereinafter referred to as “the Convention”） is an international standard for policies related to persons with disabilities. The Convention is characterized by the adoption of a “comprehensive model of human rights” that guarantees the right to freedom and social rights, and is based on the premise that reasonable accommodation through affirmative actions can be used to remedy discrimination. Article 28 of the Convention clearly states that “appropriate services according to one’s needs” should be provided, and that “assistance for expenses related to disability shall be used”. The “Concluding Observations on Japan’s Report” （hereinafter referred to as “Concluding Observations”）, adopted by the Committee on the Rights of Persons with Disabilities in September 2022, clearly states the following : “The social security system that ensures an adequate standard of living for persons with disabilities and their families is insufficient”, and that “Disability pensions are significantly lower than the average income of the people”. Thus, the relative deprivation of persons with disabilities in Japan is clearly recognized, and drastic improvements in income security for persons with disabilities, such as disability pensions, are recommended.

This paper re-examines the current state of disability pensions under Japan’s universal pension coverage system, through documents related to the Convention, to assess the possibility of expanded implementation of disability pensions in Japan in accordance with the 2022 Concluding Observations.

In principle, the Japanese Ministry of Health, Labor and Welfare does not recognize ownership of an automobile as daily necessity, for recipients of public assistance. Exceptions are made to allow recipients to commute to work in areas without convenient public transportation, to pick up and drop off children at daycare centers, to work independently, or, for persons with a physical disability, to seek medical treatment or go to work or school.

The issue of car ownership for people with disabilities who are receiving public assistance should have been settled after a 2013 trial involving Hirakata City （known as the “Hirakata Welfare Automobile Ownership Lawsuit”）. However, four other lawsuits, two filed in Suzuka City, Mie Prefecture in 2022, one filed in Seki City, Gifu Prefecture in 2023, and one filed in Ebetsu City, Hokkaido Prefecture in 2024, granted these cities a stay in implementation of the decision.

As public transportation systems are being withdrawn or reduced in size, the role of the private car as a necessity is increasing in rural areas. However, the ownership of automobiles is generally not permitted when receiving welfare benefits. It has been pointed out that this may be contributing to the suppression of welfare benefit utilization in rural areas, but there have been few empirical studies focusing on this causal relationship. In this paper, we conducted a quantitative analysis using the instrumental variables method and fixed effects model to examine the impact of automobile ownership rates on welfare benefit rates in regions. The results of the analysis revealed that, in models without fixed effects, an increase in automobile ownership rates was found to have a significant negative relationship with welfare rates, suggesting that automobile ownership may be suppressing welfare rates in regions. This suggests that the nationwide uniform restrictions on automobile ownership may be acting as a barrier to welfare utilization in rural areas, necessitating a reexamination of the implementation of the system in light of its intended purpose.

This study clarifies the structure of skill formation and promotion by quantitatively analyzing the relationship between types of skill formation and promotion and determinants of how workers are allocated to each type of skill formation. The study identifies four patterns of skill formation of workers in their 20s-40s : （1） “developing expertise within one function,” in which workers improve their expertise in a specific function after reaching the age of 30 and three patterns that extend skill formation while in their 20s ; （2） “broadening their skills within one function ;” （3） “performing one job within one function ;“ and （4） “skill formation over some functions.” The “developing expertise within one function” has higher promotion rates compared to others. However, it is comparable to the “skill formation over multiple functions” in terms of promotion to section managers and above. Meanwhile, assignment to the “developing expertise within one function” is influenced by workers’ potential such as educational background and academic achievement. Overall, the findings suggest that skill formation regarding promotion requires knowledge breadth and depth, and such pattern is shaped by individuals’ potential.

This paper examines the working conditions of platform work in Japan in terms of the Japanese employment system. Based on interviews with platform workers who work in the delivery sector, including for Amazon, as well as union representatives, this paper discusses how delivery companies secure the enforceability of labor. Three types of labor organization are classified : direct contracts between Amazon and delivery workers via the Amazon Flex service, contracts between delivery workers and Amazon’s subcontractors （called “delivery providers”）, and workers employed in the existing delivery sector. In addition, this paper argues that these classifications of delivery workers can be characterized in three ways : as a loophole created by idealized platform work under direct control, as a utilization of the extended Japanese employment system under indirect control, and as a utilization of the existing Japanese employment system under indirect control. These categories of laborers are made possible by the utilization of a peripheral labor force as a characteristic of the Japanese employment system and the existing delivery sector in Japan.