From transfer to social service: a new emphasis on social policies for the aged in Japan

The Gold Plan, the central government's attempt to build a nationwide network of care service provision for the aged, seems partly because of its patchwork character and partly because of its stress on the low-cost strategy to be running into two problems: (1) It is adding new institutional ambiguities and functional confusion to the old fragmentation, instead of producing a well-integrated system; and (2) the response to the central policy varies much across the municipalities (its carriers) so a disparity among them in the level of service provided is emerging. A "public care service insurance" scheme, in the planning stages since April 1994, will offer a solution to the first problem. However, it will leave the second problem unsolved and may introduce a market factor into the field of social service. As it is, the service provision itself is overwhelmingly entrusted to private organizations.