Study on the User Selection System and the Change of Composition of Social Service Providers in Japan - Centering on the Analyses of Care Services for the Elderly andWelfare Services for Persons with Disabilities

This study aimed to explore the history of marketization and decentralization of welfare in Japan, to examine the discussions about the introduction of user selection system that has been represented as themotto of ‘FromMeasures to Contract’ and the principle of self-responsibility and to analyze the change of social service providers for the long-termcare services for the elderly andwelfare services for persons with disabilities. The biggest changes that were caused by implementing long-term care insurance are the introduction of market principle, the diversification of providers, decentralization( local transfer) and the establishment of caremanagement system. The marketization and decentralization of welfare in Japan have proceeded as the part of deregulation; the deregulation is an administrative reformaiming to abolish government regulations and tominimizing the fields of government activities. In Japan, the introduction of Long-termCare Insurance in 2000, the implementations of Assistance Benefit Supply Systemin 2003 and Services and Supports for Persons with Disabilities Act in 2006 have increased the numbers of users and service providers in all services that for-profit corporations have been allowed to participate in; the market share of non-profit foundations such as public organizations and social welfare foundations has decreased and that of for-profit corporations has greatly increased. In Japan where the commercialized social welfare services have been generalized based on the introduction of Long-term Care Insurance and the implementation of Services and Supports for Persons with Disabilities Act, the complimentary measures for market such as the assistance to advocate rights, grievance settlement and third-party evaluation have been examined and implemented in order to solve the problems that could happen in themarket. It, however, has not been proved how much these measures affected the market functions and how they can solve those problems. The profound studies and discussions about how the expansion of market share of for-profit corporations that aim to increase the number of users and to make profit affects the field of social service and what kind of problems it would cause should be suggested.