WUNRN
Multiple Gender Dimensions
Japan
- Changing Shape of Child and Elderly Care
Traditionally in
Japan, the care needs of children, the elderly, sick or disabled have been met
within the family. As one of the welfare states with the highest proportion of
elderly people (defined as those who are 65 years and older) the state provided
a few care services, but they were limited and the coverage was restricted to
those with the most intense care needs. However, a number of social forces have
made it necessary to expand the public role in care provision. These forces
include demographic change (ageing), changes in family structures (the
increasing proportion of one-person households and households that include only
elderly persons) and, to some degree, changes in the labour market (the
increase in female labour force participation).
For
elderly care, the rapid expansion of demand for public care services coincided
with the retrenchment of social spending caused by a rapidly deteriorating
fiscal deficit. It became clear that the government would not be able to meet
the future increase in care demands without radical reform. As a result,
Long-Term Care Insurance (LTCI) was introduced in 2000.
In the case of childcare, the state response was
triggered by declining fertility. The main rationale, in order to raise fertility,
was that it was necessary to ease the pressure of child-rearing on women, and
one of the ways of doing so was to encourage women to work. However, the
relationship between state provision of care and fertility was never clearly
spelled out or understood, and the policy response to childcare was
half-hearted and confusing.
This paper by Aya Abe describes the scale of the
elderly care problem in Japan, examines the government’s role in providing care
and, to a lesser extent, considers the market’s role before and after the
introduction of the LTCI. It also looks at changing patterns in state provision
of childcare. The paper expands on the idea of the “care diamond” introduced by
Razavi and applies it to care for the elderly and children in Japan in order to
compare the two.
Three main findings of the paper can be
highlighted.
First, both for elderly care and childcare, the
author finds that gender inequalities in care provision remain strong. The bulk
of care is provided by women in the immediate family, whether it is the wife,
daughter or step-daughter in the case of elderly care, or mother, in the case
of childcare. The introduction of the LTCI reinforced traditional tendencies by
emphasizing home care over institutional care, and a combination of cultural
and socioeconomic factors has kept the gender bias in place. One reason is the
weak representation in, and influence on, the policy-making process by
women’s—as well as other—social movements. Another is the fact that the value
of women’s time in the labour market is quite low compared to that of men. A
growing proportion of the female labour force is composed of non-permanent
workers whose wages are significantly lower than those of permanent workers.
This is reinforced by care policies that leave women with no alternative but to
interrupt their careers in their 20s and 30s in order to take care of their
children. Because these women have already given up their permanent job earlier
in their life, they are pushed into taking care of the elderly when they are in
their 50s and 60s. Thus, care policies and employment policies reinforce
women’s role as caregivers.
Second, the care diamonds for elderly care and
childcare are quite different in Japan, mainly because of different policy
objectives. The stated objective of the LTCI is to “socialize the burden of
care among the entire society”. But according to the author, the hidden motive
is to cut the governmental fiscal outlay for elderly care. In contrast, the
policy objective for childcare is “to balance work and family”, ultimately
aiming at increasing fertility rates and women’s labour force participation.
The result of these different objectives is that the LTCI tries to emphasize
home-based solutions, while childcare policy emphasizes institutional care.
Another notable difference between elderly care and childcare policies is the
role of markets. In elderly care, there is an almost complete overlap of state
and market spheres. Indeed, Abe argues, the LTCI works as a market solution to
the fiscal burden of state-provided care services. The money for care services
is thus collected (from all citizens over 40) and distributed (according to the
state’s classification of care needs) by the state, while service provision is
almost entirely carried out by private institutions. In contrast, childcare
provision is divided between the public and private spheres.
Finally, Abe says, what is conspicuously missing in
the development of both elderly and childcare policies is the voice of
caregivers, notably women, and those receiving care themselves. Here, care
policies do not differ from other social policies in Japan, which are notably
bureaucracy-driven.
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