Industrialization

One of the biggest differences of long-term care governance structure between Japan and Taiwan is the policy of term care industrialization; To be specific, the meaning of long-term care industrialization here is the collaboration and the integration towards long-long-term care services between the government sectors and the for-profit cooperation. For-profit cooperation would be able to provide long-term care services with the governments. In this sense, Japanese government has cooperated with for-profit organizations for almost two decades; instead, as Taiwan is concerned, industrialization in the long-term care industry has not started; yet a few industries have been involved in the long-term care industry since last year.

On the aspects of Japan, industrialization is a must-do when it comes to financial sustainability. When people have more choices for care services, they are more willing to pay for long-term care insurance. That is, in order to enhance both the variety and the quantity of the services, long-term care services have to be generalized. Namely, the services should be more widespread and even increase in numbers. The two scholars (J5) and (J6) in Japan had both mentioned in the interview,

“If the goal is to generalize the long-term care service and to increase the service amount, the participation of for-profit corporations is necessary.” (J5)

“Since the amount of long-term care service was small and lots of people want to pay for more services, Japan allows the participation of the for-profit corporations after the year 2000; so if Taiwan wants to increase the number of long-term care services, it is very effective for the government to permit the entry.” (J6)

The central government in Japan (J1) also had mentioned,

“Elderly care used to be a household responsibility. However, in order to promote the socialization, it is necessary to significantly increase the supply of service; therefore, we enabled the entry of for-profit corporations.” (J1)

On the other hand, it is more profitable for the existing industries when the private industries are taking parts in the long-term care service in Japan. The NPO (J3) had stated,

“As it was difficult to pursue substantial benefits in existing industries in Japan, it is necessary to permit the entry of for-profit corporations.” (J3)

That is to say, were it not for the industrialization, it would be more difficult for the long-term care industries to reach a particular amount of profit; furthermore, when there are more profits, more industries would participate in the long-term care services; therefore, more of a benign competition it would be.

In terms of Taiwan, both the scholar (T3) and the local government (T1) hold the same argument: industrialization of long-term care service would lead the market to a benign competition, and therefore more people would be willing to pay for the services. As a result, the government would not have to worry too much on the financial shortage.

“Industrialization will stimulate some social welfare institutions since they don’t really have the concept of operating a business… The entry of for-profit corporations can

positively stimulate the market and can help the social welfare institutions to learn the concept of business operation of for-profit organizations and integrate the policy…I think the more participation of the service industries, the more satisfied people would be, so basically, industrialization would lead the market to a benign competition” (T1)

“I think allowing the entry of for-profit organizations is good because that would become a benign competition; so I think industrialization basically can stimulate the development of the industries.” (T3)

Meanwhile, though industrialization is a good stimulation to the market, respondents (T4) and (T1), which are the local government and the scholar, declared that it is still necessary for Taiwanese policy makers and the government to adopt supplementary measures in order to prevent possible problems that might occur after the entry of the for-profit corporations. For example, when a large amount of private industries participate in the care service, it would be highly possible that some industries pursue more for the profit but not the quality. Such supplementary measures could be a good supervised mechanism for the service quality or a sound grievance mechanism. With a better quality of service, people would be more willing to participate in and to pay for the long-term care services; moreover, as long as the industrialization is well-functioned, the shortage of finance of the government declines. In short, a successful industrialization would be one of the key elements affecting financial sustainability.

“I think the most important thing is how to maintain a good quality of the services, so that people would be more willing to pay for it; therefore, though I support the long-term care industrialization, there must be some rules and supervisions such as the evaluation system and the inspection system” (T1)

“I think the critical point for industrialization is whether consumers have the right to protecting themselves because the problem now is the inequality of the relationship between care recipients and care givers. So, if there were dissensions or entanglements between them, the government should have measures to protect the care recipients.” (T4)