Analytical Method

This research would be applying the analytical method of “content analysis”. Qualitative approaches to content analysis is identified by M. Schreier (2012: 21) as “interpretive, naturalistic, situational, reflexive, having emergent flexibility, inductive, care-oriented, and putting emphasis on validity”. In the other word, the method is suitable and feasible for this research to be well-analyzed after the process of in-depth interview.

Content analysis is used to be an analytical method about analyzing documents with objective, systematic, and quantitative ways (Berelson, 1952); however, nowadays, the method gradually became an analytical method for interpreting both the manifest contents and the latent contents (Wamboldt, 1992: 313-321) including qualitative documents and interview transcripts, therefore we called it “qualitative content analysis” (Graneheim, Lundman, 2004: 105-112). In addition, sometimes a qualitative assessment of the materials is most appropriate (Babbie, 2012:

304). As for this research, it would be more suitable to adopt the approach qualitatively by utilizing conventional content analysis. Hence, data would be analyzed by reading through each transcript multiple times to gain a sense of the data and furthermore to seek the insight. Later, the meaningful texts would be highlighted and further be discussed in order to tap the underlying meaning of the interview contents.

Chapter Four- Result

The four institutional aspects include the governance structure, the service delivery, the finance scheme, and the sustainability scheme of Japan and Taiwan are showed in the graph 15. After collecting the public released data and the in-depth interview, we analyzed and compared long-term care policies of these two countries based on the four aspects using the approach of comparative institutional analysis, document analysis, and content analysis.

Consequently, more elements that affects financial sustainability would be revealed, and the research questions would be answered. In this sense, it would be more evident for the government, analysts, and the policy makers in Taiwan and even in Japan to make right choices and schemes when it comes to resolving the issue of long-term care financial sustainability.

Graph 15. Institutional Aspect input

Source: This research

4.1 Governance Structure

The governance structure in Japan and Taiwan would be discussed and compared. From the graph 16 and 17, we can see how the two governance structures are distinctive from each other. The Central government from both countries are both responsible for the policy making.

Then, the works are assigned to the local governments and finally to the provision of the care recipients.

Japan’s central government is called Ministry of Health, Labour and Welfare (厚生労働 省). It is also divided into various Bureaus such as The Pension Bureau that are for planning pension schemes, The Health and Welfare Bureau for the Elderly that is for planning long-term care policies, and The Social Welfare and War Victims’ Relief Bureau that also includes the department of health and welfare for people with disabilities. More importantly, every policy and model designed for long-term care schemes are all from their own policy making group.

Also, according to National Governors' Association (2019), apart from Taiwan, Japan has 3 levels of government, including central, prefectural and municipal. There are 47 prefectures and within the prefectures, there are 1741 municipalities in total; furthermore, there are 3 types of municipalities in Japan, which includes cities, towns, and villages, which is also called as Shichoson (市町村). The local government, the prefectures and Shichoson, cooperates and supervises the central government and offers the evaluations and insurance services for the long-term care recipients.⁵

The most different part of the governance structure for both countries is the participation of the industries, namely industrialization. Before the year 2000, Social Welfare Cooperation (社会福祉法人) is in charge of the service delivery. Not until the long-term care insurance

policy was conducted did the for-profit cooperation start to collaborate with the government and participate in the long-term care services. As in Taiwan, the government also has allowed a few industries to collaborate with them and take part in the long-term care service delivery in the recent two years.

In Taiwan, the central government is also in charge of the policy decision making and model designing as mentioned. According to Ministry of Health and Welfare, the central government upgraded the Department of Health to Ministry of Health and Welfare in 2013.

Then in the year 2018, they were integrated into the Department of Long-term Care (長期照 顧司); moreover, it is divided into four divisions, including the policy making and developing;

employment training and implementing; service network planning and promoting of resources in remote areas; finally, planning, promoting and implementing the services for housing, community, and institutions (a more precise table can be seen in appendix 2). After the central government adopted the measure, the resources are assigned to the local government for the action. The local government establishes care centers, sets the cross-bureau long-term care promotion team, assigns care managers that manage the caregivers to reach the goal of caregiving such as housing care. After the care center provides long-term care for the elderly, they report back to the central government for the evaluation. From the evaluation, they self-detect for the improvement and adjust for better policies.

Graph 16. Long-term Care Governance Structure in Taiwan

Graph 17. Long-term Care Governance Structure in Japan

Source: Ministry of Health, Labour and Welfare: 介護サービス事業者の業務管理体制の監督について(2015)

From the public released data mentioned above, we perceived the structural differences of long-term care governance between Japan and Taiwan. On the basis of that, we got two main insights from the in-depth interview: industrialization and integration. In the following paragraphs, the connections between these two viewpoints regarding financial sustainability will be further discussed.