Recherche FFJ Research Statement Ritsu Yamamura

Ritsu Yamamura


Comparative Study of Social Policy for People with Disabilities

Positioning of Japan between Two Types of Policy Framework, Trend and Movement

2020/02/26

Abstract

There are two type of framework in social service policy for people with disabilities, need-based system and cause-based system. Several European countries shifted the latter to the former, however, it has been not even discussed about those change in Japan. The aim of this research is to get understandings and theoretical fundamentals of those systems and change by analyzing both systems and course in which countries went through to change from causebased system to need-based system. And finally, getting suggestion for future of Japanese policy systems for people with disabilities.

いわゆる障害者サービスの供給体制には、ニーズを基盤として構築されたニーズベース型の体制とそ のニーズの原因を基盤とする原因(属性)ベース型の体制があり、ヨーロッパの各国では後者から前者への移行が進んでいる。しかしながら、日本ではそのような変革についての議論すらみられない。本研究は、これら2つのシステムとその移行について、理解と理論的基盤を獲得するとともに、どのようにしてこられらの移行が起きてきたのかを明らかにし、さらには今後の日本の障害者制度に向けた示唆を得ることを目的として行われる。

Background

“Need-based system” and “cause-based system”

People might not doubt that there is certain area of “disability policy”, which are policies for people with disabilities. However, some social policies in the world have abandoned definitions of “disability” in their eligibility or target, although they are for people with disabilities in fact.

The eligibility of those new policies are mostly not “being with disabilities”, but “having needs”. In other words, services and benefit are provided depend on what kind of need they have, not what kind of disabilities. Depending on disabilities means depending on reason that people needs social services and benefit, cause of their needs.

So I call policy system in which people get social services and benefit by their need is “need-based system”, and one by reason is “cause-based system”. And my concern is on shift from “cause-based” to “need-base” in some countries.

Reasons of “need-based system”

Those shifts are, in some points of view, very reasonable. I think it is very understandable that “need-base” system would be mainstream because of …

  • Difficulties and unreasonableness to classifying disabilities
  • Disabilities are getting more and more complex and diverse. On the other hand, in the view point of Social Model of Disability which is getting to be more important to understand disability, disability is defined by social environment. One person who is called “disabled” in some situation could be “non-disabled” in other situation. So disability has even mobility now. However, definitions of disability should fix in cause-based system, it is difficult and unreasonable in the current concept of disability.

  • Overlapping of need between people with and without disabilities
  • Several needs are overlapping between several people in need. Age, gender, race, one-parent, sickness and, of course, disability. The reasons of need are various but sometime they have common needs. Same needs are satisfied by same service. If there are identical services in each different area, it might be loss or cost for social policy.

Struggle of Japanese policy for people with disabilities

In Japan, social policy for people with disabilities has been changed on occasions same as other countries’. However, major changes have been after 1990’s. From around 1970’s, social services for people with disabilities were certainly “expanding”, but it was separated in each type of disability, physical, intellectual and psychiatric disability. Those tree systems were independent and had each same type of services. The problem was about people with several type of disabilities. And also, distinction between types of disability was big.

As solution of those issues, government carried out big reform of policy for people with disabilities, at 2005, those tree systems were integrated into one law. However, new issues have been found that people with disabilities except those tree claim their need. Government changed eligibility of service customer again, but unsolved problems still remain.

Beside inside problem, Japanese policy for disabilities are dilemma against policy for elderly people. Elderly people and people with disabilities are both having need for “care”, “finance (work)”, “guardianship” and etc. Japan has public nursing care insurance that started from 2000. In addition to that, no small number of people with disabilities got older and being elderly, too. It has caused practical issues.

Research Question

  • What are exactly “need-based system” and “cause-based system”?
  • Which system is better?
  • How and why have systems been chosen?
  • How and which direction should Japanese systems be changed to?

Methodology

Literature review: Books, papers, government documents and statistics
Interview: Service customers, care givers (professionals), policy makers and governors
Economic statistics: Cost-benefit analysis using government statistics

Ethical Review

In the case of needed, researcher will get approval of ethical review committees of adequate institutes.

References

Oliver, M & Barnes, C. (1998) Disabled People and Social Polisy – from exclusion to inclusion, Addison Wesley Longman.

Brazier, J. et al (2017) Measuring and Valuing Health Benefits for Economic Evaluation, OUP Oxford.

Yamamura, R Ed. (2019) Nyumon Syogaisya-Seisaku (First Book for Policy for People with Disabilities in Japan), Minerva.