日本社會福利服務的民營化－“公共介護保險制度”現況之探討

Social Welfare Privatization in Japan: A Study of the Existing Situation of the Long-Term Care Insurance System

莊秀美(Hsiu-Mei Chuang)

《臺大社會工作學刊》 11期 (2005/06) Pp. 89-130

https://doi.org/10.6171/ntuswr2005.11.03

摘要

高齡化社會、高齡社會的到來，已帶動開發與開發中的國家傾力於建構老人福利政策與制度，特別是人口結構已趨成熟的社會，無不關注後期高齡者的社會照顧問題。以日本而言，長期照護保險制度之實施，乃採民營化、契約化方式建構服務供給體系。其中以（營利）企業加入服務供給體系最受囑目。長期照護保險制度的實施開啟日本（營利）企業參與社會福利服務經營之端緒。
文中以日本的「公共介護保險制度」實施出發，探討公共介護保險制度實施後，企業參與長期照護服務輸送的發展狀況，及對長期照護服務供給體系結構的影響等。本文主要內容如下：(1)日本社會福利基礎改革背景、理念與內涵；(2)日本公共介護保險制度的制定與實施；(3)企業參與長期照護服務之現況；(4)公共介護保險服務供給的改革課題；(5)長期照護服務供給體系建構之展望。本文的目的乃期望藉由探討日本長期照護服務民營化的實施現況、困境與改革方向，提出對我國建構長期照護服務供給體系之建議。

關鍵字

社會福利民營化 ； 長期照護保險制度 ； 長期照護服務

並列摘要

The demand of long-term care services is rising nowadays. In hence, to develop long-term care services system has become an unavoidable issue on welfare policy in aging society and aged society. Nowadays, Japan already became an aged society, runing further ahead than other countries in terms of aging population rate, and the needs of elderly care is growing. So there are a lot of reforms in the aging population welfare policy in Japan nowadays. For example, The ”Long-Term Care Act” has been taken to action in 2000. The Long-term care insurance system promotes the participation of independent enterprises, for matching the demands of the needs. The participation of independent enterprises in care services has started in Japan.
This paper examines the participation of independent enterprises in care services after the long-term care insurance system enacted in Japan. The following issues have been taken consideration: the making-decisions process, the contents, and the existing issues of ”Long-Term Care Act, Japan”, the situation and efficiency of the participation of independent enterprises in care services, the problem of care-service on suppling-system, and the solving policy etc. Therefore the concrete experience toward long-term care insurance system of Japan will offer a lot of points of long-term care countermeasure for us.

並列關鍵字

social welfare privatization ； long-term care insurance system ； care service

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