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How Policies Change

How Policies Change: The Japanese Government and the Aging Society

John Creighton Campbell
Copyright Date: 1992
Pages: 444
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    How Policies Change
    Book Description:

    Japan is aging rapidly, and its government has been groping with the implications of this profound social change. In a pioneering study of postwar Japanese social policy, John Creighton Campbell traces the growth from small beginnings to an elaborate and expensive set of pension, health care, employment, and social service programs for older people. He argues that an understanding of policy change requires a careful disentangling of social problems and how they come to be perceived, the invention (or borrowing) of policy solutions, and conflicts and coalitions among bureaucrats, politicians, interest groups, and the general public. The key to policy change has often been the strategies adopted by policy entrepreneurs to generate or channel political energy. To make sense of all these complex processes, the author employs a new theory of four "modes" of decision-making--cognitive, political, artifactual, and inertial. Campbell refutes the claim that there is a unique "Japanese-style welfare state." Despite the big differences in cultural values, social arrangements, economic priorities, and political control, government responsibility for the "aging-society problem" is broadly similar to that in advanced Western nations. However, Campbell's account of how Japan has taken on that responsibility raises new issues for our understanding of both Japanese politics and theories of the welfare state.

    Originally published in 1992.

    ThePrinceton Legacy Libraryuses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

    eISBN: 978-1-4008-6295-5
    Subjects: History

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. List of Tables and Figures
    (pp. ix-x)
  4. Preface
    (pp. xi-xvi)
  5. A Note on Conventions
    (pp. xvii-2)
  6. CHAPTER ONE Introduction
    (pp. 3-24)

    Japan is aging. The decade of the 1990s will see the fastest growth of the elderly’s share of the population ever experienced by any nation. Anyone reading newspaper editorials, listening to politicians’ speeches, or talking with ordinary citizens will discover that the aging society is universally regarded as a major challenge for the nation. And to an extent not always fully recognized in Japan, much less in the West, the nation has responded. The expansion of programs for the aged in the “old-people boom” years in the 1970s was perhaps the largest policy change in postoccupation Japan. In the 1980s,...

  7. CHAPTER TWO A Theory of Policy Change
    (pp. 25-51)

    My plan of attack at the outset of this study was to identify the most significant policy changes in the old-age policy area, find out what caused them, and then look for general patterns and variations—an almost purely inductive approach. But any inquiry must be based on at least an implicit theory, and I started with two. One was the conventional model of governmental outputs as resulting from inputs: pressures from the general public, conflicting social groups, service providers, influential politicians, opposition parties, and so forth. The other was a more technocratic view of government as problem solver, monitoring...

  8. CHAPTER THREE The Aging Problem: Establishing Pensions
    (pp. 52-104)

    In the early 1950s, as Japan was emerging from the immediate postwar recovery and from being ruled by foreigners, the problems of old people were hardly at the top of its policy agenda. Economic rebuilding and the political controversies about occupation reforms and the conservative “reverse course” were the main concerns. Even within the social policy domain, taking care of all the people left bereft or impoverished by the war was a persistent worry, although the toughest problem for the immediate future was what to do with the children of the postwar baby boom. Imagine the reaction of a politician...

  9. CHAPTER FOUR Policy in the 1960s: The Old-People Problem
    (pp. 105-138)

    The early development of Japan’s pension system, as described in the previous chapter, was overwhelmingly centered on a concern for the eco nomic security after retirement of current workers—what has been called the aging problem orrōgō mondai.The choice of funded rather than payas-you-go financing for the main pension systems and the lack of fuss about income maintenance for those already old—as noted, the Welfare Pension for those 70 and over was tiny and grew very slowly—reflected both the government’s priority on economic growth, favoring investment over consumption, and a general lack of interest in the...

  10. CHAPTER FIVE The Old-People Boom and Policy Change
    (pp. 139-180)

    Japan was ready for change in the early 1970s. Several factors that added up to a new choice opportunity for the nation were converging:

    1. Ikeda Hayato’s 1960 plan to double national income in a decade had been overfulfilled, the standard of living had reached Western levels, and Japanese were ready to think about new goals.

    2. Economic growth itself had brought contradictions: industrial development caused pollution and overcrowding; rising incomes of salarymen and workers exposed the widening gap with those left behind.

    3. Growth brought an economic surplus as well, particularly a surplus in government revenue that could be...

  11. CHAPTER SIX Starting Small Programs
    (pp. 181-209)

    Although large programs of the sort discussed previously account for the bulk of public expenditure—indeed, both pensions and free medical care are essentially money-disbursing mechanisms—much of the business of government is conducted through smaller programs with relatively narrow purposes. Richard Rose observes that understanding how such programs expand may well require rather different explanations from those devised to analyze aggregate expenditure growth.¹ It can be added that the process by which small programs get started may well be quite different from the large policy changes more often studied by political scientists, if only because of differences in scale....

  12. CHAPTER SEVEN New Agenda: The Aging-Society Problem
    (pp. 210-253)

    The old-people boom ended in 1975. It was a year of transition in the view taken of old people and social welfare in the Japanese government. As we have seen in the previous two chapters, pension benefits were greatly increased in 1975 without demur, and new small programs were still being initiated. But now, influential voices were heard arguing that Japan had gone too far, talking about “reconsidering welfare” and the need for a “Japanese-style welfare society.” Old-age policy changes would now be oriented less toward the old-people problem than toward the aging-society problem (kōreisha shakai mondai),the problems created...

  13. CHAPTER EIGHT Expanding Employment Policy
    (pp. 254-281)

    Efforts to help older people work are the most unusual aspect of Japan’s policy toward the elderly. Most European countries have been trying to move aging workers out of the labor force to help solve their problems of youth unemployment. The United States has concentrated on removing legal barriers to older people retaining their jobs, as through the Age Discrimination in Employment Act, but has done relatively litde to improve the ability of the elderly to work, or encourage employers to hire or keep them. Only Japan pursues a consistently positive policy of job maintenance and creation for older people,...

  14. CHAPTER NINE Health Care Reform
    (pp. 282-312)

    The mid-1980s brought the enactment of several policy changes aimed at curbing old-age health care expenditures, beginning with the Health Care for the Aged Law (Rōjin Hokenhō) passed in 1982. This law ended the ten-year-old “free” medical care system by introducing a small patient copayment; it also cross-subsidized the deficit-ridden National Health Insurance program from more affluent programs, and initiated a set of health service activities aimed at keeping older people healthy. The Health Care for the Aged Law was quickly followed by revisions in the medical care fee schedule to reduce the costs of treating and caring for the...

  15. CHAPTER TEN Reforming the Pension System
    (pp. 313-351)

    In the fall of 1981, a new novel calledPension Collapsewas much read and talked about in governmental circles.¹ It was written in the style of the best-sellingJapan Sinks,but here Japan in the year 2000 was engulfed not by a tidal wave but by a flood of government deficits, inflation, unemployment, loss of work ethic, intergenerational conflict, and a host of other social pathologies, all caused by a pension system run amok. The book was signed with a pen name, but everyone knew that the author ofPension Collapsewas actually Murakami Kiyoshi, an insurance executive who...

  16. CHAPTER ELEVEN Conclusions
    (pp. 352-396)

    This project has had three purposes. The first, and most important, was to make sense of Japanese policy toward the elderly. The second was to try out a comprehensive theory of policy change. The third was to throw some new light on the Japanese policy-making process—new both in theoretical approach, and in exploring a policy area that few have considered. Given my starting assumption that public policy is best seen as an aggregate of past policy changes, all three of these purposes have already been substantially fulfilled, to the extent of my knowledge and abilities, in the detailed analyses...

  17. APPENDIX National Programs for the Aged
    (pp. 397-404)
  18. Index
    (pp. 405-418)