Changing Welfare States in a Time of Mass Aging: Policies, Markets for Eldercare Workers, and the Private Sector in Japan and Their Implications for Cross-National Comparison

As welfare states engage the realities of super-ageing, restraints on public funding have combined with giving local governments and the private sector more flexibility to meet needs. Stakeholders in local governments and the private sector push the bounds of this new flexibility within regulatory constraints, innovate to transcend those limits, and lobby for further flexibility. Privatization and devolution of policies for the elderly also bear on the private care industry’s financial resources, care labor markets, local needs, intranational inequalities, and international migration patterns. This paper addresses the question: What is the relationship among government policies, markets for caring, markets for migrants, and private sector innovation to meet increased needs for caring? The paper draws on Japan’s evolving approaches to securing a care workforce and adopting care-work migration by highlighting how care-industry entrepreneurs have sought to work within the policy system to meet the country’s escalating care needs. The paper contends that government policies—both for formal eldercare institutions and for migration—do not dictate but interact with market behaviors of care-related industries and potential employees. Policies become structuring mechanisms that may drive an entrepreneurial private sector and local governments to develop alternatives preferable to those envisioned or provided directly by government, particularly because of the demand and costs of much-needed labor. The paper exposes the strategies of residential care facilities, training schools, recruitment agencies, and local governments that seek to maneuver within and stretch government policies concerning care provision and the care labor force. The paper further argues for a framework for comparing welfare regimes that takes into account the adaptive response to aging that recognizes the interaction of cuts to the public insurance systems, private sector innovation, local governments, care labor market conditions, and international migration.