Changing meanings of frail old people and the Japanese welfare state

The passage of the Kaigo Hoken or Long-Term Care Insurance (LTCI) bill by the Japanese legislature in late 1997 signifies a major expansion, and indeed a qualitative change, in the development of social policy in Japan. Japan is only the second large country in the world to adopt a social insurance model for long-term care. The other such program was started by Germany in 1994, and was hailed by analysts as "virtually unparalleled in Western welfare states after 1975" (Goetting, Haug, and Hinrichs, 1994, p. 288) In fact Japan's program is much larger and in some ways more innovative than the prior German example.