Support Systems of
Working Cares in Japan and
Taiwan-Controls and
Globalisation
Masaya Shimmei & Yueh-Ching Chou
Masaya Shimmei: Human Care Research Team, Tokyo
Metropolitan Institute of Gerontology
Yueh-Ching Chou: Institute of Health & Welfare Policy,
National Yang-Ming University, Taipei, Taiwan
Distinctive features of the EastAsian welfare system
• Fast population aging and policy learning process
• Confucian remnants and family obligations
• Generous public policies to elder populations
• Relatively well established disability benefits
• Strong labour market orientation with welfare
system
• Strong central government control
• Strong influence of medical and health services
Support available to carers through statutory employment rights and working time/place flexibility
Country
Carers of seriously ill or disabled children
Carers of frail, sick or disabled older people
Carers of sick or disabled partners
Paid family care leave, max. 93 days for each family member (self-employed not eligible).
Japan
Paid or unpaid nursing leave for 5 days per year (10 days per year if more than one dependant).
Legal right to request flexible working: employers must offer carers i) shortened working hours; ii) flexible working time; iii) limitation of extra
working hours, up to one year per application.
Unpaid parental leave for 2 years (until child’s
3rd birthday), parents without labour insurance.
Paid parental leave (60% of salary) parents
(one at a time) with children aged 6 mths-3 yrs,
parents with labour insurance.
Taiwan
Unpaid leave to care for relatives.
Paid care leave, 5 days p.a. children <12 yrs,
civil servants only.
Flexible working or unpaid one-hour early
leave, employees with children <3 yrs,
companies with 30+ employees only.
Publicly-funded support available to carers through national social and healthcare systems
Healthcare system (with 30% user fees).
Social services
Early intervention support services.
Some respite services for carers under
Japan
Community carer support programme within LTCI
Nursing care at home.
the Basic Law for Persons with
(training, carer exchange, support schemes).
Short-term hospitalization.
Disabilities and LTCI
Day service for disabled children.
Specialist medical care.
Variable, discretionary LA-funded carer services (respite, training, support groups, counseling, information).
Taiwan
Universal insurance-funded healthcare (NHI) system.
Financial support available to carers through state welfare benefits and social security arrangements
Family Care Leave Supplement (through unemployment insurance, for carers with prior employment record only).
Japan
Special Child Rearing Allowance.
Welfare Allowance for Children with Severe
Disabilities.
Income tax allowance.
Family Caregiver Benefit (some municipalities only).
Income tax allowance.
Taiwan
Special Care Allowance for low income citizens (family
carers aged 16-64 and without a full-time job only).
Income tax allowance.
Commonality and differences in support
to carers in Japan and in Taiwan
• Commonality
• Compartmentalised public and financial support for carers through
state and social security benefits
• Differences
• Japan
• Universal statutory employment rights to all range of carers
• More flexible and generous paid leaves
• Public financial (fringe) benefits for carers of disabled children and for disabled
partners
• Taiwan
• Care for family members (older/disabled) --Family responsibility
• Public policies/benefits provided for care recipients but not carers
• Paid care leave only available for care for young children aged less than 3 since 2009
• Employers/support from workplace--never been involved (lack of flexible
working hours or part-time job provided)
• Policies being developed, e.g.,
• Care for young child less than 3 has been concerned since 2002
• Care for older people –LTCI under developed (2016 LTCI law might be
issued)—paid concern to older people (ageing population 37% in 2050)
instead of carers
• Care for disabled children --lack of attention
• Care for disabled spouse aged younger than 65-- new issue
Related legislation in Japan
1950s 60s Major social welfare legislations
1970s
1972:Working Women Welfare Act
1980s
1986:Equal Employment Opportunity Act for Men and Women
1995:Childcare and Family Leave Act (Revised) extended to care of ‘other family members’ in
addition to childcare, employers recommended to offer family care leave.
1990s
1999: Childcare and Family Leave Act (Revised) obliged employers to offer family care leave.
1998: Law to Promote Specified Nonprofit Activities (NPO Law)
1999:Equal Employment Opportunity Act for Men and Women (Revised) Labor segration strictly
prohibited
2000: Long Term Care Insurance Act: (includes a family carer support programme).
2000s
2000: The Basic Structural Reform of Social Welfare
2001: Family Care Leave extended / amended.
2002: Family Care Leave extended / amended.
2003：Support Fee System for Disabled
2004: Family Care Leave extended / amended.
2005: Family Care Leave extended / amended.
2005:Long-term Care Insurance Act: (Major Revision)
2006:Abolish Support Fee System for disabled and legislated Services and Supports for Persons
with Disabilities Act
2009: Childcare and Family Care Leave Act (revised)
Direction of Policy Change in Japan
• Policy response (Japan)
• The Basic Structural Reform of Social Welfare (2000)
(1) To establish a system which respects individuals’ choice
(2) To expand high-quality welfare services
(3) To improve regional welfare to give comprehensive support to
achieve individuals’ independent life
• Implementation
Unit of Intervention
Service Provision
Decision for service use
Before
After
Household
Individual
Quasi-public
Privatised
Administrative disposition
Contract based
• Policy learning
• Different stage of social developments and response at the policy
level corresponding policy learning (Glendinning et al, 2009;
Colombo et al, 2011)
Direction of Policy Change in Taiwan
• 1991: live in migrant care workers available for family to hire through the application from the
Council of Labour (306 care workers in 1991; 197,854 in 2011)
• NGO /parental groups + LA: 1993: Respite care initially introduced (in Taipei City)
• Parental group/NGO+ law makers1997: Disabled Persons (Respite Care) Act (20 days a year)
•
Family Carer or family caregiver a new term
•
•
Taiwan Association of Family Caregivers (TAFC), established in 1996, by health professionals, scholars and carers
Lack of concern by woman group
• gender equality movement:
•
2002: Gender Equality in Employment Act: unpaid leave to care for relatives
• 2004: 5 days per year paid care leave (govt. officials only).
• 2007: Welfare of Older People Act: included Special Care Allowance to mid- or low-income
senior citizens
• 2007: Welfare of People with Disabilities Act: LAs to co-operate with NGOs on respite/ carers’
services.
• 2009: Employment Insurance Act: unpaid care leave for carers of family members
paid care leave for parents with children aged less than 3
• 2009: Welfare of Older People Act: LAs to co-operate with NGOs on respite/carers’ services.
•
2016: LTCI Act: care allowance (in cash) to family carers or care recipients, under debated
• TAFC campaigns on four main issues: one day a week respite for family carers; paid family care
leave; inclusion of family carers in the forthcoming Long-term Care Services Act (drafted in 2011);
and economic security for carers
Strength and weakness of support
system for carers in Japan
• Strength
•
•
•
•
Fiscal control
Individualized unit of intervention, less family obligations
Job creation
Capacity building of human resources
• Weakness
• Unclear distinction between household and individual ,
creating vacuum of responsibility between public and private
• Compartmentalised legislation between carers of elder and
disabled, no or limited support for spouse carers
• Shortage of manpower
• Less impact of voluntary organisations supporting carers
• No cash benefits to cares?
Strength and weakness of support system
for carers in Taiwan
• Strength
• Social movement/NGOs strong: woman groups, disabled
and older people groups, carer association
• Social change in democratic society: nothing impossible
• Weakness
• Citizens: Family responsibility –majority people: filial
piety
• Care still a family affair > dedomesticalised, degendered,
• NGOS: different preference: eg. Migrant care workers
• Association for migrant care worker: equal pay for local and
migrant workers—family affairs law
• Disabled and older people association—cheap fee for migrant
care worker
• Government: election oriented > civil rights/well-beings
• International force: Taiwan isolated
Conclusion and recommendations
• Conclusion
• Japan - consensus built, entitlement enlarged but still
compartmentalised beneficiaries
• Taiwan - in the phase of building consensus among women,
cooperatives and the government
• Policy Recommendations
• Dissemination of the concepts of support to carers in order to
enhance its positive implementation at work place
• Resolve the chasm between individual and household
responsibilities
• Define clear state responsibilities and develop intermediary
organisations supporting carers to effectively provide
indivualised service
• Streamline the benefits for carers of all the categories on the
ground of universalism
• Set a standard with regard to qualification of care workers
and construct decent labor market through capacity building
Workshop F: East Asian countries
Support Systems for Working Carers in Japan
and Taiwan - Controls and Globalisation
1. What is distinctive or important about this welfare system?
2. What differences are there in the two countries?
3. What is the direction of change in these countries?
4. What are the strengths / weaknesses of the support this
system offers to working carers?