John Creighton Campbell

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. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover 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.

These essays by no means cover all areas of interest in long-term care programs, but they offer new insights (and intriguing questions for future research) about how differently policies in this important area can be carried out in different countries.

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. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover 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.

Compared to the rest of the world, Japan has a healthy population but pays relatively little for medical care. This book analyses how the health care works, and how it came into being. Taking a comparative perspective, the authors describe the politics of health care, the variety of providers, the universal health insurance system, and how the fee-schedule constrains costs at both the macro and micro levels. Special attention is paid to issues of quality and to the difficult problems of assuring adequate high-tech medicine and long-term care. Although the authors discuss the drawbacks to Japan's stringent cost-containment policy, they also keep in mind the possible implications for reform in the United States. Egalitarian values and a concern for 'balance' among constituents, the authors argue, are essential for cost containment as well as for access to health care.

Compared to the rest of the world, Japan has a healthy population but pays relatively little for medical care. This book analyses how the health care works, and how it came into being. Taking a comparative perspective, the authors describe the politics of health care, the variety of providers, the universal health insurance system, and how the fee-schedule constrains costs at both the macro and micro levels. Special attention is paid to issues of quality and to the difficult problems of assuring adequate high-tech medicine and long-term care. Although the authors discuss the drawbacks to Japan’s stringent cost-containment policy, they also keep in mind the possible implications for reform in the United States. Egalitarian values and a concern for ‘balance’ among constituents, the authors argue, are essential for cost containment as well as for access to health care.