노인장기요양서비스 준시장화와 공급관리체계의 변화

Abstract

As a result of the promotion of quasi-marketization in the flow of welfare reform that reorganized the welfare state regime since the 1990s in various countries, the role of the government as a provider and financier has been reduced in the provision of welfare services, but the role of the government as a manager surrounding the provision of services in the quasi-market has been reinforced. However, the role of the government as a service provision management entity in the quasi-market has been deployed differently in different countries, and as a result of the policy deployment, it is noteworthy that the governance patterns following the promotion of quasi-marketization appear differently.
 Against this background, this study is intended to look at changes in policies surrounding the overhaul of the service provision management system, focusing on policy deployment for the overhaul of the provision management system following the quasi-marketization of long-term care service for the elderly, to see how such policies have been deployed in advanced countries with examples from representative countries (the UK and Japan) that executed the reform of quasi-marketization. Therefore, in order to determine the changes in the provision management system that has been overhauled following the quasi-marketization reform of long-term care service for the elderly in the UK and Japan since the 1990s, this study approaches the provision management system from the viewpoint of the “pluralization of provision management” to analyze how the management system (regulation and evaluation system) surrounding service provision in the quasi-market has been pluralistically overhauled. In particular, in relation to the pluralistic overhaul of the service provision management system, this study analyzes what roles are played by the government including local governments as managers after the establishment of the regulation and evaluation system to guarantee the quality of service following quasi-marketization and what relationships have been established with the public organizations that have newly emerged as regulation and evaluation bodies. Furthermore, by identifying changes in the role of local governments following the promotion of quasi-marketization through such policy deployment along with how the new governance frameworks for regulation, evaluation, devolution, etc., have been established and changed, this study captures the current state of pluralistic governance for long-term care for the elderly in the UK and Japan and presents implications for long-term care governance for the elderly in South Korea.