Privatization Policies and Changing Inter-Sectoral Relationships in Japan: Summary of a Seven-Year Panel Study on the Long-Term Care Insurance System

Abstract

The author examines whether and to what extent the relationship between the government and the private sector has changed as a result of the introduction of the new nonprofit organization system in 1998 and the privatization policy under Long-Term Care Insurance (LTCI) in 2000. Surveys of nonprofit and for-profit LTCI service organizations were conducted from 2005 to 2012 in two municipalities in Tokyo Prefecture, Japan. The outcomes demonstrate that the government–private-sector relationship has not changed to any significant degree. The government, rather, has extended its influence over both the nonprofit and for-profit organizations. At the same time, the for-profit organizations became more similar to the nonprofit organizations because of the resource allocation mechanisms under LTCI. It was difficult to detect the distinctive roles of existing nonprofit organizations over time. However, there seems to have been little competition between nonprofit and for-profit organizations aimed at replacing each other.