Analysis on the effects of the decentralization on the efficiency and equity of the social security system

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Like in other developed countries, social security system in Japan requires its reform. Central government in Japan controls the whole of the social security system while the municipalities have the discretionary power in the delivering the social security services, to some extent. (Note that in Japan, the notion of the social security system includes the health insurance, pension benefits, long term care insurance, income support, benefits for disabled, and so on.) However, the municipality is not just a provider. Governor in the municipality must be elected through the election. Hence the municipality provides the supplement services additional to the national services or the services specific to the residents in the area if the residents demand the governor to provide such services. The purpose of this research is to empirically clarify the effect of the political decentralization on the efficiency and equity of the social security system, and analyze how the governance roles or tas … More ks in social security system should be allocated to the central and local government in the normative view point.Research results are as follows. At first, we reviewed the history of the political decentralization process in Japan, and the possible effects of the process. Municipality specific benefits or services have not been included in the social security benefit statistics, so that we tried to estimate it. Especially on the public provision of the day-care center services for children or provision of the nursery schcol services are considered By using the municipality-based data set, the effects of the abolishment of the financial support by the central government to the local government was empirically analyzed.On the public health care system, the function of the regional health planning were considered, and the effects of the subsidy to the public hospital are empirically analyzed in terms of the horizontal equity. On the long term care, by using the questionnaire survey to the elderly, the relationship between social network of the elderly and their health status, and the demand for needs for the welfare services provided by the municipality.On the income support system, the interview-based research was made for clarifying the appropriateness of the discretionary power and of the burden of the work for the specialist in charge of income support, in municipality. Another study tries to estimate the quantities and costs of the care for the elderly in the “homeless shelters". “Homeless" means the person without living home in Japan. They said that the homeless lost their home with the bankrupt or long lasting unemployment. However, this research figure out the fact that the possibility of the existence of the aged person in the homeless shelters without the experience of the homeless situation.One of the limitations of this research is that we did not deal with the matters on the welfare system for disabled persons. This is our future research agenda. Less