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

与其他发达国家一样，日本的社会保障制度也需要进行改革。日本中央政府控制着整个社会保障制度，而市政府在提供社会保障服务方面拥有一定的自由裁量权。(Note在日本，社会保障制度的概念包括健康保险、养老金福利、长期护理保险、收入支持、残疾人福利等。然而，市政当局不仅仅是一个供应商。市政当局的州长必须通过选举产生。因此，如果居民要求省长提供服务，市政当局提供国家服务之外的补充服务或该地区居民特有的服务。本研究的目的是实证分析政治分权对社会保障制度效率和公平的影响，并分析政治分权对社会保障制度效率和公平的影响。 ...更多信息 从规范的角度来看，社会保障体系中的社会保障金应该分配给中央和地方政府。首先，我们回顾了日本政治分权过程的历史，以及这一过程可能产生的影响。市政府的具体福利或服务没有包括在社会保障福利统计中，因此我们试图对其进行估计。特别是考虑了为儿童提供日托中心服务或提供托儿所服务的公共服务。对中央政府取消对地方政府财政支持的影响进行了实证分析，在公共卫生体系方面，考虑了区域卫生规划的作用，从横向公平的角度对公立医院补贴的效果进行了实证分析。在长期护理方面，通过对老年人进行问卷调查，了解老年人的社会网络与健康状况的关系，以及对市政府提供的福利服务的需求。在收入保障方面，通过访谈研究，明确了收入保障专家的自由裁量权和工作负担的合理性。在市政当局。另一项研究试图估计“无家可归者收容所”中老年人的护理数量和费用。无家可归者是指在日本没有家的人。他们说，无家可归者失去了他们的家与破产或长期失业。然而，本研究指出，在没有无家可归的情况下，老年人在无家可归者收容所中存在的可能性，本研究的局限性之一是，我们没有处理残疾人福利制度的问题。这是我们未来的研究方向。少

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