International
Longevity
Center-Japan

GlobalInformation
JournalonLongevity
andSociety2008

Get Around This Table ...

ILC Global Alliance
ILC-USA
Robert N. Butler, M.D.
President and CEO
Professor of geriatrics at the Brookdale Department ofGeriatrics and Adult Development at the Mount Sinai
Medical Center
Founding Director of National Institute on Aging

ILC-Japan
Shigeo Morioka
President
Former CEO of Yamanouchi Pharmaceutical Co., Ltd.
(current Astellas Pharma Inc.)
Former Chairman of the Fair Trade Council of
the Ethical Pharmaceutical Drugs Manufacturing Industry

International Longevity Center=ILC was

ILC-France

founded with the aim of studying various issues

Françoise Forette, M.D.

concerning population aging with low-fertility
from the international and interdisciplinary
perspectives and sharing the findings broadly
to educate the public and to make policy
proposals.

CEO
President of the Board of Directors of the Hospital Broca
Former Special Adviser on Aging of the Minister of Health,Social Security, Elderly, Family and Disabled Persons

ILC-UK
Sally Greengross, OBE
Chief Executive

Eleven centers have been established todate in the world: in the United States, Japan,

A crossbench (independent) member ofthe House of Lords

France, the United Kingdom, Dominican

ILC-Dominican Republic

Republic, India, South Africa, Argentina,

Dr. Rosy Pereyra, M.D.

the Netherlands, Israel and Singapore. These

President

centers constitute an alliance (called ILC Global

Organizer of Grand Parents Institute
Former General Director of State Services to the Elderly of
the Ministry of Health and Social Assistance

Alliance) that promotes joint studies as well as

country-specific activities.
This concept of ILC Global Alliance wasadvocated by Dr. Robert N. Butler, a global
authority on gerontology (current President &CEO of ILC-USA). In Japan, a group of privatecompanies endorsed his vision; also, thenMinistry of Health and Welfare (currently
Ministry of Health, Labour and Welfare) assented tothe thought. Consequently after three years of
preparatory work with the guidance of the
Ministry, ILC-Japan was launched in November

ILC-India
R.A.Mashelkar, Ph.D.

President
Chemical engineering scientist
Bhatnagar Fellow at National Chemical Laboratry
President of Global Research Alliance
Former Director General Council of
Scientific and Industrial Research

ILC-South Africa
Monica Ferreira, DPhil.
President

Board of the International Institute on Ageing (UN-Malta) (INIA)
Board of the World Demographic Association (WDA)
Steering Group of the African Research on Ageing Network (AFRAN)

ILC-Argentina
Lia Susana Daichman, M.D.

1990. Since then, we have actively sought to

President

promote policy proposals and advocacies in

Chair of Latin American Committee for the Preventions ofElder Abuse
President of INPEA

low-fertility aging society as well as to share ourfindings and to educate the public.
Additionally we think it one of ILC-Japan’s
crucial missions to provide abroad information
on problems of population aging in Japan andthe systems and status to cope with them.
ILC-Japan is proactively making efforts torealize an aging society where all generations
will support one another and live happily.

ILC-Netherlands
Mr. Jacques H. Schraven
President

Former president of Royal Shell Netherlands
Former President of the Confederation of the Netherlands

ILC-Israel
Sara Carmel, Ph.D, M.P.H.

President
Professor of medical sociology and gerontology at
Ben-Gurion University of the Negev in Israel
President of the Israel Gerontological Society
Chairperson of the Fund for Research in Aging,
Ministry for Senior Affairs

ILC-Singapore
Marry Ann Tsao, Ph.D.
President

President of Tsao Foundation

Contents

Roundtable Discussion
1

Is There Anything I Can Do to Help?

		Natural Elderly Independence and Participation in Society		Keiko Higuchi

Hitoshi Kato				

Chairperson, Women’s Association for
the Better Aging Society

Non-fiction author

2

The Aging of Suburban Residential Areas:		Creating New Ways of Living

		Mariko Sonoda

		Associate professor, Meiji University

Professor, Kyoto Bunkyo University

		

Yukihiro Kadono

Ken Miura		
Professor, Kwansei Gakuin University			3

Associate professor, Graduate School,
Osaka City University

The Health Insurance System in JapanIts History and Significance		Hidehisa Otsuji

Yoshio Gyoten				Former Minister of Health, Labour and WelfareHouse of Councilors Member

Medical commentator

4 The Adult Guardianship System and		 Human Rights of the Elderly
Sachiko Murata•12

Yuko Nishikawa

		

		

•2

•28

•38

Makoto Arai		
Welfare journalist			Professor and Dean of
Tsukuba University Law School		

Hiroshi Kanekawa

Sachiko Takagi				

Executive Director, Japanese Association of
Certified Social Workers

Senior Staff, General Affairs Welfare Division,
City of Machida... to Create the Global Network for the World’s Next Challenge
5

A New Form of Local Community

		

Takeshi Sasaki

Tokumi Odagiri

				Professor, Gakushuin University
Chairperson, Self-Supporting Zone Study Panel

Professor, Meiji University
Member, Self-Supporting Zone Study Panel		

Mitsuo Makino

Yoshinori Yamaoka				

Mayor of Iida City in Nagano PrefectureMember, Self-Supporting Zone Study Panel

Professor, Hosei University
President, Japan NPO Center		Michiko Mukuno		Professor, Oita University

Participants’ List		

•52

•66

This journal includes the part of roundtable discussion at the beginning part of every issue of “Global Information Journal
on Longevity and Society” (originally in Japanese) published by ILC-Japan in 2008. The roundtable discussion was attended by leading persons of each field and this issue is the extracts of those discussions from vol. 5 to vol. 9 which were translated into English and compiled by ILC-Japan.

1Participants:RounKeiko Higuchi
Chairperson, Women’s
Association for the Better Aging
Society

dt
ab
le
ss
scu
Di

ion

1

Is There Anything
I Can Do to Help?
Natural Elderly Independence andParticipation in Society• The role of the elderly in family life (multiple answers)
Counsel family and relatives
Support the family (income earner)

Care for small children
No role

50
(%)

40

30

20

Source: “2006 Global Comparative Survey on
the Lives and Feelings of the Elderly” by
the Cabinet Office
Note: The subjects of this survey were men
and women age 60 and over not living inelder care facilities. The survey was conducted in Japan from November-December
2005 and in other countries from December 2005-Febuary 2006.

2

10

0

Japan

USA

South Korea

Germany

FranceHitoshi Kato
Non-fiction author

The topic of what role the elderly can play in their communities and in society is related to how people live after they retire from work. It is a topic
that has been addressed in many forums. There have been changes in family relations, as well as in the roles that the elderly play in the family. Whatis necessary so that the personality and experience of each elderly person
can be used and, most importantly, so that the person can enjoy interactingwith his or her family and community and fulfilling his or her role therein?
From various perspectives, we talked with Keiko Higuchi, who wrote abook that focuses on the power of grandparents, and Hitoshi Kato, whowrote on the individual lives of retirees with great care.

Kato: Ms. Higuchi, when I readyour book, Grandma Power•1, it reminded me that ways of thinking in
the world today are quite myopic.
Likewise, I feel a strong dissatisfaction and concern that the mass media has such a one-sided view.
Perhaps the decline in the influential power of grandparents is one
reason that diverse thinking is becoming difficult.
I was born in 1947, but my parents worked long hours to support
the family in the chaotic post-war
period, so I was raised by my grandparents. Looking back now, I think•1 Grandma Power(Shinsui-sha, 2006)
With the sudden increase in the population of the elderly and working women,
the importance of the role that grandparents play is globally being reevaluated. This book discusses the future of theinfluential power of grandparents, taking into consideration child-rearing by
grandparents, changes in family relations now and then, and so forth.

my grandparents taught me that
there is not just one path. My
grandparents showed me that there
are many values in the world andthat, adults and children are accepted and encouraged for who they areeven in local communities.
Parents feel responsibility andpressure toward child-rearing, but
grandparents can interact with their
grandchildren as “good people” unconditionally. To play the role of“good people” is very important.
Grandparents exist to interact with
their grandchildren and foster lovethrough their gentleness and3

Roundtable Discussion

1

permissiveness.
In my view, the fact that there arepeople in addition to family who
will affirm, accept, and indulge chilimportant for today’s children who

the family has declined, and theirmust live with the feeling that there
is no way out. The role that the el-good to create a place to meet in lo-

derly should play lies therein, but I
have been concerned lately that

It is difficult for individual grandparents to gain influence, so thiseven grandparents tend to pigeon-means raising social power ofgrandparents within the communi-

hole children into one value system.

grandfathers who have plenty of so-

Power, I too am perplexed by today’s
grandparents, perhaps because
grandparents in their 60s were raised
completely immersed in studying forcollege entrance exams.
When I was a child, I had manyfriends whose grandparents had already died, but thanks to the average lifespan increasing, almost all
children born today have living
grandparents. As you have said
though, Mr. Kato, with the shift tonuclear families, there is very little
interaction with grandparents.
Despite the fact that we’ve•2 Increase in the number ofcal communities.

ty. In particular, I want to encourage

Higuchi: As I wrote in Grandmacial experience and diverse
viewpoints.

Kato: Unfortunately, the reality of
aging is that grandparents are increasingly cut off from the family
and the community.•2
For example, nursing homes
need to be established using various
community resources, but they are
adopting a system of shutting everything in these facilities. I think
the facilities should first be open to
the community.

Total number of households(unit: 1,000 households)

nuclear families and elderly
households

Figures if the number of
elderly households in 1953 is 100

50,0002,100

40,0001,700

30,0001,300

20,000900

10,000500

04living to the age of 100, the influential power of grandparents withinmain role is to indulge the children.
That’s why I thought it would be

dren within the community is very

Source: “Comprehensive Survey of Living
Conditions of People” by the Statistics andInformation Department, Minister’s Secretariat, Ministry of Health, Labour andWelfareNote: “Elderly households” means “households composed only of men age 65 or older and/or women age 60 or older with orwithout unmarried individuals under age
18” until 1974 and “households composedof people age 65 or older with or without
unmarried individuals under age 18” from1975 onward.

reached a time when people enjoy

1953

1955

1960

1965

1970

1975

1980

1985

1990

1995

2000

2005 (Year)

100

“

From the individual to the collective,
the 21st century as an era ofreinventing community

Higuchi: This is a little abstract, but

AARP discusses “Reinventing

to sum up, I think the 21 century is
an era of reinventing community. In
my understanding of history, the 19th

Retirement,” but considering thishistory and the view that people

century was the “human rights century,” and the 20th century was thereinventing retirement will dependstwar century, but on the other hand,
it was a “century of solidarity” in thesense that labor unions and cooperatives spread and the social security
system took root as a system in advanced nations. In other words, various collectives resulted from the factthat happiness was not possible justby establishing the individual.
However, this comes with a riskthat collectives will become the cornerstone of aging society and eventhe individual established first will
become ambiguous. This is the 21st
century in which we live.
The “individual,” established in
the 19th century, and the “collective,” established in the 20th century,
both are important legacies discovered over the course of time, so thismust not be denied. We will carefully protect these and nurturethem appropriately to the time.

”

will start living to age 100, I thinkon reinventing community.

Kato: Expecting currently employed businesspeople and young
people to get involved in community is difficult in reality, I think.
However, local community is becoming weak and hollowed out,
and I strongly fear that the good elements of local community will belost if this continues.
I think the first priority is the rebuilding of local community bybaby boomers and others, using retirement from work as one impetus
for this.

Higuchi: I completely agree. Thisabsolutely does not mean a return
to a communal type of community
in which the individual is obscured
as in the past. While keeping thespirit of the past’s strengths, wemust methodologically build a5

Roundtable Discussion

1

community for the 21st century.

save divorced families from

For the fun of it, I gave Kanjicharacters to the word local todestruction.

mean “the elderly (= lo) can (= ca)stay (= l).” Ideally the elderly should

the power of grandparents to support daughters and daughters-in-

be able to stay in his or her own
place where they have always lived

law who are still employed hascome to the fore. With higher di-

without being isolated within thevorce rates and longer life spans,community.

people finally have begun to under-

Kato: My feeling is that of course I

stand that the elderly are the powerholders who support the family andwas raised by my family, but also by
the community. In a good sense,

community.
When I visited England in 2005,

people in the community scolded

I learned that the British Ministry ofme. It may be impossible to revive
this kind of relationship right away

Education and Age Concern were

now, but perhaps it could be represented in some way.

Higuchi: Rebuilding community is
actually becoming a huge movement globally. In 2004,
Generational Review (Oxford
University Press) published a special

issue on grandparents. In England,
there is a grandparents association,and one reason for this is that there
are so many divorced families.
Grandparents have the power to“
6

In addition, as life spans increase,working together to promote the recruitment of mentors in community
elementary schools throughout thenation. Approximately seven mentors are placed in an average-size elementary school. Three documents
were required to apply: (1) a police
certificate that indicates no criminal
history, (2) letters of recommendations from owners and/or supervisors of companies where one has
been employed to the present, and(3) essay. Local boards of education
and Age Concern would confer and

The first priority is the rebuilding of
local community by retirees”

make decisions.

or two, but seven mentors. In

In Kingston, a neighborhood near
Wimbledon, those responsible forJapan, too, school reforms, such as
principals recruited from private

recruitment were excited andcompanies, are a hot topic, but I

pleased, saying, “We finally found agold mine of male volunteers.” Like

have heard that new endeavors are

Japan, participation in volunteer ac-

sonable number of mentors and us-

tivities in England is primarily by

ing the power of grandparents inthe community, I think people will

middle-aged women, and male participation is not going very well.

often shot down. By securing a rea-

understand that this will lessen the

However, when skilled people ofstrong character who could academi-

burden of current teachers, andcally mentor children were selected,
6 out of 7 were male, and they had

tors and teachers, it will be possible
to educate children really well.

backgrounds as middle school principals, veterinarians, and so forth.

Higuchi: From the viewpoint of us-

through cooperation between men-

The role of mentors is to help
teachers in teaching classes and tocare for children outside class time.

ing male influence, there actually is

For example, the school gate does
not open until 8:00am according toTokyo, ordinary retired businessmen started going to cooking classes for men, and as a result, a groupof friends formed. At the time,
Suginami-ku was promoting a “elderly daycare service” using empty
classrooms in a middle school, andin order to encourage men to go,
this group of friends began volunteering there, and this became the“Shokei Fureai no Ie.”•3

an agreement with the Teachers’
Union, but immigrant families andother families where parents leave
for work early often ask that thegate be opened at 7:00am. Mentors,
therefore, open the gate and fix asimple breakfast for children who
are not able to eat breakfast at
home, as well as to care for children
after school in the afternoon. There
are many children whose parents
cannot speak English, so mentors
attend classes and help these children so that they do not fall behind
academically.

Kato: This mentor system is excellent, because there are not just one•3 Shokei Fureai no Ie
An elderly daycare service center operated in empty school classroom withparticipation by local residents. Ikigaino Kai, an NPO started by friends who
met in a cooking class for retired men,
was contracted by Suginami-ku andopened the center in February 2001. Assuggested by the concept, “programs
that satisfy the intellectual interest ofmen,” 70 percent of the approximately
100 registrants are male. In addition to
mah-jong, go, calligraphy, and gardening, they help middle school students
plant rice in school fields.

something interesting happening inJapan right now. In Suginami-ku,

Kato: I’ve also visited Shokei
Fureai no Ie a number of times towrite about it. From the male perspective, many aspects of the elderly care environment today are notsatisfactory. “In that case,” thought
those men, “instead of just complaining, why not make a place7

Roundtable Discussion1

where we could enjoy ourselves.”

whether facilities today are reallyAnd such positive thinking is excellent.•4 In addition, being involved aseasy places for women to live.

volunteers allows each of them to
use their abilities in computerees assisting when women takework, negotiations with bureaucracy, and other areas from when they
were employed to find a new way of
involvement that goes beyond theboundaries of traditional volunteering. This is very interesting.

Higuchi: Since women tend to live
longer, I think it is inevitable to acertain extent for the aging society,particularly nursing care facilities,
to be feminized. However, it is also
necessary to consider the differences in how men and women have
lived up to now. The elderly have
lived with this history. That is why
if elderly men provide services byusing their familiarity with the culture in which they have lived up tonow, I think that a certain balance
will return to welfare in Japan.

Kato: Regardless of feminization, I
think we need to investigate again•4 Level of interest in NPO

activities

Source: 2006 Annual Report on the Aging
Society
Materials: “Survey on Attitudes of the Elderly Toward Participation in Local
Communities,” 2005, by the Cabinet
OfficeThere are still cases of male employbaths, and there are many nursing
homes that do not have any place toapply makeup.

Higuchi: That’s right! I think one
standard for measuring the quality ofa nursing home is whether or notthere is a beauty salon in the home.
Today’s elderly generation, particularly women, does not complain
very much, so this type of desire is
not likely to come to the forefront,
but if men come in and start complaining, women will do the same. It
is important for both to have power.
When men grow old, they end
up smothered by women’s groups
and just feel annoyed without any
will to try break through the situation on their own.
The baby boomer generation has
voiced objections since they wereyoung, and when baby boomer retirees become involved in communities and facilities, a culture in

Already participate in activities

Would like to participate in the future

Not interested

Do not know

100
(%)

7.2
33.8

10.1
42.6

80

7.8
39.3

10.0
42.6

Interested, but do not know

11.8

56.7

60

41.4
34.4

40

38.7

33.5
29.4

Interested

20.3

20
0

8

18.5

50.2

9.2
3.6

Total

13.3
4.3

Age 60-64

10.3
3.9

Age 65-69

10.0
3.8

Age 70-74

4.7
3.9

Age 75-79

3.6
0.9

Age 80+which the elderly and facility users
speak their minds will probably
take root. In this sense, I have great

unteer work for the elderly.
I would like to introduce one ex-

hopes for the baby boomer

ample in which everyone was able
to live happily, enjoy their lives, andgeneration.

warmheartedly see their friends
breathe their last breaths.

Kato: Practically speaking, too,baby boomer business men arequick and good at filling in documents. Some also have communica-

An acquaintance, who is a little
older than I, organized a senior association in a community in
Kawasaki City, Kanagawa

tion and negotiating ability. Whenone becomes a member of the aging

Prefecture. Since he had been an ex-society from now on, he/she will in-bors came and asked him to be theleader, so he served as the associa-

creasingly be asked to be involvedin community and facilities as users, volunteers, and ombudsmen.

ecutive officer of a company, neigh-tion’s first chairman. 209 of the 400

thing I can do to help?” and “Ifelderly in that community became
members, which is quite a membership rate. There were no bylaws andno dues, and whenever there were

there is anything I can do to
help…” are important, and they are

expenses, they were divided equally
among those participating in eachthe basis of volunteering. However,instead of only helping people
through specific actions, I think it isactually very important for the elderly themselves to live happily andto build such an environment.
Perhaps this is saying too much,
but I think this is the important vol-session. Some of the members
wanted to decide on bylaws anddues, but they questioned whether
bylaws were necessary for a neighborly association and decided toeliminate as much administrationas possible.
Everyone actively and indepen-

Higuchi: The words, “Is there any-“

It is very important for
the elderly to live happily”
9

Roundtable Discussion

1

dently came up with activities
which they were enjoying, but one
member eventually died the otherpresence of these wise people isday. That person belonged to thevery important in that they nicely

karaoke group, so his wife asked
each person to sing one of her hus-build an atmosphere in which anyone can be himself/herself and walkband’s favorite songs when his cof-with everyone at his/her own pace.

fin was taken from home. Everyone,
led by the karaoke group members,
raised their voices and wholeheartedly sang his favorite songs.
When I heard that they had criedand sang for him while remembering his life, even though they were
just neighbors and not related byblood, I thought what a wonderfulscene that must have been.

Kato: Hearing this makes me thinkthat those people in Kawasaki probably want to die in their community. There’s something special about
being able to imagine your ending
in a community where people
would have such a funeral for you
when you died.
I, too, have met many people
throughout Japan because of mywork as a critic, but there are wise“
10

people everywhere who are running
informal associations well. The

Higuchi: Living happily while attending funerals and visiting the ill
helps people. I think it is good andnatural to help people as a result of
trying to enjoy life instead of making a conscious effort to help
people.

Kato: That will set an example forthe next generation to happily andenjoyably grow old. That is muchbetter than saying life is a waste andboring with a long face.
However, instead of placing theburden for all of this on individual
effort and mind-set, society mustalso think about creating a framework so that the elderly can live
comfortably and feel secure.
No one is ever 100% satisfied
with their current situation.

By earning wages,
many elderly could be proud of
still working”

Everyone feels inadequate in someway. For example, financially speaking, if we are creative enough, weshould be able to provide a place ora way to earn 50,000 yen or even
100,000 yen.•5
The elderly may have difficulty
working full-time as permanent
employees. Therefore, it is necessary to create an environment
where the elderly can work limited
times, such as mornings only or
two hours per day.
At an automobile parts factory in
Nakatsugawa City, Gifu Prefecture,around ten people over age 60 work
only on weekends. By working on
Saturday when permanent employees are off, they can achieve balancein their lives and earn income of 50100,000 yen per month. One yearof work would make it possible forhusband and wife to take an overseas trip, and like the earlier storyof mentors in England, this will
make both permanent employees
and part-time elderly employees
happy, and it will support theJapanese economy.
Silver Human Resource Centers
have too many regional differences,many center managers who hailfrom the government bureaucracy,
and too few work programs and selections to match the times.

Higuchi: The Silver Human
Resource Center in Fukui City,
which is headed by a female private

citizen, is establishing a new childrearing support program. Recently,
many women professionals work
until the mandatory retirement age,and there are many elderly persons•5 Primary income sources as a80(%)

percentage of living expenses(Japan)60

with credentials needed by government, such as dieticians and nurses,
so it should be possible to create

40

jobs based on a new mind-set.

Kato: Being able to earn enoughmoney to give some spending money to grandchildren inspires thegreatest confidence, so I think there
should be a volunteer wage set separately from the Minimum Wage
Law. By earning wages, many elderly could be proud of still working,and that will prevent the need forlong-term nursing care more than20

01980 1985 1990 1995 2000 2005 (Year)

Public pension
Work income
Assistance from children, etc.
Income from assets
Private pension
Withdrawal from savings, etc.
Public assistance (welfare)
Source: “2006 Global Comparative Survey on
the Lives and Feelings of the Elderly” by
the Cabinet Office
Note: The subjects of this survey were men
and women over age 60 not living in eldercare facilities.

anything.

Higuchi: I think that preventing theneed for long-term nursing care inthis way would be the greatest contribution to society. The elderly
would be able to interact with people, earn a little money, show off totheir grandchildren, and contributeto society, so no one loses.
Before thinking rigidly about devising ways of effectively preventing
the need for long-term nursing care,the most important thing is first foreveryone to come alive by being
themselves and doing what comesnaturally.
		(5/29/2007)
Photography: Masahiro Minato

11

Participants:RounMariko Sonoda

Yuko Nishikawa

		 Associate professor, Meiji University

		 Professor, Kyoto Bunkyo University

dt
ab
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ss
scu
Di

ion

2

The Aging of
Suburban
Residential Areas:
Creating New Ways of Living• Where would you like to live when you are no longer physicallyable to care for yourself?
I want to stay in my own home.
I want to remodel my own home and stay there.
I want to move in with my children.
I’d like to move into a housing complex for the elderly.
0

20

40

I’d like to enter a long-term care facility.
I’d like to go into the hospital.
Other

60

80

100 (%)

Japan

U.S.

South Korea

Germany
Source: The Cabinet Office, “2006 Global
Comparative Survey on the Lives andFeelings of the Elderly”
Note: The subjects of this survey were men
and women age 60 and over not living inelder care facilities. The survey was conducted in Japan from November-December
2005 and in other countries from December 2005-Febuary 2006.

12

France

50.5

16.5

38.4

38.9

52.8

3.6 5.9

18.5

40.0

30.5

38.9

34.4

6.2

4.7

4.2

12.5

7.2

2.9
0.2

5.5

12.8 1.4 2.7

7.5

6.9 4.8 2.8
0.1

17.7

4.7 2.2
0.1

13.3

5.8 3.2

Yukihiro Kadono

Ken Miura

		 Professor, Kwansei Gakuin University

		 Associate professor, Graduate School,
		 Osaka City University

Most of the suburban residential areas known as “New Towns” developed
and grew on the outskirts of major cities in the period of rapid economic
growth in the 1960s, as the younger generation formed households and hadchildren. The majority of residents in these suburban residential areas were
nuclear families, and for the most part the households were headed by “salarymen,” a new occupational category at that time. They created a newmodel for the family: a husband who worked outside the home, a wife who
did the household chores, and their children.
In a short time, the members of the first generation of suburbanites will
retire from their original roles and join the ranks of the elderly. As they confront their own physical aging, they have also begun to deal with the agingof their communities.
In those suburban residential areas, the voices of children are no longer
heard, and residents are predominantly elderly. Do communities like thishave a future? Can they regain their previous liveliness and vitality? Above
all, who will continue the existence of these communities as the originalresidents pass on?
We’d like to look at new ways of living in suburban residential areas inthis extremely gray society, keeping in mind all the angles and possibilities.

13Roundtable Discussion

2

dential areas.

What will happen to the New Towns

Nishikawa: I think of modern

with the aging of the urban areas?

housing as a container for families,
so I’ve been researching the connec-

Sonoda: Right now, it is the majortion between families and their con-cities and other concentrations of
population that are facing the prob-

tainers. Currently, I’m studying
urban areas, particularly Newlems of their aging populations.
Given that the problem of aging is
especially urgent in the New Towns,

Towns, as an extension of my study

I’d like to consider what will happen to the urban areas.

research on the modern Japanesefamily and housing, it would look

The baby boomer men may besymbolized by the catch phrase,

something like this.
Before World War II, there were“Can you keep fighting 24 hours aday?” It’s no exaggeration to say

two main household models: theof housing. If I were to map out mylarge extended family household,headed by the father or oldest
brother, and the urban household,that they gave everything they had
to their companies.•1 They will startback to their homes.
These men used to say that theirmade up of a nuclear family. There
were two main housing models tocorrespond to the household mod-homes were just places to sleep, andthey concentrated on their jobs, sothat they soon became strangers totheir own families. First I’d like tohave Professor Yuko Nishikawa talkabout what will happen to thesefamilies and the places where they
live, especially the suburban resi-

els, “houses with open hearths” forextended family households and“houses with parlors” for nuclear
family households.
After the War, the urban household became the standard model forfamilies, and at the same time, thenotion of individual identity arose,

The Wartime Generation
Born 1931-1945

The Baby Boomers
Born 1946-1950

retiring in 2007 and they’ll be going•1 Comparison of Generational

Work Ethics, Characteristics
of Lifestyle Attitudes

Source: Masako Amano, ed. The Baby Boomer Generation: New Theories—Opening
the Way to Relational Autonomy (Yushindo Kobunsha), 2001, excerpt from p. 11

				• Corporate warriors
		• Shared experience of losing the war, rising out of poverty, rebuilding the nation of their ancestors• A lifestyle single-mindedly devoted to work		
• Service to the company that involves the family		• Their hobby is work; they are proud of having no other hobbies.

14		• Company people		• Faded memories of the experience of losing the war,a lowered devotion to the common good, striving tolive better than ordinary people		• The growth of the company is a source of happinessfor the family.
		• The generation that takes work assignments awayfrom their families
		• Although they value their hobbies, they are still devoted to work.

along with the corresponding hous-time housewives, and at the sameing styles of “houses with westernstyle living rooms” andtime, the era in which the one-childor two-child family became thenorm. I also wonder if this is the“single-bedroom studio apartments” which are occupied by thebaby boomers and their children,

generation in which the gender-

respectively.

“men at work and women at

based division of labor, the idea ofI think that retired baby boomer

home,” took hold.
The prevailing housing patterns

men are returning to their homes
not as “fathers” but as “husbands”

were large urban apartment blocks
and suburban New Towns.

in a nuclear family. They didn’t return to an extended family home

Furthermore, about the time thatwith a hearth or to a three-genera-

the children of this generation weretion home with a traditional parlor,of university age, their families encountered financial difficulties, andbut to a house with a western-styleliving room, a nuclear family home

it was said that they needed 125%of the husband’s income to survive.
Housewives’ part-time work cov-

where the children had grown up
and left. I’d like to summarize thebaby boomers in simple terms.

ered the additional 25%. By the way,
wages for housewives who work
part-time never rise. One of the ma-

Their time was one in which tertiary industries flourished and many
people moved to the cities. It wasalso the time when increasing numbers of women went on to higher
education.•2 It was the generation

jor accomplishments of feminist research is its analysis showing thatthese wages remain stagnant because women’s work is viewed as
supplementary income.
The “salarymen” of this generation can anticipate receiving a pension in their old age, but at the samethat experienced the first stages ofwomen’s liberation, and ironically,
the generation with the highest rateof marriage and percentage of full-

			
			

First generation,born 1916-1920

Second generation,born 1946-1950

			
Men		
Employed men		
Men		
Employed men
			
Age 35-39		
and women in theAge 35-39		
and women in the					entire population				entire population
Occupational composition		White collar		
22.4			15.7		
28.7		
32.3
		Commerce		
11.5			10.7		
17.8		
14.3
		Blue collar		28.8			24.1		
35.9		
31.4
		Agriculture, forestry, fishing		
27.5			40.4		
3.6		
9.2
Percentage of population concentrated
in the Tokyo area: Tokyo, Kanagawa,16			
14.8		
21.9		
20.8
(entire population)		 (men and women age 35-40)		
(entire population)
Saitama		 (men and women age 35-39) 			
Educational attainment (men and women)		Secondary education
Higher education

30.3
6.2

•2 Changes Between

Generationsin Terms of Occupational
Composition (%)

Source: Yo Takeuchi, Traces of the Dreamof Popular Modernism: Varying“Refinement” and the Universities.
Shinyosha, 2001, excerpt from p. 10

74.7
22.2

15

Roundtable Discussion•3 nLDKThis is how living units are described inJapan, with “n” being the number ofrooms in addition to the LDK (a single
room that serves as the living room, dining room, and kitchen). Most postwar
housing was designed on the LDK model. In places like the New Towns, where
gender roles were clearly defined, the“n” in houses with Western-style livingrooms was “the number of persons in
the family minus one,” and some people
remarked that the “minus one” was thehusband.

2

time, many of them were forced outof their jobs by restructuring.
Another problem that we cannot ignore is that many people working

to solve these problems createdeven stronger networks of humanin the primary and secondary industries have no heirs to carry on

relationships, and the resulting

their work and are facing the end of
their family businesses and the for-

Participants worked hard to develop new media, including group

malities required to close themdown.

handbills, newspaper inserts, andelectronic media, including web-As Professor Sonoda has pointed
out, for about 40 years, most men

sites. This forty-year period saw awere only “night time citizens” ofdren’s culture,” led by women.
We are approaching a shift to atheir communities, so inevitably,
women, who were “24-hour citizens” of these communities took up
their management and administration. This was a characteristic ofJapanese-style New Towns. The
women were left alone in theirnLDK•3 apartments which were de-16

ration of high-rise apartment
blocks. However, gathering together

movements enjoyed some success.

flourishing of “women and chil-“women and elderly people’s culture.” Specifically, there are numerous problems connected withnursing care for the elderly. First,
there’s the problem of how the wife

signed specifically for a closed nu-

should take care of her husband’sparents if they live far away. Second
is the question of whether theyclear family, but eventually, theycreated links with other women.
Countless networks arose out ofties forged at the co-op, at part-timejobs, at the PTA, in garden allotments, while caring for family
members, or in citizens’committees.
In the early years of the New
Towns, the infrastructure was incomplete, with too few schools or
roads, while a whole range of problems arose in later years: too few
hospitals or facilities for the elderly,
stores closing, elementary and junior high schools shutting down orbeing consolidated, and the deterio-

should have their parent move inwith them or not. Finally, there is
the question of what to do about
one’s parents’ funeral arrangements
and final resting place. Before long,
baby boomers have found that theirown problems of aging are catching
up to them. At present, there are
empty classrooms in the elementaryand junior high schools of the New
Towns, while, on the other hand,large numbers of facilities for the elderly are being built in the vicinity.
In the past ten years, New Towns
have often been seen as areas
fraught with problems, but in fact,
it’s just that the previously men-tioned changes in the population

Sonoda: Unlike the “nested” struc-

structure due to low fertility andpopulation aging and the phenome-

ture of the modern Japanese family,
the issue for the concept of egalitar-na associated with these changes

ianism is whether it will be possible

surfaced 10 years earlier in these areas than in most parts of the coun-to remake and replace the existing
structure from the bottom up.

try. Therefore, instead of being areas

Professor Nishikawa believes andfraught with problems, New Towns

hopes that this will be possible, but

are places where the issues facing
society first emerge, and I wonder ifwhat do you think, Professor
Kadono?

we shouldn’t consider measures forsolving these problems in the New

Kadono: If I may speak from myTowns as early attempts to solvethese problems for Japan as awhole.
Even if baby boomers have withdrawn from the workforce, they still
have enough time, physicalstrength, emotional strength, andeconomic security to weave together new networks, so I have great expectations of their potential. For along time up to the present, thefamily has been the fundamental
unit in the modern national model,
but I believe that the largest issue iswhether it will be possible to breakaway from the nested structure of“family, region, and nation” andweave bottom-up networks basedon a horizontally egalitarian philosophy. When that happens, interaction between men’s and women’sculture, among regional cultures,
and among foreign and generational
cultures will be essential components. I’m looking forward to thatkind of major change.

experience of conducting actual
field surveys, the men are obsessedwith potential challenges they may
face after retirement. They thinkthat they can’t simply return to theirhomes or to their communities, andquite a few of them have gotten involved in activities. However, morethan a few of them think that it is
too early for them to be part of theirneighborhood community. Theybase themselves in networks thatthey developed during their years of
employment, and they try to work
themselves into the community
gradually instead of forcing theirway in. Yet both of these groups are
made of people who are aware of
the problems with their situation.
The overwhelming majority end up
in a sort of limbo at home after retiring from the work force. It’s important to consider how to get intouch with and support those retirees who are not particularly savvy
about their own situations, andwho don’t know where to go or

17

Roundtable Discussion•4 People in early or late old age

recognized as needing care
(Units: 1,000 persons)2whom to link up with.

Persons in early old age (age 65-74)
Need support		
Need care

One thing we must pay attention
to is the difference between the cir-

how to think about the earlier and				

cumstances of people in the early

the baby boomers. In Japan, baby
boomers are many in number, but

126		(0.9%)		

556(3.9%)

Persons in late old age (age 75 and over)
Need support		
Need care		
		
		

580		
(4.9%)		

2,914(24.7%)

Source: Ministry of Health, Labour, and Welfare: Report on the Status of the Long-TermCare Insurance Program, FY2005.
Ministry of Internal Affairs and Communications: Population Estimates, calculatedon the basis of figures confirmed in March
2003

stage of old age and people in thelater stage.•4 Nowadays, there are allkinds of networks being created in
the New Towns, but as the baby

the greatest percentage of
people:■ Persons living alone■ Couples without children■ Couples with children■ Single parents with children■ Other2025

Source: National Institute of Population andSocial Security Research: Future Estimatesof the Number of Households in Japan (Estimates by Prefecture), August 2005

places where they feel comfortableage, a great transformation will takeplace. Will the children of the baby

a catastrophe on our hands all at
once as their physical conditions

boomers continue with the town

deteriorate.
So if that’s the case, are the New
Towns and suburbs in a hopelessstate?

Unless new, unrelated third parties enter the picture, we will not beable to maintain these areas with

Nishikawa: For the individual, thejust the next generation, and I believe that the lack of mechanisms to
support such efforts will really be aworks, but society as a whole needs
a clear-eyed recognition that the notion of linking housing and regions

major issue in the future.•5

to blood relationships and families
is already a fantasy, out of synchwith reality.
When we need care, we have tohave some relation with the next
generation, but despite the fact that
we can no longer assume that theseyounger caregivers will be our own
children, we pretend that the elderly will be cared for by their own
families, an assumption that is completely divorced from reality.
I think one of the major keys tothis issue is building relationships
with younger people who may beoutsiders without family ties. I myself have reached the age when I
may need care, and I am keenly

Sonoda: Professor Kadono has not-2000

they’re concentrated in an extremely small age range. Even if they’re inwhile they’re healthy, we could have

have envisioned? I must say thatwould be unlikely.

•5 Housing models followed bylater stages of old age in relation toboomers enters the later stage of oldplanning projects that their parents

18

Then we have to ask ourselves

ed that there are many options forbaby boomer men to find venues
for action and places where they
feel comfortable. It seems that there
are three types of men: those whosomehow settle in comfortably,
those who feel self-sufficient and remain detached, and those who havecome back home but don’t know
how to relate to the larger community and tend to become reclusive.
Women may readily conform to theegalitarian concept that Professor
Nishikawa talked about, but I suspect that it’s more difficult for men.

family is one of the important net-

aware that we must create venues

Kadono: If we look at tracts of sin-

for learning such things as how tocommunicate well with other peo-

gle-family houses, we find that they
were built in the late 1960s and ear-ple or how people can make things

ly 1970s when the so-called firsteasier for one another or meet one
another’s needs.

generation moved onto previously
undeveloped land and brought up

40

For a long time, care was entirely

their children. Since these areas are30

the job of the family, based on thefull of memories of those early days,

fiction that family members could
understand one another without

residents are generally quite satisfied with their living environment.

speaking, but we probably need aparadigm shift, especially among

Yet despite this, they feel a longstanding yet free-floating anxiety

the baby boomers, who have al-about the environment for elder

ready begun to see clearly that theycare or medical treatment. In othercannot depend on their own
children.•6

words, people in the early years ofold age, who don’t need long-term

Will it be possible for generations tounderstand one another and to keep
up these residential areas?

Sonoda: You’ve mentioned thecatch phrase “paradigm shift,” butquestions such as whether people
will be able to interact in ways thatsupercede family ties, whether suburban residential areas will survive
and grow, and whether the processof handing them over to the next
generation will proceed smoothly
are of great concern to the generalpublic, not just to elderly people. I’dlike to hear what Professor Kadono
thinks about matters such as interaction among generations and thecontinuing existence of residential
areas.

care, are already vaguely uneasy
about their future in these residential areas. However, since they arehighly satisfied overall, they don’t
particularly feel like moving while•6 Interactions between the60elderly and their children andgrandchildren… 2005 (FY)

(%)

50

20

10

0

1980 1985 1990 1995 2000 2005 (FY)

I prefer a lifestyle that lets
me always be with them.
I prefer to meet themoccasionally for a meal orconversation.
It’s all right if I can just talkto them once in a while.
I prefer not to interact withthem at all.
Source: Annual Report on the Aging Society
2007
Materials: The Cabinet Office, “2006 Global
Comparative Survey on the Lives andFeelings of the Elderly”
Note: The subjects of this survey were men
and women age 60 and over from all partsof Japan. In the FY2000 and FY2005 surveys, some respondents (7.0% in FY2000
and 6.9% in FY2005) answered, “I don’t
know.”

they’re still in good health. Duringthat time, their physical condition
starts to deteriorate a bit, and that’s
when they tend to think about their
future for the first time.
Another point is that people wholive in areas developed between
1965 and 1985 have almost all paid
off their housing loans, and a small
percent of them could move out of
the area if they felt like it.
Alternatively, there are cases inwhich older people want to hand
the house over to one of their children and move somewhere else. Yet
these situations are in the minority.
Few adult children can live with ornear their parents, whether it’s be-

19

Roundtable Discussion•7 Percentage of elderly people

cause of the location of their jobs or“hardware” of the environment.

100

other reasons.
Anyway, it is common for chil-

There’s no information whatsoever

living with their children… 2005 (year)

(%)

80
69.0
64.6

60

59.7
54.3
49.1

45.0

40

20

0

1980 1985 1990 1995 2000 2005 (year)

Source: Annual Report on the Aging Society
2007
Materials: Statistics and Information Department, Office of the Minister of Health, Labour, and Welfare, Comprehensive
Survey of Living Conditions of People(Figures for 1980 are from Welfare Administration Basic Survey).

20

2dren to be living far from their par-about an area being active and lively, or about the presence of older

ents.•7 So how shall we support theand retired people who could help

elderly after they are widowed? The
answer is to rely not upon the chil-young parents take care of theirchildren.

dren but upon people in the neigh-When young parents are asked

borhood, or, in other words, thenetworks that they cultivated while

what kind of place they would liketo live in, they reply that they wantthey were still in good health.

to be in a neighborhood where

However, older people can disap-

there are other parents of their gen-pear from neighborhoods abruptly.
All of a sudden, a formerly healthyeration raising children. Mature residential areas with many elderly

elderly person has to go to the hospital. In most cases, once they goresidents are unlikely to have children of the appropriate ages.

into the hospital, they never leave.

Besides, it’s only natural that young

Their house stands empty for awhile, but you can’t tell whether it
is vacant or not, just by looking atparents should give a wide berth toneighborhoods that have vacant lots
and conspicuously vacant houses.

it. After the resident dies, the houseis eventually put on the market.
Few people make the logical decision to sell a house right away
once it’s standing empty. They tend
to have irrational feelings about
their homes, and there is a time lag
between a house becoming vacantand its being put on the market.
Once an existing home is on themarket, we encounter the questionof whether the community is attractive enough to entice an unrelated
member of the younger generation
to move there. Advertisements forexisting homes only show the proximity to a transit station and theavailability of necessary stores andservices, or, in other words, theIn order for mature residential areas to continue their existence, they
have to appeal to families on the basis of their being good places toraise children. They have to identify
what makes their area attractive forbuyers on the existing home market
and advertise the attractions of thecommunity and its activities. At thesame time, the buyer has to understand these. In other words, weneed to recognize that it will be difficult for these suburban residential
areas to survive unless they can get
new people to rent or buy there.

Sonoda: I’d like us to consider what
communities can do to attract buyers from the next generation. Does

anyone have any good ideas?

younger than the rest of us. What

Kadono: In the end, it’s not a matter of attractiveness as a housing development located so many minutes

kind of attractions would entice
you to want to live in a suburban
residential area?

from a transit station. I think it boils

Miura: Like Professor Kadono, I

down to appealing to buyers on thebasis of the quality of life that one

feel that there’s a time lag problem.
The other day, I had a chance to talkcan enjoy living in a town or area. A

to someone from the Takarazuka

New Town community alone can-City Hall, and he said that they also
wonder how they should manage

not offer enough attractiveness thatmakes it distinct from other residential areas. If that’s the case, thenwhat is required is ideas for making

houses whose owners have grownold and gone into nursing homes.

lifestyle resources out of resources

Even when private care providers or
NPOs ask the owners to allow thethat are available in the areas surrounding the New Town.
It depends, for example, on how

houses to be used for elder care orchildren’s centers, they just can’t accept the idea, because they thinkwell the community can create a“lifestyle image” for its area, basedon such features as old-style villag-

that if they rent the house out, they
won’t be able to get it back in theevent that their son wants to live

es, temples, or historic buildings,
and natural features such as mountains or the sea. And in fact, the majority of New Towns will notsurvive unless they have systems to
support this image.

there. I think that if the city acted as
an intermediary and set up a system
in which it would guarantee rentals,
these properties would move quitesmoothly. If the public sector justgave a little bit of encouragement,
the situation would change.
As Professor Kadono mentioned

Sonoda: Professor Miura, you’re“

These suburban New Towns cannot bythemselves create attractions thatwill distinguish them from other places”
21Roundtable Discussion

2

before, if New Towns develop plac-

the place of a private intermediaryes where the elderly and children
can be together, these facilities will

to provide advice and explanations

be attractive in a way that conven-

the neighborhood as local activities
and networks. If they like it, theytional public institutions are not,and I wonder if such facilities mightserve as mechanisms to transform
both households and the New
Towns. That might make the New
Towns sustainable.

Kadono: We are thinking about

22

about such non-material aspects of

can contact an agent. Furthermore,
we should disseminate information
widely over the internet and othermedia, so that potential buyers wholive far away can acquire such information easily. In addition, I’m
thinking about developing a mecha-

moves in the similar direction
though they are not yet concrete.

nism by which heads of community
associations and people from NPOs

The private companies that are bro-

can provide advice if the prospec-

kering existing housing don’t havefirsthand information about thearea. The real estate agents whotive buyer wants more details.

have put down roots in that area
know some things about the changes in family composition and life-

panded versions of the ties forged atstyles, but there are still no such
entities in the suburban housing developments. Initially, I thought that
local governments, NPOs, and other locally active organizations could
be certified to take a major role inthese transactions and act as intermediaries in place of real estateagents. However, that was not verypractical, because these organizations knew too much about private
matters. Also, it’s not feasible forgovernment to take action in the
midst of a tendency toward small
government.
For example, when someone islooking for a house, the head of acommunity association could takeidents and private companies canform ties and create mechanisms for
issuing and receiving information,
the New Towns will become moresustainable.

Sonoda: Those can be viewed as exvarious places that Professor
Nishikawa was talking about. If res-Kadono: Since all kinds of privacy
problems will arise within any single community in a town, we will
have to create organizations thatcover a rather wide area and disseminate information. For example,
a statement such as “located along arail line” is easy to understand andgenerates a clear image. I believethat if multiple apartment clusters
and housing clusters can work diligently to improve public awarenessof housing along rail lines or in-

What makes this idea possible iscrease their ability to get information out, this will lead to a greaterthat many intellectual people live in

likelihood of the housing areas totive in society and acquired highcontinue existence, and at the sametime that may lead to organizationof mechanisms for supporting thelevels of awareness. I wonder if we
can achieve new things if we combine the potential of these people.

elderly.

Perhaps they will find a way to use

the New Towns who have been ac-

empty houses to create gathering
Is it actually possible for elderly people to live in a community and support one another?

Sonoda: All of us already recognize

places that form the core of thecommunity.
Conversely, the difficult aspect isthe time lag that Professor Kadono
has mentioned. No one knows what
to do, and there are situations inthat there are limits to what blood
relatives can do about long-termcare and community problems, butwhich no one can make any moves
anyway until the resident dies.
There are groups that make good

I wonder if it will really be possible
to create “third relationships” that
substitute for social systems anduse of their experiences and networks, and those that find the area
convenient for the time being andmarket transactions and allow people to live and support one anotherin communities. As an expert in elder care, what do you think about
this, Professor Miura?

don’t make any moves. I believethat the situation in the New Towns
will change considerably dependingon which groups take the initiative.

Miura: I think it’s both possible
and difficult.

“

Sonoda: The key phrases “canmake moves” and “can’t makemoves” have popped up here, and

New Towns can become more sustainable bysetting up mechanisms for receiving anddistributing information easily”
23

Roundtable Discussion

2

depending on their own circum-

and for the community.

stances, there are residential areasthat can make steady, proactive

Probably most elderly people are
beset with anxieties about whatmoves or have the strength to getwould happen if they became un-things going, and those that can’t
make any moves. Furthermore, inable to cook for themselves or if

terms of individuals, there are peo-

they fell and no one noticed.
Anxiety about supporting one’s ba-

ple who can take actions and people

sic lifestyle, let alone long-term

who can’t take action, and I wonder
what will happen if we get a con-care, manifests itself in the elderly
themselves thinking of paying large

centration of such people in a suburban residential area.

amounts of money to make reserva-

Miura: I think there will be increasing friction, not only amongindividuals but among areas, and it
will be a terrible situation.
On the other hand, terrible situations can also serve as a motivation
to change things. As Professor
Nishikawa said, problems gave riseto networks. In particular, when
considering how the future elderly
and the baby boomers will spend
the period when they need care, we
may gradually give up the fantasy
or fixed idea that entering a nursing
home places the least burden on the
person in question, for the family,•8 Where would you like to live

when you are no longer
physically able to take care ofyourself? (Japan)

Materials: The Cabinet Office, International
Comparative Survey of Lifestyles and Attitudes of the Elderly, 2006
Note: A survey of men and women age 60 andover, excluding those who are institutionalized. The item “I want to remodel myhome and stay there” was added in 2005.

0

tions in pay nursing homes.•8
If you actually survey care facilities, you find that only an extremely
small percentage of residents are receiving specific care, and a wide variety of 24-hour care services andin-home support services that takecare of people in the community
are starting to come into being. I
wonder if building a life in New
Towns or in the suburbs will become a sought-after option, so thatpeople don’t have to pay large
amounts of money to enter a longterm care facility.
In such cases, the importantquestion will be how the elderly
can build relationships in the area.

I want to stay in my own home.
I want to remodel my own home and stay there.
I want to move in with my children.
I’d like to move into a housing complex for the elderly.
20
40

I’d like to enter a long-term care facility.
I’d like to go into the hospital.
Other
60

80

100（%）

1990
59.1

3.8

7.6

7.8

19.4

1.8

2.5 5.6

8.6

17.6

2.6

11.8

14.2

2.9

1995
62.4

2000
2005
(Year)

24

59.9

2.5

50.5

16.5

8.0

3.6 5.9

12.5

7.2 2.9“The important question is how to
involve local businesses and residents inproviding support that creates relationships

Furthermore, what about the prob-

the presence of people with aware-lems that people can’t solve on theirown? For example, as their lower

ness, we may be able to use rising
long-term care needs as the oppor-

limbs weaken and they can’t get

tunity to create a community that isaround very well, how will we create times when they can interact

friendly to the elderly as well as to
the general public.

with other people?

”

Note that all communities are

If we work backwards from theidea of supporting elderly people’s
lives in the community instead ofstrapped for resources these days,
but some communities will see
their lack of resources as a reason tokeeping them housebound, thatgives us an opening toward the concept of performing functions that
replace institutionalization. In otherwords, what we’re asking in the end
is how to form relationships in thecommunity even while using public
services.
For example, if one of the local
restaurants has a staff that’s good atcreating a sense of community, thenit can be not just a restaurant but awelcoming place for both children
and the elderly. If the restaurant canoffer care, it may perform about
80% of the functions of a long-termcare institution.
Given the availability of unoccupied houses for housing stock andget smart and creative and do thebest they can, and some communities will give up because of a lack ofresources, just relying on whatever
the government provides, and nothave much success.

Kadono: I agree with what you
said. The New Towns have educational facilities and shopping facilities, but all of these facilities areexcessively focused on a specificpurpose. If we look at long-termcare for the elderly, specialized longterm care facilities fulfill only asmall part of the need. What’s needed are schemes that allow the elderly to eat their meals in an ordinarymanner, go shopping, and have fun

25

Roundtable Discussion

2

while enjoying interactions withbusinesses, maybe we should pro-others in the community, even if
they have become physically weak-

mote restaurants with especially at-er than before. I’d like restaurants,

stores that are unusually responsive

shopping areas, and entertainment
establishments to become the kindsof places where the older elderly

to their customers and graduallychange the identities and procedures of existing entities. By doing

people who have lost some of theirso, conventional facilities canphysical strength can enjoy themselves easily by relying on the rela-evolve to a very different type oftionships they have cultivated over
the years.
I’m not talking only about existing businesses. Companies shouldmake use of vacant lots and vacantbuildings as sites for community
businesses, and it seems to me that
we could restructure local government support to facilitate funding
for these kinds of ventures.
Making it possible to develop such
facilities within communities andrecreating them as places that theelderly can enjoy even when theyneed long-term care is an essential
part of community planning.

Sonoda: So it was proposed that,instead of creating completely new“26

tentive servers or convenienceplace.

Nishikawa: However, don’t you
think that local government support will be needed? In the older
cities, retail areas have gone bankrupt, leaving streets that consist almost entirely of shuttered façades,
and the shopping areas near the
New Towns were replaced by supermarkets. Yet even supermarkets
have started to move out of theseareas. Massive stores complete withparking lots have started to spring
up in the outer suburban areas, andthat trend is occurring throughout
the country.
In reality, when we age, we will
sooner or later lose the ability tomove by ourselves or express our-We can’t rely entirely on individual efforts andideas alone. We need some consideration andefforts from local governments”

selves. Caretakers can form net-in these New Towns since their cre-works, but it’s difficult to form
networks of people who are receiv-

ation some forty years ago.

ing long-term care. We can’t rely en-

ferring the housing in those New
Towns and their continuation as

tirely on individual efforts and ideas
alone. We need some considerationand efforts from local governments.

Sonoda: What have come up in to-Once that’s come to pass, trans-

residential areas becomes feasible.
When it comes to providing longterm care, mobilizing our knowledge of how to support elderly

day’s discussion are matters that wehave to think about on a number ofpeople in the community instead of
keeping them housebound makes

levels, given the urgent situation

us see unoccupied houses and very

that Japanese society is facing,
namely, the aging of its major cities,

ordinary local facilities as extremely
attractive resources.

and, more specifically, the aging of

If New Towns are to remain plac-

its suburban housingdevelopments.
In order to develop a full-featured

es where the baby boomers, especially the men, can continue to live
and lead enjoyable lives after they

lifestyle for the elderly and a secure
caregiving environment in the suburban housing developments, wequit working, we will have to rebuild relationships among people,
between the government and thefirst need to make a major assumption about a paradigm shift awayfrom relationships that are restricted to family ties. It has been pointed
out that, if that shift happens, it will
become possible to develop networks as extension of various ties
among the residents who have lived

residents, and between private companies and the local community, toname a few. In broad terms, the direction we should take is to broaden
these kinds of networks as a meansof making the New Towns sustainable.
(7/30/2007)
Photography: Masahiro Minato27

Participants:RounHidehisa Otsuji
Former Minister of Health,Labour and WelfareHouse of Councilors Member

dt
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ion

3

The Health
Insurance System
in JapanIts History and Significance• Health expenditures in OECD member nations (2005)
		Country

Source: OECD Health Data 2007 (final revision date: June 27, 2007)
Notes:
1. Rankings in each of the categories to theright are among OECD member nations.
2. Asterisked figures are data from 2004.

28

Percent of		GDP (%)
Rank

Expenditures per
capita ($)
Rank

USA

15.3

1

6,401

1

Switzerland

11.6

2

4,177

4

France

11.1

3

3,374

8

Germany

10.7

4

3,287

10

Belgium

10.3

5

3,389

7

Portugal

10.2

6

2,033

23

Austria

10.2

7

3,519

5
14

Greece

10.1

8

2,981

Canada

9.8

9

3,326

9

Iceland

9.5

10

3,443

6

The Netherlands*

9.2

12

3,094

13

Sweden

9.1

13

2,918

16

UK

8.3

18

2,724

17

Japan*

8.0

22

2,358

19

Yoshio Gyoten
Medical commentator

Japan’s universal insurance system allows anyone anywhere anytime to receive advanced medical treatment repeatedly at a low cost. There now is
growing concern over the future of this system, which has supported people
since the end of World War II. In addition to issues such as soaring medical
costs for social security, a shortage of doctors and nurses, hospital bankruptcies, and uninsured people, the essence of healthcare itself – i.e., what
is good health, what is illness, what is death – is being redefined.
Approximately 50 years have passed since health insurance coverage became universal. In this talk, we will look at this history and think about
what we must protect now.

A Compelling Thought from My
Personal History

Gyoten: On August 15, 1945, when
Japan lost World War II, I was a student, and the area near my house
was devastated. There was nothing
to eat, and of course we were notable to attend school. Anyway, because of my desire for food, I started
working as an odd-jobs man at the
GHQ established in Yokohama at theend of August, jumping at the
chance to get three portable meals
per day.

There I met some Allied Occupation intelligence officers who hadstudied post-occupation Japanesemanagement and political strategy atthe Harvard University Graduate
School. They eagerly explained,“Japan in the future must not become a country in which illness
leads to poverty, which prevents people from seeing doctors or going to
the hospital, which in turn causes
the illness to become even worse.”
Destiny led me to meet these elite officers who showed no arrogance to
the Japanese people who had lost thewar, and this completely changed

29

Roundtable Discussion•1 American occupation policy
After World War II ended, General
Headquarters (GHQ) adopted a policyof promoting democracy and ending
militarism and ultra-nationalism in Japan. The Japanese Constitution, which
was created based on a GHQ draft,shows America’s strong intention to rebuild Japan as an ideal democratic statewith its renunciation of war (Article 9)
and right of all people to maintain minimum standards of wholesome and cultured living (Article 25). However, when
the Korean Conflict broke out in 1950,
America changed its policy, and Japan
became viewed as an important militarybase.
•2 ABCC
Major casualties occurred when an
atomic bomb was dropped on Hiroshimaon August 6, 1945, and on Nagasaki on
August 9, 1945. After the War, the U.S.
army sent experts to investigate thestate of damage. Japanese doctors joined
these experts and formed the Japan-US
Joint Investigation Team to investigate.
Then in 1947 the ABCC was establishedunder the direction of U.S. President
Truman, and with the participation ofJapan’s National Institute of Health under the Ministry of Health and Welfare
starting in 1948, the state of atomic
bomb victims was investigated. Thiswas reborn as the Radiation Effects Research Foundation, a cooperative JapanUS research organization, in 1975.

3

my outlook on life.
Later I joined NHK and have reported on health, medicine, andwelfare ever since, but my way of
thinking has its roots in this meeting with American military officers.

Otsuji: When I was three years old,insurance system was an ideal forthe young American officers as well.
My first contact with the idea of
public health beyond doctors seeing
patients came from my meeting withthem. The plan was to work hard inJapan on tuberculosis, parasites,

my father, who was a Navy Major,
was killed in fighting near themental illness, and malnutrition.
After this, the Korean Conflict

Solomon Islands. My mother raised

started in 1950 and suddenly
changed the policy of the American

me and my younger sister by herself, but life was very difficult.
However, everyone around us waspoor, so I can say it was an equitable society with no gap between
rich and poor.
My mother worked continuously
to make ends meet and died youngat the age of 41. I was 20 years old at
the time, and my younger sister wasa high school student. I had been attending the National Defense
Academy, but withdrew and looked
immediately for work. However, in
those days, it was not easy for a childwithout parents to find a job or eventake a company entrance exam, so I
was quite frustrated. I am who I am
today thanks to the support and helpof many people. I can never forgetthose to whom I am indebted.
I once was told by the chairmanof a certain organization, “If you
want to repay me, devote yourself
to the people of Japan.”
I have come this far by always
keeping these words in my mind.

30

Gyoten: I think a universal healthoccupation•1. As a result, the idea ofthe young American elite officers tocreate a social security utopia inJapan was derailed.
The first place I was assigned
when I joined NHK was Hiroshima.
The Atomic Bomb Casualty
Commission (ABCC)•2 had been established in Hiroshima, and data on
atomic bomb victims had begun to
be gathered, but activities focusedmore on collecting information thanhelping victims. Information on theatomic bomb already had become amajor part of national strategy.
However, at the same time, theseeds sown by the young officers of
the Allied Occupation gradually began to sprout. In 1961, the new
Health Insurance Law was enforced
and a universal health insurance
came into existence.•3 Then continuing from the special military procurements for the Korean Conflict,the aftermath of the East-West confrontation and the special militaryprocurements for the Vietnam War

“Universal health insurance must be
firmly maintained”

suddenly revived Japan’s economy

consistently with the Council on•3 History of Japan’s medical

and brought long-term peace, prosperity, and healthy long life.

Economic and Fiscal Policy to support that belief. The members of the1922 Health Insurance Law is enacted

Healthy long life is thought to beCouncil, regardless of their personalmatter of course now, but I would
like to communicate to the later gen-beliefs, seemed to be trying to pass
everything through the Council witherations that this happened by his-the strong-man logic that eventorical chance thanks to theenthusiasm and efforts of theAmericans who presented an ideal

health could be bought with money,
that the wealthy naturally could buy
better medical care.

and many Japanese who took thisand built it as a system.

Regarding health expenditures,
there were proposals for an insurance deductible system that would
make patients responsible for a certain amount and lifting a ban on
mixing insured and uninsured treatment, but I continued to condemn
this as something that would benefit
only the wealthy, so I always felt as if
I were sitting in the defendant’s seatat the Council.

Otsuji: I also feel very happy that
universal health insurance resulted
from the hard work of our predecessors. In Japan, each person has an insurance certificate and is able toreceive high-level medical treatment
wherever he/she works or lives.
Today’s long-lived society and nationof longevity were possible precisely
because this system was establishedand made medical care accessible.•4
We must firmly maintain this as atreasure. That is what I strongly believe from my personal experience.
After becoming Minister of
Health, Labour and Welfare, I argued

system(insurance for workers)
1938 National Health Insurance Law

is enacted (health insurance bymunicipality)
1961 Revised National Health Insur-

ance Law and National Pension
Law are enacted (institution ofuniversal health insurance andpensions)
1973 Welfare Law for the Aged is re-vised (free medical care for theelderly)
1982 Health and Medical Service Law

for the Aged is enacted (elderly
health services and medical expenses are covered by the entire
population)
2006 Medical system reform (increasein share paid by elderly patients,
prevention of lifestyle diseases)•4 WHO health achievementlevel rankings
Healthy life expectancy(2002)

		

Rank

Japan

1

Sweden

3

Italy

7

France11

Germany

14

England

24

USA

29

Source: WHO, OECD reports

Current Situation in Japan and theU.S.

Gyoten: Given the encounter that I
mentioned earlier, I personally like
America very much, but unfortu-

31

Roundtable Discussion•5 SiCKO
A movie directed by Michael Moore thatwas released in June 2007 in the UnitedStates and in August 2007 in Japan.
This movie exposes the American
healthcare system in contrast withcountries such as England, France,
Canada, and Cuba. With its U.S. release, the movie grossed the second
highest opening box office revenues indocumentary history.
•6 Crawford Sams
Crawford F. Sams (1902-1994) came to
Japan in August 1945 as the Chief of the
Public Health and Welfare Section of theGHQ. He devoted his efforts to matterssuch as measures against infectious diseases, the beginning of school lunches,and public health center reforms, and hegave Japan a modern public health philosophy. In 1951, he resigned and returned to the United States when
General Douglas MacArthur was removed from his command.

39.6
31.8

12,000

40

30

23.1
8,000

20
12.0

4,000
4.9

10

7.1

0

0

1950 1970 1990 2010 2030 2050
(year)

Source: Annual Report on the Aging Society,2007
Materials: Up to 2005, the National Census
by the Ministry of Internal Affairs is used;from 2010 onward, results are estimatedusing hypothetical median birth and death
rates in the Population Projections for Japan (December 2006) by the National Institute of Population and Social Security
Research.
Note: The 23,328 people age 70 and over in
Okinawa in 1955 were divided between
the age 70-74 category and the 75 andover category based on the percentage thatpeople age 75 and over comprise of the
population age 70 and over in the year before and the year after.

•8 Historical and projected100

average life expectancy

(age)

Women
Men

90

85.90
81.90

80
70
60

87.93 89.22

74.66

78.62

80.06 80.95

75.92
62.97
69.31
59.57

50
1950 1970 1990 2010 2030 2050
(year)

Source: Annual Report on the Aging Society,2007
Materials: Up to 2005, the Complete Life Table by the Ministry of Health, Labour andWelfare is used; from 2015 onward,
results are estimated using hypothetical
median birth and death rates in the
Population Projections for Japan(December 2006) by the National Instituteof Population and Social Security Research.

32

ing difficult to see, because themarket principle of putting corpo-tural country, and our spirit of helping each other, which could be called

rate profits first and America’s arro-

Japanese style socialism, has broughtgant imposition of its doctrine andpoint of view on others have gone

success, so I think we should contin-

SiCKO•5 directed by Michael Moore.

(%)

16,000also believe that Japan is an agricul-

The other day I saw the movie

Aging rate or ratio of
those age 75 and over tothe total population(Unit: 10,000 people)

nately America’s greatness is becom-

too far.

•7 Historical and projected aging
Total population3

ue with this in the future.
However, I am anxious that thesame mistakes will be likely to bemade in Japan as in America.

I learned from this movie that in
America, where there is no public

Actually, now there are some people

universal health insurance system,

cannot pay insurance premiums, so I

1/6 of the total population, i.e. approximately 45 million people, live

am concerned that the universal
health insurance system in reality is

without health insurance, but evenstarting to fail.

some people who actually are covered by health insurance have beentreated terribly as victims of profit-

Gyoten: In my view, Japan’s healthchasing by some private insurancecompanies.
Once a person falls ill, he could gouniversal coverage, is a superb system that can be regarded as this century’s greatest cultural asset. All

bankrupt or lose his/her life without
being able to obtain medical treatment. Hospitals receive high praisefrom insurance companies for refusing to treat, and insurance claim processors are given a target volume ofclaims to turn down.
I poignantly remember the wordsof Brigadier General Sams•6, who

Western industrialized nations havesome kind of health insurance system, but only the Japanese system
has maintained a certain quality of
benefits and worked for nearly half acentury. The contribution of this to
the Japanese people is reallyimmeasurable.
After emphasizing this positive aspect, I am going to complain, butphysicians who provide care, patients who receive care, and the remaining population who is potential
patients takes universal health insurance for granted and have become
dependent on it, which is actually a
big problem.
In the 1970s, Japan’s aging rate

was Chief of the Public Health andWelfare Section of the GHQ during
the occupation. He repeatedly said,“Do not become like America” and“Make Japan a country where people
help and support each other more.”Otsuji: Being able to speak like thatright after the War is very sharp. I

who are uninsured because they

insurance system, which provides

“”Japan’s healthcare system can be
regarded as the greatest cultural asset of
this century

reached 7% and it became an aging

Financially speaking, Japan is insociety as defined by the UN. By
1993 already, the rate increased todeep debt, and health expendituresthat were 7% of national income in

14.3%, and Japan became an aged

2004 are expected to reach 9% insociety. This is a surprising speed,
and rural areas in particular have be-2015 and 11% in 2025.•9 In other•9 Projected social security

benefits and contributions(May 2004 estimates)

Ratio of health expenditures to national
income (%)
20

(%)

15
11.2
10

marked population decrease.•7

words, the ratio of health expenditures to Japan’s economic scale willgrow. This is a major reason that

In addition, the era is finishedwhen illness consisted mainly of

medical spending is coming understronger attack.•10

acute infectious diseases such as tuberculosis, typhoid, dysentery, andJapanese encephalitis, and a person’slife or death depended on fate if hecontracted such a disease. Now the
majority of the population takes longlife for granted. This change in social
structure and consciousness requires
both acute care focusing on the latest
technology, as well as warm care to
support the end of life.

The Council on Economic andFiscal Policy claimed, “We have nomoney, so health expenditures will
be handled as an aggregate amount.”
I opposed this saying, “Health expenditures should be calculated by
setting aside what is necessary. Are
you telling people to die because
there is no money?”come ultra-aged societies with

5

2004

pension and elderly medical caresystems were designed for Japanesewith an average life expectance inthe 60s, so naturally things do not
add up today when people are living
to age 80.•8

14France, 2003, 10.1%
Sweden,2002, 9.2%

10

Figures show data from the beginning
year and most recent year, and the healthexpenditures as percent of GDP for themost recent year.

1960

6
4

2025

Source: OECD Health Data; South Korean
aging rates are from population estimatesby the Korea National Statistical Office.

1980

8

2015

(year)

with population aging(global comparison)

Canada, 2003, 9.9%

12

2010

Source: Projected Social Security Benefits andContributions (Ministry of Health, Labourand Welfare)•10 Health expenditures increase16

Otsuji: In the first place, today’s

8.2
7.1

0

(%) Health expenditures as percent of GDP

USA, 2003, 15.0%

9.2

1960

2
4

6

1990

1960

1970

1985

South Korea,1960
2003, 5.6%
8

10

Japan,
2002, 7.9%
England, 2002, 7.7%

12Aging rate

14

16

18

20
(%)

33

Roundtable Discussion

3•11 Trial concerning atomic bomb

Japan is not a culture like America

cooperation in which the roles ofKazuo Higashi, a boy of 16 who was
working in Nagasaki as part of the student mobilization, applied in 1994 forofficial recognition as an atomic bomb
illness patient because of impaired liverfunction, but was denied, so he filed alawsuit with the Tokyo District Court in1999 and won the lawsuit in March
2004. The Minister of Health, Labourand Welfare appealed, but on March 29,
2005, the Tokyo Supreme Court also
ruled that it was atomic bomb illness.
As a result, attention was focused onwhether the next Health, Labour andWelfare Minister, Hidehisa Otsuji,
would appeal, but on April 11, 2005,
the Ministry of Health Labour and Welfare announced that it would not appeal.

where “winning is right.” It is a culture where right must win. However,each are re-acknowledged and thegood points of each are used.

illness

I am very concerned that a violent
way of thinking is suddenly entering
Japanese society under the pretext of“regulatory reform,” in which winning by competing is acceptable andOtsuji: Some politicians are leaders

the market will decide who wins andloses.

and some are consensus builders. I
myself am a consensus builder who

If regulatory reform goes too far,the law of the jungle will prevail, andwants everyone to get along as much

so I think the time has come to stop

as possible. Both types of politicians
carry the various experiences, histo-

once more and think about whether

ry, and culture of a community, andself-responsibility and ex-post facto
checks are really acceptable.

are elected as representatives to

Realizing after someone dies that a
mistake was made is too late. I thinkthat exposing social security, especially medical care, to the market
principle is completely incongruouswith the Japanese consciousness.
Since the time of Prince Shotoku,
Japanese culture has respected harmony. With decentralization andprivatization, conflict between national and local and between public
and private has become a concern.
Instead of conflict between central
and local, public and private, weneed to come up with a policy for“
34

Japan’s Challenges in the Future

make political decisions. That’s why
I think it is good to have a wide
range of experiences, including difficulties if possible.
Thinking intellectually and moving forward logically may appear atfirst glance to make sense, but this is
far removed from the feelings of real
people. Marie Antoinette is famousfor once saying, “If they have no
bread, let them eat cake!” If people
like Marie Antoinette start running
politics, what exactly will happen to
Japan?
When I was the Minister of
Health, Labour and Welfare, theMedicine is a benevolent art.
Such doctors are becoming hard to find”Japanese government lost a lawsuit•11

come ill, and the healthier and stron-

involving atomic bomb illness ,ger they were, the deeper thisand I had to decide whether or not
to appeal. Technical officials fromanguish is.
A doctor in whom one can placecomplete trust at such a time has a

the medical field argued, “It is medically impossible to say or determinethat bombing alone is the conclusive

very important job in society. Mr.

cause of the illness involved in the

doctor?

trial.” I replied, “That may be thecase medically, but they have lived
dozens of years fearing that theywould become ill sometime, so thebombing politically could be a causeof the illness.” Ultimately, we did not
file an appeal.
Technical officials, in their capacity as doctors, and administrative officials each have a professional
responsibility to explain their views.
In response, politicians have the roleof making decisions as politicians. I
believe that fulfilling one’s responsibilities and roles is the right thing to
do for the people in the end.

Gyoten: There are also more opportunities to think about death in thisline of work. Even people who havereigned over society as leaders feelloneliness, pain, and fear of death asa single human being when they be-“

Otsuji, what do you expect most of a

Otsuji: There are doctors who run
after money, but I always want doctors to value the spirit of medicine asa benevolent art. As a child, I was examined by a nearby village doctor
and found money in my medicine
bag when I got home. When I hurried back and asked the doctor about
this, he said, “I put in the medicine
that will work best.” Of course, thisalone is not a benevolent art, butthere were many doctors like this.
Even now there must be many doctors who believe medicine is a benevolent art, and many provide
treatment while sacrificing their own
lives. However, such doctors are becoming hard to find.

Gyoten: I think a change in howpatients think is also necessary.
Everyone will die regardless of

We must understand that the system,
healthcare, doctors have limits”
35

Roundtable Discussion

3

whether a person has great wealth or

persimmon and ends up denying the

makes every possible effort to remain healthy. We must understandfact that sweet persimmons werethat there are some things in thisIn my impression, our current
Diet debate tends to be an exchangeof unproductive arguments like this,world that money and effort alone
cannot control.
For example, many people believe

and honestly speaking, I sometimes

that even if they fall ill, they will re-feel emptiness.

turn to normal if they see a doctor
and get medical treatment, but weA good example of this is the issueof selling of Employees Pension hos-must realize that medicine is not almighty and doctors are notpitals and social insurance hospitals.

Superman. No matter how perfect a

In the context of discussing thewasteful use of pensions, they were

healthcare system is, if we do nothandled on equal terms with buying

understand that everyone will surely
die, we will tend to develop the out-

golf balls and determined to be
wasteful spending. Rejecting therageous belief that death was causedby the system or the attending physician. This in reality is unnecessarily

sweet persimmons, i.e. welfare pen-

intimidating medical professionals.

Otsuji: No system, including thehealthcare system, can be withoutinconsistency. I basically think thatJapanese have excellent qualities, but
one negative aspect of Japanese istheir tendency to decide that everything is bad just because there are irresolvable discrepancies or verysmall vices.
If 99 out of 100 persimmons on atree are sweet, the tree should becalled “sweet,” but if someone finds
one sour persimmon, he says, “This
isn’t sweet. You lied. Apologize!”Why can’t he think that the persimmon tree fulfilled its role very wellby producing 99 sweet fruits? Hemakes a fuss over finding one sour

36

produced.

sion hospitals and social insurance
hospitals, just because there weresour persimmons, i.e. golf balls andGreenpia resorts, is just like saying
to cut down the whole tree.
I was the chairman of the Health,Labour and Welfare Division, so I
tried to argue that hospitals are abastion of reassurance for local residents and that their logic was unreasonable, but I was vastly
outnumbered.
I was left wondering what was important and whether that decision
was really the right one, and I myself
still think that the hospitals should
be kept somehow.

Gyoten: As someone who has been
involved for a long time, I think wemust also reflect on the state of themass media today. Though there isfreedom of discussion, everyone
tends to run in the same direction
and pace, and I fear that they may
end up knocking down the persimmon tree all of a sudden. Perhaps
journalists do not study enough, but
often their arguments are overly

persimmons.
Some years bring sweet persimmons and some sour, and someyears there are many and some few.
The virtue of the Japanese was toshare and support each otherthrough good and bad years.

emotional and they speak as if they

When I finish my current term, I

alone are right, so it is difficult tocalmly have a principled and insight-

will reach the mandatory retirement
age for Diet members, so I will retire,

ful debate.
I am concerned that if doctors andbut during the rest of my term, I
want to strongly advocate for help-

public officials are bashed too much,ing each other as my philosophy.

there will be a decline in young people who want to take up these professions, and this will deal abody-blow to the future of Japan.
If we do not recognize that there
are honest people who live according to their own convictions in themass media world and among public
officials, doctors, and lawmakers,
and if we do not aim for a healthysociety of mutual trust, society will
have to pay the cost after someshort-lived fussing, just the same as
the issue of hospital closings.

Otsuji: Japanese are exceptional
people for having made this country
what it is. Everyone must continue
trying to nurture the persimmon tree
and humbly be grateful for its fruit.
Instead of eating persimmonsgrown and harvested by someone
else and calling them sweet or sour, I
think now we need to try our ingenuity at how to make sweeter persimmons and how to produce more

Gyoten: As I listen to you speak, I
realize amazingly that although wehave never met before, our lives havecrossed paths in the context of upholding the universal health insurance system, and because of this, wehave been given the opportunity tothink about Japan together.
As I said at the beginning, mystarting point is in a universal insurance system in which everyone helps
each other. The wonderful
Americans whom I met after Japan
lost the war and who taught me that
this must not be thwarted for economic reasons would certainly be
surprised if they saw America today.
I had almost given up on people
who claim that putting the economy
ahead of everything else is the global
standard, but Mr. Otsuji, your words
have encouraged me, and now I
think that I will continue to say whatneeds to be said.
(10/10/2007)
Photography: Masahiro Minato37

Participants:RounSachiko Murata

Makoto Arai

		 Welfare journalist

		 Professor and Dean of Tsukuba
		 University Law School

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4

The Adult
Guardianship
System and Human
Rights of the Elderly• Do you know about the adult guardianship system?

Don’t know

1.7%

Never heard of it

72.7%

Source: Based on the “General Survey on Dementia and Disclosure of Diagnosis” by the
Tokyo Metropolitan Institute of Gerontology (April 2004). 2,000 people weresurveyed.

38

Know about it in detail

10.5%

Have only heard the word

15.1%

Hiroshi Kanekawa

Sachiko Takagi

		 Executive Director, Japanese Association of
		 Certified Social Workers

		 Senior Staff, General Affairs Welfare Division,
		 City of Machida

In Japan, the world-class long-term care insurance system has become entrenched in the life of the elderly, but there has not been much use of theadult guardianship system that started at the same time. As the number ofseniors with dementia increases, this will be important for ensuring that theelderly can make their own decisions, lead a dignified and appropriate life,and be protected from infringements on their rights.
In this talk, by referring to examples overseas, we would like to discuss
the problems of the current adult guardianship system and think about how
to ensure more use of this system.

0

5,000

10,000Commencement ofguardianship
7,451

Commencement of
curatorship

2,030
1,968
1,687
1,627
1,521
1,043
884

Commencement ofassistance

859
945
784
805
737
645
621

Voluntary
guardianshipSupervisor
appointment

360
291
243
192
147
103
51

9,297

15,00014,532
14,462
12,74620,00017,91025,00030,00029,38035,000•1 Number of petitions for adultguardianship

		
		
		
		
		
		
		

2006
2005
2004
2003
2002
2001
2000

Source: Overview of Petitions for Adult
Guardianship, April 2006-March 2007,
Family Bureau of the General Secretariatof the Supreme Court
Note 1: The number of cases for each year isthe number of petitions from April of thatyear through March of the following year.
Note 2: A total of 5,610 signed voluntary
guardianship contracts were registeredfrom April 2006 to March 2007, and thecumulative number of registrations fromthe 1st year to the 7th year is 20,548.

39

Roundtable Discussion•2 Concept of normalization
This is the concept of protecting the livesof disabled and elderly persons as members of society as much as possible instead of separating them as a specialgroup. Specifically, this means creating
an environment and conditions wherethese people can live a normal life withordinary people in the local community
instead of putting these people ininstitutions.

4

Murata: Eight years have passed(Betreuungsetz). In the past, there

since the start of the adult guardianship system to protect the assets

were an incapacitation system andquasi-incapacitation system as pre-and lives of seniors who have im-decessors of the adult guardianshippaired judgment. Over 4.5 million
people have been certified as need-system in Japan, but these wereused more for the intentions of

ing long-term care under the long-those around an incapacitated per-term care insurance system, which

son than to protect the individual

started at the same time, and half ofseniors receiving certification, or 80

rights of the person himself.
Furthermore, it was a very prob-

percent of those in care facilities,
have dementia. Despite this, only

lematic system in that a notation
would be made on a person’s family

120,000 people use the adult guard-

register, and it constitutes grounds•1ianship system , which I must say

for disqualification so that rights ofis much too few.
Given these circumstances, I

incapacitated persons would be
limited. At any rate, it was decided

would like to look at whether thethat the word incapacitation causes
discrimination.
Therefore, the name was changed

human rights of seniors are really
being protected and what the current status and problems of the•3 Legal guardianship andvoluntary guardianship in
Germany

In Germany, when the Adult Support
Act was revised in 1999, there was a
departure from the system that heavily
relied on legal guardianship. This is areturn to the idea of respecting self-determination, and also from the viewpoint of reducing Support Act related
expenses upwards of EUR580 million,
voluntary guardianship is recommended. There are approximately 600,000
people who use the voluntary guardianship system.

adult guardianship system are.
First, I would like to have Mr.
Arai provide an overview of thesystem.

Source: Bundesministerium der Justiz: Justizstatistik GÜ 2 der Amtsgerichte 19952005, erg. Mitteilung der Württ. Notarlate;
Auswertung: Deinert

This concept started in Northern
Europe and is already well established in the welfare field.
The German Adult Support Act
began in 1992 eight years before

tem was established under a newlaw created in 2000 based on theGerman Adult Support Act
200,000

400,000

600,000

800,000

1,000,000

1,200,000

Increase from the prior year2005

+3.50%

2004+5.20%

2003+5.08%

2002+6.19%

2001+6.68%

2000+7.82%

1999+7.51%

1998+7.64%

1997+7.69%

1996+10.15%

1995

40

The most important part of thephilosophy behind this system isthe concept of “normalization”•2.

Arai: The adult guardianship sys-0

Number of people who use legal
guardians in Germany

to “adult guardianship,” and there
was a new start with this system.

1,400,000

Total number
1,198,373
1,157,819
1,100,626
1,047,406
986,392924,624
857,582
797,642741,007
688,118
624,695

Japan, and 1.2 million people out of

The woman’s children were di-a population of 82 million use legal
guardians.•3 Use in Japan is only

vided on everything, and when can-

one-tenth of this, which is the lowest use among advanced nations.

completely bedridden mother, one

The standard is said to be 1% of the
population, so in Japan where thepopulation is 120 million, 1.2 million people would normally use thecer was found in their almost
side wanted to use all medicalmeans to keep her alive as long as
possible, while the other side did
not want her to suffer any longer. In

system.

this example, the guardian has noright to decide•4, but in any case, it

Murata: Recently there has been

would be difficult to say which side
is right.

news of seniors with dementia being conned by dishonest businessmen, nursing care patients being
abused, and pensions and real estate
being swindled by relatives, so theneed for this system is urgent.
The reported cases are probably
just the tip of the iceberg, but Mr.
Kanekawa and Ms. Takagi have actual contact with people who have
impaired judgment ability and theirfamilies, so I would like to ask them
about the current situation in thefield.

Kanekawa: First, I would like tomention the difficulty of physicalcustody. In the past, I became aguardian for a wealthy elderly
woman. It was case in which her
four children were divided two
against two in their opinions about
nursing care. The two sides each insisted that they would be the guardian and take responsibility for hercare, so as a social worker I received
a request from the family court.

•4
In physical custody under the adultguardianship system, consent tomedical treatment is personal to aperson, and therefore, like consent tosurgery, it is not included in the authority of the guardian.

Furthermore, on the surface thisseemed like an issue of physicalcustody, but actually it was the prelude to an inheritance dispute, andnow five years have passed since
the woman died, but her estate still
has not been settled either in arbitration or court.
There had been trouble between
this woman and her children in thepast, and this came to the surface as
she got older, but the guardian
could do nothing about it. This isjust one example, but various problems are brought into the adultguardianship system.

Takagi: In the City of Machida,
there are many apartment complexes that were built in the 1950s and1960s, and an increasing number of
dishonest businessmen seem to betargeting seniors who live there
alone.
For example, a small note containing only a cell phone number
and a message saying, “You can41

Roundtable Discussion

4borrow money easily,” is put in theadult guardianship system for social

mailbox of an elderly person repeatedly. The person then casually calls

workers and employees of community comprehensive support cen-

the number because he/she comes

ters, although there still needs to be

up a little short with just his/her
pension that month. He/She intend-done more, so I think that this is
recognized by people in the field as

ed to borrow ¥30,000, but he is

one option to resolve problems.

only lent ¥20,000 after the ¥10,000
fee, and with interest he is billed¥50,000 the following month.
Moreover, the lender comes for themoney in the middle of the night.
It’s nice that there are kind electrical appliance stores that come tochange just one light bulb, butwhen I went to an elderly person’splace, he/she was living alone but
had two large refrigerators, a TV,
and an air purifier. He/She wasforced to buy all of them on credit.
There are also cases of groupabuse. A group of friends comes toinvite one of the members who suffers from memory loss to go out.
Then the person is forced to pay formeals and even souvenirs. They
seem all nice and chummy at first,
so it is difficult to detect.
We organize seminars about the“Why doesn’t this system take root?

Murata: The City of Machida is a
progressive municipality that is actively working on use of the adultguardianship system, but in Japan
overall, the system still has not taken root. The philosophy of the system is excellent, so why doesn’t it
take root?

Arai: At first, it was said that thesystem feels discriminatory. People
are worried that they will be labeled
as incompetent if they use the adultguardianship system. However,
now that the word “dementia” issaid so much, I don’t think this is aproblem any more.
I think it israther a matter of the legal con-

It will be difficult for the system totake root unless the consciousness ofsociety as a whole is fundamentally changed42”

sciousness of Japanese people. I

have a feeling that people also havecannot help but think that Japanesepeople clearly lack the desire toa hard time petitioning to the court.

protect one’s rights by using laws

Kanekawa: That’s right. That’s why

and systems.
People fiddle with their cell

I don’t think we need to shout difficult words such as human rights.

phones in areas where cell phones

Simply said, it is a matter of protect-are prohibited on trains, and if you

ing a person’s life. We may lack thecustom of respecting people as hu-

say anything, you may be falsely accused of groping. The fact that there
are far more people with strategic
bequest motives in Japan than inmans even if they have a disability,
but the law is a means for protect-

the United States•5 suggests that

ing a better life and it should be
used well.

Japanese people are self-seeking.
People probably think that people

Takagi: The overwhelming majori-with impaired judgment are just being incapable, so why is it necessary
to protect their rights.
I have a feeling that it will be difficult for this system to take root
unless the legal consciousness ofsociety as a whole is fundamentallychanged.

Murata: There may be a lack ofconsciousness, but perhaps there isa resistance among us living normal
lives to say loudly that we will use
laws to protect our own rights. I

ty of people who actually come toconsult with me believe that theirfamilies will somehow help them ifsomething happens to them. Often
the idea does not occur to them toprotect their lives themselves. Evenin the case of multi-generational
homes, it is not understood that aparent’s assets belong to the parent
and cannot be touched by the child.
In many cases, people first realize
this when a parent’s judgment becomes impaired and they are considering use of the adult

Bequest motives
Ways of thinking consistent with the life cycle model(1) I want to make an effort to leave a bequest if		 my children care for me in my old age.
(2) I will not make any special effort to leave a bequest to		 my children, but if assets remain in the end, I will leave		 them as a bequest.
(3) I will not leave a bequest to my children.
SubtotalWays of thinking consistent with the altruism model(4) I want to make an effort to leave a bequest regardless of		 whether or not my children care for me in my old age.
Subtotal
Total			

Japan

U.S.

6.4

3.4

69.3

51.1

5.0
80.7

2.9
57.5

19.3

42.5

19.3

42.5

100.0

100.0

•5 Japan-U.S. comparison ofbequest motives

Source: “Japan-U.S. Comparative Survey on
Savings,” Postal Services Research Institute, 1995
Remarks: Shows the percentage of respondents who have each way of thinking.
Unit: %. The number of non-respondents is
excluded from the denominator.

43

Roundtable Discussion

4

guardianship system upon recom-

ship system is only explained in a

mendation by a bank or such. In
the case of parents with disabled

simple pamphlet. This is quite dif-children as well, there is a wide-

Germany, which makes many different pamphlets and even teaches

spread belief that the parents can doanything.

Murata: The long-term care insur-

other cause of this low level of understanding. Why, when theance system and the adult guardianship system are “two wheels of one

long-term care insurance system iscart,” but they are quite skewed.

understood by almost everyone, isthere so little information available

Another reason that the adultguardianship system does not takeabout the adult guardianshiproot may be that people cannot

system?

imagine themselves using this sys-

Arai: Compared with the Ministry

tem to live with the support of aguardian. I was able to see people

which has jurisdiction over longterm care insurance, the Ministry of
Legal Affairs which has jurisdiction
over the adult guardianship system
has a lower budget. The Ministry of
Health, Labour and Welfare spent a
lot of money on publicizing longterm care insurance, and the mass
media reported on long-term careinsurance frequently.
Meanwhile, the adult guardian-

44

about the system in schools.

Murata: Lack of information is an-of Health, Labour and Welfare“

ferent from the situation in

actually living this way when I went
to Germany, but how can Japanesepeople get an idea of what it is likewhen there are so few examples
around them in Japan?
What are things like in Machida
where the system is used more?

Takagi: I do not have specific figures for the number of users in thecity, but Machida has a populationof approximately 410,000, andThe long-term care insurance system andthe adult guardianship system are “two wheels of one cart,”
but they are quite skewed”

there are over 400 new consulta-

about this.

tions per year. This suggests thatmany people want to use theCompared with then, there isquite a bit more information avail-system.

able now, so I think people have

When the system first started, it
was hard even for field workers tomore knowledge and can get a picture by looking at actual examples.

•6
If a guardian is appointed, the guardianship court in Germany is required tomeet with the ward and examine the situation. As part of the administration,
Guardian Support Centers, upon being
consulted, have the authority to ask the
court to assign a guardian and to challenge the guardianship court. Guardian
Associations recruits volunteers, does
training, and so forth.

get the image, but employees at carefacilities would see the case of one
resident and think they may be able
to use it for another resident, or acase worker would realize a new thescope of his/her job because he/shetried but was not able to reissue abank statement that his/her client
had lost, so he thinks about using
the guardianship system.

Problems with the system and its
management

Murata: We have to get the adultguardianship system to take root,
but we cannot make progress without addressing problems. What are
the problems with the current law?

However, care must be taken, because when it is hard to picture,people often panic due to incom-

Arai: The biggest problem is that

plete information. When the system
was first introduced, I was explain-consent to medical procedures. The
physical custody part is down-

ing the system at a certain pay nursing home, and the residents started
to panic when I said employees of
the home could not sign contracts
or manage savings on behalf of theresidents if their judgment became
impaired. The employees also had
not studied and did not know muchplayed to a striking extent. There isno advanced nation where consent
for medical procedures is not clear.
The Ministry of Justice says it is notnecessary, but it definitely isnecessary.
What is the point of becoming aguardian of a nursing home resident
if the guardian cannot even provide
consent for a flu shot?
Another problem is that we justmade a law, but failed to make aframework for that law to work. In
Germany, a budget is allocated, andthe courts, welfare administration,and private companies work together to make the system function.•6 In addition, the law has been

guardians do not have the right to45

Roundtable Discussion

4

reviewed and already revised twice,costs tens of thousands of yen to

and now it is in the process of being
revised a third time. Japan has re-petition the court, obtain family
registry documents, and have aviewed the long-term care insur-

medical certificate issued. In addi-

ance system, but not the adultguardianship system. The systemtion, assessment fees are ¥50,000-

cannot be operated flexibly while

100,000. Under the system, thesecosts are to be paid by the petition-

solving current problems like this.

er, not by the individual. If there is a

Kanekawa: I think there are prob-

third-party guardian who is not a
relative, compensation for him islems at each stage, but first is thepetition stage. In Japan, petitions
are made by relatives as a generalrule•7, but petitions by the local
mayor, which are allowed for people without relatives and people
without the support of relatives, arevastly different depending on thelocality. There are places like theCity of Machida whose mayor actively makes petitions, but there arealso places where not even one petition has been made yet. Even
though Japan has a usage support
system in place, this is a voluntarytask of local government, so it all
depends on the willingness of themayor.
Also, the cost is a problem. It•7 Percentages of various

relationships between
petitioners and individuals in
adult guardianship cases

Source: Overview of Petitions for Adult
Guardianship, April 2006-March 2007,
Family Bureau of the General Secretariatof the Supreme Court
Note: These are the percentages of the total
33,112 petitioners in cases to commence
guardianship, curatorship, assistance, andappoint voluntary guardianship supervisors from April 2006 to March 2007.

Local mayor 3.1%

quite difficult to get a guardian forsomeone without financial means.

Takagi: In Machida, the start-up of
the adult guardianship system camefrom senior citizens. This is an effective system for both the welfareof the disabled and livelihood protection of the economically challenged, but it was started by seniorcitizens. A budget was allocated,
and working laterally in a verticalorganization, explanations weremade to other departments. As thiswas being done, the General Affairs
Welfare Division was establishedand became the contact point for
the entire adult guardianship sysIndividual 2.9%

Prosecutor 0.01%
Voluntary guardian 0.6%
Legal guardian 0.3%

Other relative 10.6%

Spouse 7.3%

Sibling 18.7%

Parent 30.5%

Child 25.9%

46

also an issue. Thus, in reality, it istem. Now mayoral petitions exceed

ship means that guardianship60 cases and are increasing.
I am prepared to go to any meet-should be supported by society as awhole, because guardianship requires a professional level of exper-

ings and lectures upon requests, nomatter how small those are.In addition, I organize meetings of guard-

tise and families have a conflict ofians appointed as a result ofguardian should be someone otherthan a family member.

mayoral petitions, where information is exchanged. In this way, thesystem is gradually taking root in
Machida.

Murata: There currently are very
few cases of professionals becoming
guardians. The overwhelming majority of guardians are relatives orinterest. In the future, I think a

Some conservative people saythat this will sever family relationships, but that is not true. The extremely difficult job of guardianshipis left up to professionals while family relationships are preserved as is.
It can be thought of in the samefamily members, but is this reallythe best way?

way as long-term care insurance.
We need to have national debate on
this in order to build up the system.

Arai: Legally speaking, the adult

Kanekawa: In addition to problems

guardianship system is part of fami-with the law itself, people in thely law. In Japan, traditionally the elderly are usually cared for by theirfamilies, so to a certain extent thiscannot be helped. However, given
the trend toward the socialization ofguardianship, I think it is difficult
for families to provide care on theirown. The socialization of guardian-field cannot keep up with the system. For example, courts and legal
professionals have always verystrongly believed in protecting assets. It is difficult for them to think
about protecting life itself.
Asset management is relatively
clear-cut, but physical custody“

Many problems have been”brought into the adult guardianship system

47

Roundtable Discussion

4

problems are not something that

Max Planck Institute for Foreign

can be resolved by the authority ofcourts. It becomes necessary to real-and International Social Law also
said that social workers rather thanize that both sides are correct.

legal professionals should be the

Therefore, when providing care
for a person’s life, problems should

main players of this system and thatbe resolved with a welfare-typemind-set rather than the law. In
adult guardianship, it is the worldwide trend to emphasize not only
asset protection, but also respect forlife.

Murata: Dr. Bernd Schulte of thethey would focus on training social
workers in the future.

Arai: Legal professionals can manage assets, but they have not received
training in how to use these assets inphysical custody, so they have limitations. Recently some lawyers havestarted to become certified as social

ReasonProcess in
the City of
Machida2001
One year after the adult guardianshipsystem was established, the Machida
Adult Guardianship System Support
Program was started by the Nucleus
Type In-Home Care Support Center
under the Senior Citizens Nursing
Care Division (currently the Senior
Citizen Welfare Division).

48

At the Nucleus Type In-Home Care
Support Center, I visited difficult cases
along with in-home care support centers in the city and coordinated between the facilities and relatives. In
cases where judgment ability had declined due to dementia or the like, it
was difficult to confirm the wishes andmonitor the situation of an individual,
so problems often became complicated,
and we sensed the need for an adultguardianship system.
Likewise, in cases where judgment
is lacking due to mental disabilities andpsychiatric disorders, there was potential demand for an adult guardianshipsystem, but the problems were not asapparent or pressing as for the elderly.
Therefore, rather than spendingtime on coordination in each department, we decided to start first from departments dealing with the elderly,
where the need was felt.

workers, and some have formed

essentially an application cannot be

non-profit organizations where lawyers and social workers work togeth-

made. In cases where someone isbeing abused by a family member,er on adult guardianship. I think thisworkers at a Community

is a very good trend.

Comprehensive Support Center go
to consult the doctor, but some-Takagi: There also are problems
with doctors. A medical certificate
and assessment report are required
to apply to use the system, so a doctor’s cooperation is necessary, but
doctors still lack understanding. If adoctor refuses to provide a medical

times are told that the consent of all
family members is necessary.

What is necessary for the system totake root?

certificate for a hospitalized patient,

Murata: After eight years, theProcess

Current status

From 2001 to 2004, the system washandled by the Senior Citizen Welfare
Division.
However, during this time, consultations and mayoral petitions for disabled persons surfaced, and employees
in charge at the Senior Citizen Welfare
Division started doing consultationsand visits together with case workers
in charge of disabilities. In addition,
the Senior Citizen Welfare Division
was paying expenses necessary formayoral petitions, and practicallyspeaking, it became difficult to manage
the system within a vertical bureaucratic framework divided by recipient
category.
Therefore, the relevant departments
had discussions and decided to movethe operation to the General Affairs
Welfare Division in 2005.

Consultations and assistance with petition procedures are handled not onlyby the General Affairs Welfare
Division, but also by Community
Comprehensive Support Centers in 15
locations throughout the city for seniorcitizens and by Hikari Ryoikuen fordisabled persons. At consultation locations, forms for submitting to family
court are available, and explanations
on the system and how to fill in forms
are given. Also, if necessary, they contact legal support and other professional support organizations, as well as
accompany people to family court.
The General Affairs Welfare Division
provides training and support for thesecontact locations.

49

Roundtable Discussion

4

adult guardianship system seems toto somehow offer support to the

be at a turning point, but I want it
to take root as soon as possible likefamily guardians as they constitute
overwhelming majority. Citizen

in Germany. What is necessary for

guardians, which are a recent devel-

this?

opment, also need support.

Takagi: I think there are two

Murata: In Germany, if a family

things.
One is to more widely publicize

member becomes a guardian, he/she is provided training and taught

the system and get people to under-

exactly what needs to be done andstand how effective it is. Contact
points also should be not only at

why. In Japan, they are just left tofend for themselves in a sense. I

administrative institutions, but also

think it would make quite a differ-in places nearby. It would be great if
people are referred to consultationence if they could take a seminareven for only one day.

places at financial institutions, medical institutions, and so forth. In
Machida, we made 10,000 pamphlets containing a simple Q&A
and a map of Community
Comprehensive Support Centers,
and we distribute these to all entities for the disabled and elderly andto all the financial institutions in
the city.
The second thing is support for
guardians. Professionals receive
support from organizations towhich they belong, but I would like“

Kanekawa: I also think it is time tostart thinking about a global standard for the adult guardianship system. We should incorporate thegood points of advanced nations
and correct the system’s
deficiencies.
There are municipalities that still
have not made much progress in
adopting the system, as well as municipalities like Machida that are
top-class. I hope that cities and villages like Machida will increase not

We need a system that
supports family guardians

who make up the sweeping majority

50”

only for the elderly, but also for theshould be adopted in Japan as soon

disabled.

as possible. Religious organizations,groups of young people, and others

Arai: I think we should change ourmind-set on publicity and use
methods that stir up national debate
instead.

could do this. How about having
the government make standards
and provide subsidies?
The Japan Adult GuardianshipFor example, how about having
Namihei Isono in the TV show

Law Association is planning to holda world conference in Tokyo in“Sazae-san” suffer from Alzheimer’s

2010, and we would like to discussor performing The Rose of Versailles

the path which the Japanese adulton the Takarazuka stage withFersen suffering from Alzheimer’s?

guardianship system should take inthe future. If possible, we would

Anyway, unless we publicize it in
a completely new way, even thoughlike to prepare and propose an official framework. We should compare

we make pamphlets on the adultour system with those overseas andguardianship system available, no
one will read them.
Also, there is a shortage of per-quickly improve whatever needs tobe improved.

sonnel, so the citizen guardians ofwhich Ms. Takagi spoke will definitely be necessary in the future. I
have high expectations for the baby-boomer generation. However, iforganizations can be formed at willand do as they like, there could be
problems of abuse, so this must be
prevented. Therefore, a system likethe German Guardian Associations

Murata: Despite the fact that agood law was enacted, there are stillsome unrealistic aspects. We needto resolve the problems one by one
and make the system moreproductive.

(4/7/2008)
Photography: Masahiro Minato51

Participants:

RounTakeshi Sasaki

Tokumi Odagiri

		 Professor, Gakushuin University
		 Chairperson, Self-Supporting Zone Study Paneldtab		 Professor, Meiji University
		 Member, Self-Supporting Zone Study Panel

le
ss
scu
Di

ion

5

A New Form ofLocal Community• Potential (seeds) for economic revitalization inrural residential areas
How much potential (seeds) exists?
Ample

Not ample, but some

020

A little

40

60

Almost none
80

100

Overall
17.1
Urban areas

47.1

28.2

Rural areas

27.8

46.6

12.3

7.9

20.9 4.3

47.4

30.8

9.5

Is the potential (seeds) being used?
It is being fully used

Overall

Urban areas
Source: Based on the “General Survey on Dementia and Disclosure of Diagnosis” by the
Tokyo Metropolitan Institute of Gerontology (April 2004). 2,000 people weresurveyed.

52

0

20

1.2

21.0

3.0

Rural areas
0.4

It is being somewhat used
40

60

80

I do not know
100

66.9

30.8

16.8

It is not being used

52.6

73.1

10.9

13.7

9.7

Mitsuo Makino

Yoshinori Yamaoka

Michiko Mukuno

		 Mayor of Iida City in Nagano Prefecture
		 Member, Self-Supporting Zone Study Panel		 Professor, Hosei University
		 President, Japan NPO Center

		 Professor, Oita University

With the declining birthrate, aging of society, population decline, and financial distress, the environment in Japan’s rural areas is tough. The serious situation in rural areas shows a glimpse of urban areas in the future.
Although there is potential for economic revitalization, this potential is not
being fully realized. What can we do to really energize rural areas? Basedon practice and research from various perspectives, we tried to find sometactics.

Problems of rural areas and the concept of self-supporting zones

Sasaki: Currently rural areas are ina very difficult situation economically, socially, and in some cases culturally. The outflow of people tourban areas does not stop. The SelfSupporting Zone Study Panel wasstarted under the Ministry ofInternal Affairs andCommunications with the aim of
stopping the plight of rural areas,
and I served as the chairperson.
The report on the concept of selfsupporting zones was completed
this May, and in the process of debate, many interesting proposals
were made on how rural communi-ties should function in the future.
One of these questioned andraised issues on the dualistic idea oflarge urban areas (represented by
Tokyo) vs. rural areas. We ended up
debating whether it is really correct
to think that rural areas are in trouble while urban areas are secure. A
very interesting viewpoint was presented that today’s rural areas rather
show a glimpse of urban areas in
the future.
I thought the most important
viewpoint was that the dichotomous idea of cities vs. rural areas
may be causing the current inability
to act. So what should we do to
generate activity? It is necessary forrural cities, towns, villages, and other local governments to combine

53

Roundtable Discussion•

Changes in Iida’s population
pyramid (population in thecurrent city limits)
1970

Men

Women

85&+
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4

ate an environment to which theyvate sector in order to change thisdichotomy with a mechanism thatcan return. In the Southern Shinshu
region including Iida, this means

promotes circulation between thethat industries must be created totwo.

which young people can return.
That is where the idea of eco-thinking about urban vs. rural isunfortunate. Even large urban areas

2000
85&+
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
Age

0

their strength with that of the pri-

Makino: This dualistic way of

Age

5,000

5

0

5,000

•1 Iida’s Efforts(prepared by the City of Iida)

Integrated Approach to Achieve a Human Resources Cycle
What will the development of human resources, community and industry in the
5th Basic Concept and Plan lead to?

nomically viable self-supportingzones for local governments started.

in Kansai are losing people toDuring the high-growth era, if
young people went to Tokyo andTokyo, so rural areas futures as regions are in grave jeopardy.

entered a good university and agood company, their lives would be

In addition, we have entered an

secure, and parents in the country-

age when the birthrate is declining
and the number of elderly is in-side were content if their children

creasing, so the number of young

and grandchildren were happy.
However, now there is no such life-

people, who would leave rural areas, is rapidly decreasing. This trend
is particularly noticeable in inter-long security. Residents of ruralcommunities have started to think
it was a big problem that young

mediate and mountainous areas.
There is debate about whether
young people could be fully employed within a region, but this also
is difficult. In the case of Iida, approximately 80 percent of youth
who have graduated from highschool leave the region. This cannot
be stopped. Therefore, instead of
stopping it, the challenge is to cre-people who have left the area can
not come back. This gives me thesense that values are beginning toshift significantly.
The city of Iida’s goal to be a “culturally and economically independent city” is based on the idea ofachieving a good balance amongcommunity development, industry
development, and human resource

Integrated Approach to Achieve a Human Resources Cycle
What will the development of human resources,
community and industry in the 5th Basic Concept and Plan lead to?

Community development so thatpeople want to continue living in Iida
initiated by municipal government /spirit of municipal bylaws

Culturally andeconomically independent city
Industrial
development so thatpeople can return

Human resource
development so thatpeople want to return

regional economic
revitalization system

plan for promoting a system that
leads to increased
regional development capacity

Sustainable local society

54

development•1, while at the same

text, we will overlook essential is-time aiming for “cultural independence.” This shows their resolve tosues, and in this sense, I heartily
agree with the idea of self-support-

not cause any erosion of pride in re-ing zones.
I think there are four problems ingional cities.
This kind of effort definitely can-farming and mountain villages now.

so local residents will need to be-

The first is the phenomenon of
depopulation.•3 The hollowing-out

come actively involved in the challenges that face the communities

of rural society, which began in intermediate and mountainous re-where they live. Iida started a new
system and framework•2 based on

gions, is spreading widely, including

not be done by government alone,

to small and medium-sized regional
cities. The hollowing-out of popula-this way of thinking last year.

Odagiri: My expertise is in agricultural economics, which is in thefield of applied economics.
However, since 20 years ago, I havethought that it was necessary to go
beyond the field of industrial economics and look at community
more broadly, so I established thefield of rural policy. Regarding thedichotomy between rural and urban
areas that is being discussed, recently I have developed a strong desire
for debate in the larger context ofrural governance.
Unless we think in a broad con-High growth periodtion, land, and villages leads eventually to a “hollowing-out of pride.”
Mayor Makino has already touchedon this, but if the pride of continuing to live in a region and supporting a region is lost, though notreadily visible, it is actually a very
big problem.
The second problem is that thephenomenon of the “severely depopulated village” is rapidly spreading in intermediate andmountainous regions where hollowing-out started.
The third is that economic andindustrial problems also have

Low growth period

1970
Area of hollowing-out

1960

•2
With “diverse actors” (citizen participation) as a keyword, Iida established assembly-centered municipal bylaws rarein Japan, as well as the 5th Basic Concept and Plan painting a future image ofIida as a “culturally and economicallyindependent city with radiant people
and nature where people want to continue living and try living.” The city thus isactively pursuing city administration
under a new system.

1980

Economic structural adjustment period

1990

2000

•3 History of hollowing-out inintermediate andmountainous regions(diagram by Mr. Odagiri)

Human
S o c i a ld e c r e a s e

N a t u r a ld e c r e a s e

Land

Village

Hollowing-out of pride

Hollowing-out inthree areas

55

Roundtable Discussion

5

become very serious. Incomes are
declining much more severely than
expected.
The fourth is that as mergers be-

medical service are in place, if the“town” does not function in reality,

tween cities, towns, and villages occur, particularly in rural villages

community welfare and in-homethat have merged with large cities,
town and village offices have be-felt that we must begin with community development and humancome farther away, so some residents feel that they have been left

resource development so that theelderly and disabled could live

behind by the central city. City halls
also are unable to keep an eye on

without anxiety, so now it feels re-such peripheral areas, so it is diffi-

rural areas from the standpoint ofresearch, education, and practice.

cult for the government to understand the local challenges of these
peripheral areas.

medical care will not work. I keenly

warding to be directly involved in

Unlike the rapid economic

university and joined the Ministry

growth period, now companies canno longer take care of employees
and their families after they retire.
In addition, the increasing trend to-of Health and Welfare after graduating. I worked there for 30 years andward single people and elderly couples living alone will continue, andthen returned to my hometown of
Oita two years ago and work at auniversity now. At the Ministry of
Health, Labour and Welfare, I was
engaged in developing medical andnursing care systems, and the biggest challenge in recent years has
been the shift to community careit will be impossible to avoid a decline in the welfare role that families
play. In this context, the importanceof community will increase all themore. I have declared that I am doing community development for
my own old age, but I sense every
day that rural welfare cannot be

Mukuno: I came to Tokyo to attend“
56

and in-home medical care.
However, even if care service and

The hollowing-out of pride in living ina region and supporting a region isa serious problem”

“Today’s rural problems may be
the problems of cities in the future

successful just by depending on thehave the same salary and so forth assystem.
I am particularly concernedin the city, but jobs that can provide
a decent living are needed. How canabout the issue of mobility. In rural

rural areas create these? Also, inareas, people depend on their cars,
so users of public transit are sharply

cases where a couple returns to thehusband’s hometown, there is thedecreasing along with the popula-question of whether it is an areation decrease. In particular, buslines continue to shrink or be discontinued. Pressured by shoppingwhere his wife thinks that she canlive, which is actually a serious
matter.

centers, neighborhood stores also
are disappearing, so when people
grow old and become unable todrive a car, it will be suddenly difficult for them to do even their daily
shopping, and they will also lose
contact with society. In a survey by
the City of Oita, the top thing lacking in rural life was busses and other means of transportation.
Securing mobility and transportation is a requirement forindependence.
If there is no human exchangewith large urban areas, then it isclear that rural areas will have difficulty breaking away from their current circumstances. I myself wasvery lucky, and it is not necessary to

I can empathize strongly with Dr.
Odagiri’s “hollowing-out of pride.”With regard to Oita, for example,
the old city of Beppu is a great placewith historical buildings and astrong community, and when I takeacquaintances from Tokyo there,
everyone is impressed and pleased,
but local people do not see thegreatness at all. In particular, young
people do not like such “old, dirty”
houses, so they leave there andbuild houses with new building materials in new housing developments in suburbs cut into
mountains.
As a result, the old city is aging
and declining immensely, and evenelderly people who have lived there”57

Roundtable Discussion

5

since long ago are losing their pride

There has been particular focus

and love for the place where theylive. When revitalization is men-on the issue of post-retirement forthe baby-boomer generation, andtioned, people say that they want

the way in which to live after retire-

this or that from another place to bebrought here, but if, for example,

ment will always be an issue evenafter the baby-boomer generation.

condominiums are ineptly built justWhen a person decides that he or

to increase the population, the com-

she wants to retire and return to themunity instead will be torn apart.
Enhancing the community’scountryside, it is important to think
about how to arrange things so thatuniqueness, that which exists only
there, is the way to bring backit is possible to return. One option
is an NPO.

pride. I think this is also related tothe issue of identity.

Yamaoka: I used to do urban planning and have visited many regions.
Now I specialize in community development, welfare, and NPOs.
Over the last 5-6 years, I havemet people in every region who
have moved back from cities to thecountryside and started NPO activities. The “I-turn” pattern (movingfrom a city to an unrelated rural area)

seems common among young people, while the “U-turn” pattern(moving from rural childhood home to acity and back again) and “J-turn” pat-tern (moving from rural childhood home
to a city and back to near the hometown)

seem common among older people.
In cases where the turn home orelsewhere does not go well or the
person leaves after several years, I
think that there must have been
limitations in many areas. What canbe done by turning home or elsewhere is a big question.

58

Creation of a New Economy

Sasaki: The current difficult circumstances in rural areas cannot
wait, but what should be done exactly? And what movements are
occurring?

Odagiri: I would like to mention
three issues from the standpoint ofrural governance.
The first issue is building newcommunities. Now we are seeing
the second largest community
boom since the 1970s. These newcommunities are not geographically-based communities and neighborhood associations, but rather acombination of geographicallybased connections and function.
Therefore, so-called “hybrid” communities completely different frombefore have formed.
The second issue is the severe
hollowing-out of industry in rural

areas due to deteriorating economic

among city residents. Without theconditions. This is causing a needfor new economies. Mayor Makino’s

empathy of consumers, it is impossible to sell somewhat upscale prod-

challenge is just this. If I may sum-ucts. Therefore, among products

marize this challenge in my own
way, I think that four types of econ-

made in rural areas are those madewhile doing one’s best to protect theomies would be possible.

rural environment, for example,

The first type of economy isproducts made of wood from forest-

called the “Sixth Industry.” It is theprimary industrial sector + the sec-

thinning. This process became anarrative and is succeeding at at-

ondary sector + the tertiary sector.
Simply said, domestic agriculturaltracting the empathy of consumers.
The fourth type of economy is

and marine production is 12 trillion

the “small economy.” When people

yen and imports are 3 trillion yen,in rural areas are asked how muchfor a total of 15 trillion yen, but thisbecomes 80 trillion yen when it en-additional monthly income theyneed, elderly respondents answered

ters our mouths. The “Sixth
Industry” is what was devised sothat this difference could be re-30,000-50,000 yen, and young respondents answered at most
100,000 yen. How many small

couped by the countryside. It started with agricultural processing, but

economies of 360,000-1,200,000
yen per year can be created in rural

now there are farm village restaurants, and this is a growth industry
in farming and mountain villages.
The second type of economy isan “exchange industry-based economy,” such as green tourism. One
aspect of this industry is thatthrough an encounter between aguest and a host, both parties grow.
As a result, there is a high repeaterrate at farmhouse inns and so forth,and the potential of this as an industry is not small.
The third type of economy is an“economy based on preserving rural resources.” In this case, a narrative is unfolded from thecountryside and found empathy

areas? First it may be best to createa small economy and then hopethat a medium-sized economy develops so that young people can settle down there.
The third issue from the standpoint of rural governance is selfsupporting zones. Despite being
told to just protect agricultural andmountain villages, this is impossible
when villages are becoming depopulated. The speed of decline insmall and medium-sized regional
cities is unusually fast, so it is extremely important to revitalize rural
areas as zones.

Yamaoka: Dr. Odagiri mentioned
59

Roundtable Discussion

5•4 Working toward 70%

the “small economy,” and I thinkhometown will boost the rural(made by the City of Iida)
Internal reform is necessary in rural industrial structure to achieve 70%.

that if NPOs can be used to makesmall loans, say from several mil-economy.
In lively communities, there arelion to 10 million yen in rural areas,

many interesting NPOs. By making

then rural economies will become
more active.

efforts such as conducting activities
in rural areas while appointing for-

Whether by I-turn, U-turn, or

mer colleagues and friends who live

J-turn, the fact is that it is difficultin large urban areas as members, I

to become part of a community
based organization. So we need tothink a confluence of people willdevelop. At any rate, that kind ofdevelop a financing mechanism, independent from these organiza-

dynamism needs to be created.

economic independence

Headquarters

Manufacturing &production

Development

Sales

Current status of businesses, farmers, etc.
(dependency)

tions, and through suchmechanism, foster unique businessHeadquarters Manufacturing &production

Development

Sales

Goal
(independent structure)es. If start-up funds at the least
could be supplied, then the management ability and networks developed in cities could be used andwidespread activities could be
conducted.
When making a turn back to arural area, instead of depositing
one’s retirement bonus in a majorbank in Tokyo, we want people todeposit it in a regional trust bank or
agricultural cooperative bank sothat the money may benefit the locality. Merely bringing back a retirement bonus and pension to one’s“
60

Dynamism from a Confluence ofPeopleMakino: Within the discussion on
the concept of self-supportingzones, my biggest emphasis has
been the creation of just such dynamism. And in order to create dynamism, it is necessary to shift fromdependence to independence inproduction.•4
In both agriculture and industry,
everyone is good at making things,
but that alone is not enough. There
must be a headquarters function,
research and development, andSimply bringing back a retirement bonus
and pension to one’s hometown will boost
the rural economy”most importantly, good marketing

important to figure out how profes-

that can sell products with appropriate value added.

sionals trained outside their ruralcommunities can be connected

Rural industry promotion poli-with their communities. Formingcies up to now have only emphasized bringing in factories andcommittees of consulting firms, intellectuals, and others, and asking

increasing the number of building

them to revitalize regional city cen-sites in any way possible without

ters often does not work well, but

considering and analyzing these aspects. As a result, there are many

this is only natural in a sense, because unless professionals are in-residents who have absolutely nointeraction with the local commu-

volved with the community on along-term continuous basis, successnity in their lives, and money does

cannot be expected.

not stay within the region.

•6 Kabuchan Noen
Ichida dried persimmons, a traditional
food of Southern Shinshu, were branded
by Takeya Kaburagi and became instantly famous throughout Japan. Whileadvertised in newspapers and on TV, healso refined storage technology, which
made it possible to sell Ichida dried persimmons throughout the year instead of
only in late December and early January as in the past. As a result, sales inlarge urban areas grew dramatically.

Iida is focusing heavily on at-

In the City of Iida, various people
are learning by trial and error totracting human resources in orderto generate dynamism.•5 One

create their own region by themselves. They somehow got started.
However, dynamism will not comespecific example of this is Mr.

from this alone. In the end professional assistance is necessary, but

big success. He traveled throughout
Japan and by chance he discovered

unfortunately there are almost no
professionals in the countryside.
Young people have left their ruralcommunities and are getting professional education. There are also
many people in the baby-boomer
generation who are working as professionals in the Tokyo area. It is

he had a liking for Iida, so he began
living there. As a result of his success with Kabuchan Noen, Iida’s
Ichida dried persimmon farming
business really changed
dynamically.
In my own experience in Frankfurt,
urban planning professionals and“•5
The City of Iida aims to achieve the Tenryu Gorge 100-Year Renewal Plan byexchanging and training personnel
through a partnership with the City of
Bungo Takada, which rebuilt its city
center as “Showa Town.” Iida also iscalling on urban planning professionals
from overseas in a partnership with theCity of Wurm in Germany.

Kaburagi•6, who came to Iida from
Tokyo and made Kabuchan Noen a

Outside professionals must be
involved to create dynamism froma confluence of people”61Roundtable Discussion

5architects debated outspokenly
on community development,
and a sort of tension between professionals achieved a good effect.
In Japan, I get the impression thatprofessionals actually are not usedvery well.
Of course, some professionals are
elderly. Mr. Matsushima, Cluster
Manager for the Iida Shimoina

but there were several hundred applicants for this position, and a manin his 50s who had worked at a
trading company in Tokyo wasselected.
He said that he applied for the
position because he found the place
appealing, and as soon as he took

Local Industry Promotion Center is
a 73-year-old engineer who camethe position, he partnered withNPOs and community people andfrom Tokyo. He remained in Iida af-

began study sessions. He moved

ter retiring as president of a clock

forward with activities while respecting existing community-based

assembly company in Iida and is
working in the forefront of the aero-networks, and the organization

space industry, a new industry forthe region. However, as Dr.
Mukuno worried, he left his wife inclearly has come alive. The
Chamber of Commerce fulfills an

Tokyo and is working here on his
own, this kind of relation of families

this should energize the town as
well.
In all regions of Japan, the pillarsof the community – namely chambers of commerce, societies of commerce and industry, social welfare
councils, and boards of education –all are sectionalized and disjointed,
so they do not even have contact,
let alone partnership. If they

will be a major issue in the future.

Yamaoka: If you were going to start
up a company, I really think it
would be best to retire early aroundage 50 and make a comeback. Many
people with appeal have come together in the city of Iida, but there
are other places that are also working to create accepting
communities.
In the City of Shimanto (formerly
Nakamura City), where I have been

involved for the last several years,
the Nakamura Chamber ofCommerce publicly recruited an executive director. Chambers of commerce normally function like62

second-class administrative offices
and are not very active anyplace,important role in the community, soworked together to stop golden
parachuting and publicly recruited
personnel, there could be majorchange in communities.

Hire Outside Professionals as
Managers

Mukuno: I think there has to be

Of course, both men and women
will be paid a salary, and there areplenty of things to do in the area, so
won’t you come once you are free ofkind of marketing would be good.
In places where pride is being lost,
the tendency is to think that no one
would want to live in such an unattractive place, but outsiders may be

have concentrated on the idea ofable to discover interesting and re-somehow bringing in industry thatcan do something for a community,

warding things from a newperspective.

of thinking. In contrast, Furusato
Kaiki Shien Centers•7 and others attract people by saying something
like, “There’s nature here and thefood is good, so come bring your retirement bonus and pension to thisvillage!” This is a little different
from the active personnel recruitment that leads to economic independence. In addition, women are
asked if they would like to be a
farmer’s bride. After all, there are
women who do not want to be

Odagiri: Community development
is actually human resource development, and this is easy to understandby applying the words “operator”
and “manager” used frequently inagriculture. An operator is someone
who does labor, while a manager issomeone who uses his knowledge
to manage.
For operators, the concept of productive aging is a matter of course,
and agricultural cooperatives andlocal governments since the 1980s

There has to be some matchmaking to
attract people, the kind which leads toeconomic independence•7 Furusato Kaiki Shien Center
The Center supports middle-aged people, including the baby-boomer generation, in I-turns, J-turns, and U-turns inorder to achieve success in the “Million
Person Movement to Return to Rural
Hometowns.” Centers have been established throughout Japan in addition to
the national Furusato Kaiki Shien Center NPO.

your children? Being able to do thissome matchmaking in order to attract people. Invitations thus far

which was really a dependent way“

brides, but are attracted to farming
villages.

”63

Roundtable Discussion

5•8 Unified Headquarters forhave begun to train people who havethe Unified Headquarters for

Four headquarters relating to regional
revitalization (Urban Renaissance
Headquarters, Headquarters for the
Promotion of Special Zones for Structural Reform, Headquarters for Regional Revitalization, and Headquarters for
Revitalization of Central Urban Districts) were consolidated in order toachieve an effective and easy-to-understand framework from the regional perspective. The goals are to propose
across-the-board strategies for regional
renewal, create action plans, and implement policies in an organized and comprehensive manner.

reached retirement age and comeback to the countryside so that they

Regional Revitalization•8 created in

Regional Revitalization

can support agricultural productivity. The phrase “return to the farm at
retirement” was also coined at thised from rural areas, but instead oftime. In addition, there also is debate

only monetary assistance, counselor-level bureaucrats from national

over changing the term “severely de-government ministries are also sent

populated communities” to “lifelong
working communities” instead, andto provide human assistance.

it can be said that there are many
healthy senior citizens with low

The same program is spreading
to the Forestry Agency, the Ministry

medical expenses in Naganoof Agriculture, Forestry and
Fisheries, and the Ministry of Land,

Prefecture thanks to the underlying

Infrastructure, Transport andstrength of operators engaged in primary industries.

Tourism. In this respect, Iida’s ini-

The problem is with managers.
Under difficult circumstances, wedefinitely need to recruit managers
from outside or develop a system
for sending in outside personnel.
Now, in farming villages, people
frequently speak of human assistance rather than monetary assistance. Not only money, but also
human resources are important,and ideas that support this did notexist in Japan before now, but finally it seems a framework is beginning to be put in place gradually.
Financial authorities hate most of
all spending money on people, because this tends to lead to perpetual
assistance, but they finally have begun to realize that rural areas will
not change unless this issystematized.
A typical example of this is the“Rural Revitalization Program” of64

the Cabinet Office last autumn.
Here business proposals are solicit-

tiative was a true breakthrough.

Sasaki: In rural areas up to now,the government and geographically
exclusive society have been inseparably intertwined. Meanwhile, there
are places like Iida, where not only
geographically exclusive society, butalso open people have begun to be
active. While a new “wind” is born,
many places remain where there is
still nothing but government andgeographically exclusive society, so
this problem needs to be addressedin the future.
Far from hoping for revitalization
through public recruitment for
manager-type positions, there areeven many places where the rotation of appointments is determined
for the next 10 years. This is very
primitive, but the stronger geographically exclusive society is, thestronger resistance to outsiders is.

However, even in such places, if justbe a program for matching mature

one opening can be made to gain
access, there is a chance for change.

adults who want to do domestic
volunteering with regions that wantOnce the level of Iida is reached,such people. The City of Iida has

wariness toward incoming outsiders can be shifted instead to tension

done things in Mayor Makino’s way,
but I think there are things that canin a good way. Bringing exclusivity

be done even in places with strong

to the point of tension is the first

geographical connections.

stage, I think. The next stage is to
use this well in order to create a

The last thing to consider is that I
think there has been too much hype

win-win relationship.
While deliberating on self-sup-over globalization in recent years,
particularly in the financial world.

porting zones, I had two thoughts

In light of the lives of Japanese citi-

regarding this issue.

zens, I want to reiterate that we

One is to think of the next choice
when one reaches a certain age.

need to think from multiple perspectives, and that the viewpoints

In my view, post-war rapid
growth was an anomaly in Japanese
history. However, because thisand challenges in rural areas epitomized by “small economies” are especially needed now.

anomaly was used as a model, we
got bogged down. Senior citizens
today including the baby-boomer
generation were lucky enough toexperience this one-time historical
miracle, but this should not be used
as a model for success in the future.
It is only natural to work hard at
a company, but it is also important
to use one’s imagination for options
in one’s life afterwards. Humans
need a running start, so unless they
practice from a young age using
their imagination to think about
what is next, they will be at a loss
when they actually grow old.
The other thing is that, just as
there is Japan Overseas Cooperation
Volunteers program, which sends
youngsters overseas, there needs to(8/6/2008)
Photography: Masahiro Minato65

Participants’ List
Makoto Arai

Yukihiro Kadono

Mitsuo Makino

Professor and Dean of Tsukuba University Law
SchoolProfessor, Kwansei Gakuin University

Mayor of Iida City in Nagano PrefectureMember, Self-Supporting Zone Study Panel

Makoto Arai was born in 1950. He graduated from the Faculty of Law at Keio
University and earned a Doctor of
Jurisprudence from Munich University in
1979. Prior to his current position, he was aprofessor at schools such as the Faculty of
Law at Kokugakuin University and theFaculty of Law and Economics at Chiba
University. He is the President of the Japan
Adult Guardianship Law Association andreceived the Humboldt Research Award in2006. His publications include Adult
Guardianship Law in Aged Society; Adult
Guardianship Law and Trust Law; AssetManagement Systems, the Civil Code, andTrust Law; and Trust Law (all published by
Yuhikaku).

Professor Kadono was born in 1955 andgraduated from the Faculty of Engineering
at Kyoto University. He completed the doctoral course at the Graduate Engineering
Research, Osaka University. He holds a doctorate in engineering and is a First Class
Registered Architect. In 1987, he went towork for the Marketing Office of the Osakabranch of Dentsu. In 1995, he became aprofessor in the Faculty of Human
Environmental Sciences at Mukogawa
Women’s University and assumed his present position in 2006. He has written books
such as The Twentieth Century in the Suburbs:
Residential Areas Seeking a Focus (Gakugei
Shuppansha), and is co-editor of Suburban
Residential Areas in Modern Japan (Kashima
Shuppan).

Yoshio Gyoten

Hiroshi Kanekawa

Medical commentator

Executive Director, Japanese Association of
Certified Social Workers

Yoshio Gyoten was born in 1926. He graduated from the Chiba University Medical
School. After joining NHK, he was engaged
in the planning and production of programson health, medicine, and welfare issues. His
achievements have earned him awards suchas the Hoken Bunkasho (Health Culture Award)
and the Japanese Red Cross Society
Emperor Award. In addition to being amember of the Medical Research Council ofthe Ministry of Health, Labour and Welfare,
he also serves as consultant to the Japan
Hospital Association, advisor to theInternational Medical Center of Japan, andso forth. His publications include An Aging
Society That is Comfortable and Satisfying(published by Tokyo Kyoiku Joho Center).

Keiko Higuchi

Hitoshi Kato

Chairperson, Women’s Association for the
Better Aging Society

Non-fiction author

Keiko Higuchi was born in 1932. She graduated from the Faculty of Letters at Tokyo
University and also completed studies in
The Tokyo University Institute ofNewspaper Research. She worked for Jiji
Press and other media companies, and thenshe began to work as a freelance critic. She
was a professor at Tokyo Kasei University
from 1986 to 2003 and the first director of
the Center for the Advancement of Working
Women from 2000 to 2003. Currently, she
serves as representative of the Japan NGO
Council on Aging and Professor Emeritus ofTokyo Kasei University. Her main publications include Grandma Power (Shinsuisha),
Challenge (Graphsha, inc), and My Readiness forAging (Bunka Shuppankyoku).

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Hiroshi Kanekawa graduated from theFaculty of Literature at Gakushuin
University and completed a major at theJapanese National Institute of Health. He isa certified social worker and psychiatric social worker, and he has spent nearly 30
years in the field of health and welfare, serving in capacities such as general manager ofa private hospital and head of a special
nursing home for the elderly. He has been
deeply involved in the adult guardianshipsystem since its inception and is a directorof the Japanese Adult Guardianship Law
Association. He is the co-author of Law
Encyclopedia on Adult Guardianship and Longterm Care and Inheritance (Sanseido).

Hitoshi Kato was born in 1947. He graduated from the School of Political Science &Economics at Waseda University. After
working as a magazine editor, he became a
non-fiction author and has written about
how retirees live and elderly welfare. His
main publications include People Who
Challenge the ‘Quality’ of Long-term Care: 28
People Who Opened a New Door (Chuo Hoki
Shuppan), After Retirement: Wisdom for Living
Well (Iwanami Shoten), and Just One Person’s
Second Chance: Action Files of 55 Early
Retirees (Yomiuri Shimbun).

Mitsuo Makino was born in 1961 in
Nagano Prefecture. He graduated from theFaculty of Political Science and Economics
at Waseda University. After graduating, hejoined the Japan Development Bank (currently the Development Bank of Japan). He served invarious high-ranking positions, such as
Auditor of the Toyama Office, General
Manager of the Frankfurt Office, andGeneral Manager of the Oita Office. He resigned in March 2004 and was elected mayor of his hometown, Iida City, in October
2004.

Ken Miura
Associate professor, Graduate School, Osaka
City University
Born in 1970, Professor Miura graduatedfrom the Faculty of Engineering at Kyoto
University. In 1997, he was a Special
Research Fellow at Japan Society for the
Promotion of Science. In 1998, he wasawarded a doctorate in Engineering from
Kyoto University and became a research assistant at the Research Institute of the
Graduate Faculty of Engineering at Kyoto
University. He has held his present position
since 2004. The Architectural Institute ofJapan awarded him its Incentive Award. He
is the editor of Long-Term Care Will Changewith Individual Rooms and Individualized Care
(Chuo Hoki Shuppan), and co-author of works
including The Group Home Reader: The Key
to Caring for Elderly People with Dementia(Minerva Shobo).

Michiko Mukuno
Professor, Oita University
Michiko Mukuno was born in 1956 and isfrom Oita Prefecture. She graduated fromthe Faculty of Law at The University ofTokyo and joined the Ministry of Healthand Welfare in 1978. She was Director of
the Urawa City (currently Saitama City)
Department of Welfare from 1990-92 andbecame the first woman in charge of theAnnual Report on Health and Welfare in
1998. She came to her present position in
2006, before which she held positions as
Professor at the Japan College of Social
Work, Cabinet Office Counselor, andGeneral Affairs Manager of the Social
Welfare and War Victims’ Relief Bureau. Her
co-written publications include The First
Social Security and Keywords in Women’sStudies.

Sachiko Murata

Hidehisa Otsuji

Sachiko Takagi

Welfare journalist

Former Minister of Health, Labour and WelfareHouse of Councilors Member

Senior Staff, General Affairs Welfare Division,
City of Machida

Hidehisa Otsuji was born in 1940. He attended but dropped out of the National
Defense Academy. After serving as the vicechairman of the Nippon Izokukai (Japan WarBereaved Association) and councilor for
Kagoshima Prefectural Assembly, he waselected by the Liberal Democratic Party to a
proportional representation seat in theHouse of Councilors in 1989 and is currently in his fourth term. He served as Vice
Minister of Financial Affairs and Minister of
Health, Labour and Welfare in the Cabinetof Prime Minister Junichiro Koizumi.
Currently, he is the chair of the House ofCouncilors Budget Committee. He has
worked actively on support for emigrants to
the Dominican Republic and devoted his efforts to passing a bill relating to a special
one-time compensation payment to theseemigrants. In addition, he focuses on expanding social security.

Sachiko Takagi graduated from the Schoolof Social Welfare at Shukutoku University
and obtained a certified social worker. After
graduation, she became employed by theCity of Machida and was assigned to the
Hikari Ryoikuen Welfare Center for the
Disabled. In 2001, she was assigned to the
Senior Citizen Welfare Division and became
involved in starting the Machida Adult
Guardianship System Program. In 2005,
she was transfered to the General Affairs
Welfare Division as the restructure of thecity’s organization. She is actively involvedin the adult guardianship system in thefront line.

After graduating with a degree in English
and American Literature at Rikkyo
University, Sachiko Murata worked as anannouncer at NHK. She was a newscasterand reporter on news programs such as“Studio 102” and “NHK News Wide,” andlater became an NHK senior commentator.
She also worked as a newscaster on programs such as “NHK Special: When You
Become Bedridden,” “NHK Morning Wide
Series on Aging Society,” and “Radio
Evening Paper.”Yuko Nishikawa
Professor, Kyoto Bunkyo University
Yuko Nishikawa was born in 1937, graduated from the Faculty of Literature of Kyoto
University, completed the doctoral course in
the Graduate Faculty of Literature Research,and received her doctorate from the
University of Paris. After teaching at
Tezukayama Gakuin University and Chubu
University, she assumed her present position in 1996. She has written such works as
Geopolitics of the Postwar Period (University ofTokyo Press), Stories about Housing ad Families:
Men’s Homes and Women’s Homes, Rooms
without Gender Difference (Shueisha), and The
Modern Nation and Housing Models (Yoshikawa
Kobunkan).

Tokumi Odagiri
Professor, Meiji University
Member, Self-Supporting Zone Study Panel
Tokumi Odagiri was born in 1959 in
Kanagawa Prefecture. He completed a doctorate in the Graduate School of
Agricultural Science at The University ofTokyo. He came to his present position in
2006, before which he held positions such
as Assistant Professor in the Faculty of
Economics at Takasaki City University of
Economics and Assistant Professor in the
Graduate School of Agricultural and Life
Sciences at the University of Tokyo. He has
co-written publications such as Symbiotic
Farming Systems in Intermediate andMountainous Areas: The Frontier ofDestruction and Recovery and Reader on
Practical Community Development:
Independence and Cooperation.

Takeshi Sasaki
Professor, Gakushuin University
Chairperson, Self-Supporting Zone Study Panel
Takeshi Sasaki was born in 1942 in Akita
Prefecture. He graduated from the Political
Science Department of the Faculty of Law at
The University of Tokyo and then earned alaw doctorate. He came to his present position in 2005, before which he held positions as Professor, Dean of the Faculty ofLaw, and President at The University ofTokyo. He has served in a variety of highranking posts, such as co-representative of
the People’s Council for Building a New
Japan and president of the Japan
Association of National Universities. His
publications include What Can Politics Do?
Plato’s Spell, and The Enigma of Democracy.

Yoshinori Yamaoka
Professor, Hosei University
President, Japan NPO Center
Yoshinori Yamaoka was born in 1941 in
Old Manchuria. He completed a doctorate
in architecture at The University of Tokyo.
After working at Urban Planning and
Design Institute Co., the Toyota
Foundation, and on a freelance basis, he established the Japan NPO Center in 1996
and assumed the position of Managing
Director and Secretary General. He hasserved in his current position since 2008.
His publications include Changing Times,
NPO Practical Course (New Edition) (editor), and
NPO Basic Course (New Edition) (editor).

Mariko Sonoda
Associate professor, Meiji University
Born in 1957, she graduated from theEngineering Faculty of Chiba University
and completed a doctoral program at Chiba
University’s Natural Sciences ResearchInstitute. She is also certified as a First Class
Registered Architect. From 1981 to 1985,
she was employed by Ichiura Urban
Architectural Consultants. From 1986 to
1996, she was a senior researcher in the
Building Technology Research Institute of
the Building Center of Japan, after which
she assumed her current position in 1997.
Her publications include Housing for the
Elderly Around the World: Japan, the U.S., andEurope (Building Center of Japan).

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Global Information Journal onLongevity and Society
2008
Published by: International Longevity Center-Japan

			
			
			
			
			
			
			

Toranomon33Mori-building,
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URL http://www.ilcjapan.org

Publisher:

Shigeo Morioka, President

Editors:

Seitansha, Inc.

Printers:

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Copyright ©ILC-JapanAll rights reserved. No part of this journal may be reproduced in any form or by any
electronic or mechanical means including information storage and retrieval systems
without permission in writing from the publisher.

International
Longevity
Center-Japan

Printed in Japan
Published 2008