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Fights over Limits:
Analysis of the Past Decade in Japan

TATEIWA Shin'ya (Ritsumeikan University) May 28, 2010
Conference of Social Welfare Program Society of South Korea; held in Seoul, South Korea
Japanese & Korean Page



My presentation today will be mainly structured around3.

0 Introduction

* Many texts including this one are available at the website of our center, Global COE Program "Ars Vivendi". Improving and expanding the Korean page has become an important task since 2010. At present we also offer an e-mail newsletter in Korean, and also have an English e-mail newsletter, 24 issues of which have already been published. Both are accessible from the links below. Do not hesitate to send us any related advice or information.

Korean http://www.arsvi.com/a/index-k.htm
English http://www.arsvi.com/a/index.htm
Japanese http://www.arsvi.com

1 A few words about myself

Korean http://www.arsvi.com/ts/k.htm
English http://www.arsvi.com/ts/e.htm
Japanese http://www.arsvi.com/ts/0.htm

  My academic specialty is sociology, but a large part of my research has been conducted in the field of normative theory, a field (Japanese) sociologists rarely engage in. Another issue I have consistently addressed is the problem of "property". My objective in addressing it has been to criticize the most fundamental assumptions behind the principle of rating of people by performance, achievements, and merits. I am trying to envisage different modes of possession, different modes of dividing the society. This attempt is inevitably entwined with the manifold problems raised by the science of "bioethics." Also, since the 1980s I have been conducting fieldwork and research of social activism and policies related to people with disabilities.

Texts under joint authorship published in Korean:
Ars Vivendi: Sociology of of Diabled People Who Left Home and Institution
(first edition: 1990; enlarged and revised edition: 1995; Korean translation: 2010)

Other texts (written by me alone)
On Private Property (1997) English
Freedom to be Weak: The Art of Self-determination, Care, and Survival i2000j English
Equality of Freedom: An Another Simple World i2004j English
ALS: Immovable Body and Breathing Machine i2004j English
On Hope i2006j English
Good Death (?) i2008j English
Sole Life i2009j English

Recent texts (in collaboration)
Repairing the Tax i2009j English
Basic Income: A Possibility of Minimal Distributing State i2010j English

2 Introduction of "Ars Vivendi: forms of human life and survival" and some notes on our exchange with South Korea

Ritsumeikan University Global COE Program "Ars Vivendi: Forms of Human Life and Survival"
i2007`j
Korean http://www.arsvi.com/a/index-k.htm
cf. English http://www.arsvi.com/a/index.htm

Objectives (Korean) http://www.arsvi.com/a/200702k.htm
cf. English http://www.arsvi.com/a/indexe.htm

Events hosted

EOctober 23, 2008 Conference on History of Disabled Movements in South Korea and Japan (Japanese)
Kinugasa Campus, Ritsumeikan University, Japan
EFebruary 21, 2009 East Asian ALS Patient Home Care Symposium
Korean http://www.arsvi.com/a/20090221-k.htm
cf. English http://www.arsvi.com/a/20090221e.htm
Kinugasa Campus, Ritsumeikan University, Japan
EMay 10, 2009 International Symposium: The Future of Support by People with Disabilities: Possibilities of Collaboration between Japan, Taiwan, and South Korea (Japanese)
Kinugasa Campus, Ritsumeikan University, Japan
EMay 27, 2010 Round-table Discussion
Research Machine "Suyu+Trans", South Korea (Namsan)
EMay 29, 2010 International Research Exchange Meeting
Kyonggi University, Suwon, South Korea

My presentations in South Korea

EOctober 30, 2003 "History of the Independent Living Movement in Japan"
2003 International Forum on Independent Living by the Disabled held in Seoul, South Korea, 2003
ENovember 2, 2009 What We Lose in Exchange for Death: Notes on the Introduction of the Situation in Japan (Japanese)
South Korea & Japan International Seminar on Euthanasia (Japanese), National Assembly Members Building, Seoul, South Korea
ENovember 3, 2009 The Progress of the Disabled Movement in Japan: A Few Words on the Joyous Occasion of Establishment of the Association for Research on Disability Studies in South Korea (Japanese)
Society of Disability Studies of South Korea, Founding Conference (Japanese) Seoul, South Korea
EJanuary 19, 2010 Issues We Need to Simply Push for / Issues to be Pursued Carefully
Special Education and Multi-Knowledge Convergence held at Daegu University, South Korea
EMay 31, 2010 The Era of this Book, and the Future (Japanese)
Memorial lecture to Commemorate the Publication of the Korean Translation of Ars Vivendi: Sociology of Disabled People Living outside Families and Institutions, held in Seoul, South Korea

Plans for this year and the future

E To introduce the systems surrounding people with disabilities that exist in Japan in English and Korean
E To learn about the South Korean system and the movement by people with disabilities in South Korea To translate the related materials into Japanese
E To introduce work published in Japan to the people of South Korea
E To analyze the histories of both countries and promote reciprocal learning for mutual benefit

3 Development of the system: Several points of argument

A: Since the 1970s, the movement of people with disabilities has campaigned for long term care coverage
In the 1990s, public care system providing 24-hour care became available in some regions of the country ("Ars Vivendi")
B: In the 1980s, the problem of care of the elderly starts to gain more and more attention.
In the 1990s, debates regarding long term care insurance start:
Relaxation of progressive taxation
Idea to apply the insurance principle appears
: each needs to pay so as to be prepared for the risks in the future; the money is paid reciprocally (so that all supports all with equal burden)
In terms of decentralization & provinces, a rhetoric appears (even among the "reformists") that the policies should be based not on the (re-) distribution of wealth, but on "membership fees" (which are either equal for all or at best proportional to income)
Rhetoric (again including the "reformists") that (though to ensure that everyone gets at least the minimum income is the responsibility of the country) social services should be run by local governments and may be financed by "membership fees"
E Idea appears that any reform is good if it can get the approval of the governmental office in charge of country's finances (Ministry of the Treasury(renamed into) Ministry of Finance)
E Idea appears that by making the system based on an independent financial resource it would be possible to make it independent from the country's finances
Was implemented since 2000.

A versus B
People with disabilities who are not yet in the elderly bracket have not been applicable under elderly care insurance.
The decision not to cover them was not made due to the influence of the disabled movement.
However, at the beginning there were some arguments for such an inclusion, and people with disabilities objected.
To put it plainly, the problem was that the necessary "amount" of care could not be ensured this way:
A would provide 24 hours per day, while B offered 3 hours at best.
Thus, arguments for "integration" frequently appeared even after the new system was enforced.

Cost Support System
In 2003, the so-called "Cost Support System" was adopted as the system of support for people with disabilities.
Just before the change, it was announced that an upper limit will be set for the services to be provided.
In January, 2003, a conflict ensued over this "upper limit problem" between the Ministry of Health, Labor and Welfare and people with disabilities.
in the end, the idea to set an upper limit was dropped.
As a consequence of this dispute, the system became widely known.
The system was enforced, and the amount of services obtained through it exceeded (the government's) expectations
the plan to integrate the system for people with disabilities into the elderly care insurance resurfaced.

Services and Supports for Persons with Disabilities Act
In October, 2004 the Ministry of Health, Labor and Welfare announced a new grand design for reform called "On Future Policy regarding Health and Welfare of People with Disabilities".
An insufficient and short-time discussion was held at the Disabled Sectional Meeting of the Social Security Council
the bill of "Services and Supports for Persons with Disabilities Act" was introduced
E The act stipulates that 10% of the service cost, etc. is to be born by the users.
E The class of disability is determined based on the judgment of the examination committee the same committee also decides whether the person in question needs financial assistance.
(The framework is essentially the same as that of the elderly care insurance)
2005, Diet deliberations. Countermovement by organizations of people with disabilities. The bill was passed by the Diet in October, 2005, the system was partially enforced from April 1, 2006, and enforced full-scale from October, 1 of the same year.
The countermovement went on, and lawsuits challenging the Act as unconstitutional were filed all over the country.

Repeal, and subsequent developments
After the general election in July, 2009 there was a change of government (Liberal Democratic Party Coalition Democratic Party Coalition).
In September, 2009 Minister of Health, Labor and Welfare Akira Nagatsuma declared a repeal of the Act
In November, 2009 "Headquarters for Promotion of the Reform of System for People with Disabilities" was established.
In April, 2010, "Sectional Meeting for Integrated Welfare of Headquarters for Promotion of Reform of System for People with Disabilities " was established and its first meeting was held
http://www.mhlw.go.jp/bunya/shougaihoken/sougoufukusi/index.html (Japanese)

So what was it all about?
As was described above :
The system is built and maintained based on the essentially the same amount of about 3000 yen per month (although certain sums are taken from the tax) and it is run within that framework.
People striving to promote welfare services further have also willingly or unwillingly structured their arguments within the framework set by this system.
Since the 1980s, there was a regression of social distribution (both in the area of secured social welfare payment and social service).
In the recent years there was a growing awareness of the resurfacing of the problem of poverty, which resulted in debates over income maintenance policies.
However, the disparity of income has been in its present state for a long time, and had been gradually created in the period of several decades
At present, a revision of both the social security system (including taxation system) and of the welfare system for people with disabilities has started
The people who have until now been in opposition critiquing the policies are now participating in policy making themselves.
But at this point there is no telling what will happen, and we need to be very careful.

Ecf.
TATEIWA Shin'ya 2005 "Need to Change the Services and Supports for Persons with Disabilities Act" Seishin Iryo 39:26-33 republished in How to Survive in the Era of "Services and Supports for Persons with Disabilities Act", OKAZAKI Nobuo, IWAO Shun'ichiro (Ed.) 2006 Hihyosha, pp.43-54
TATEIWA Shin'ya@2010 "The Disabled Movement vs. Ederly Care Insurance: 2000-2003" (Japanese) Shakai Seisaku Kenkyu 10
TATEIWA Shin'ya & KOBAYASHI Hayato (Ed.) 2005 Data related to the Proposal for Services and Supports for Persons with Disabilities Act (Japanese) Future of Distribution and Support Publication Committee, 134p.

4 Criticism and/or a course for solution 1: Income Protection and Social Service are not Separate Issues
  Some would probably point out that although redistribution might be one of the functions of tax, social service is another matter altogether. But that view is highly problematic. And the fact that there is a misunderstanding about this issue is the very context that shaped the recent developments that are described above. I have already stated in several texts that there is absolutely no difference between the two (Tateiwa [2008a], [2008b], etc.). But let me add just a little more in the way of explanation.
  There is a common understanding that poverty is a problem that should be coped with, that the society has no choice but to guarantee the "minimum" for everyone, and that since we cannot take money from people who do not have it - simply because there is nothing to take - the only option is to take from those who do.   
  However, as the argument goes, since medical care and welfare are institutions meant to deal with dangers that can happen to anyone with exactly the same probability, they should be based on a system of equal contributions.
  But there are some things, which an individual needs no matter what - things needed simply to survive. And a part of them is in the realm of medical care, nursing, etc. There are some who incidentally do not need them, but there are some who do. And for those who do, the life they can lead by acquiring this additional part, provided that it is given in a sufficient amount, is either on the same level with those who do not need them or - since, after all, there are limits to what medicine, etc. can offer - is on an even lower level. If the logic of this argument is right, people should be given the amount they need to receive this additional part for the very same reason people should receive certain amount as income protection. Thus, essentially, there can be no reasons for the society not to supply the amount including all the costs that have been incurred or will be incurred to obtain this additional part to those needing it.
  But in reality the two systems are separated. One of the reasons often given is that various systems have developed separately in different forms, but the fact that individual circumstances were in fact different does not exempt those who created those systems from giving reasons for adopting this particular system and not any other. Firstly, the system employed both in medical care and in welfare does not adopt a mechanism, whereby the costs of the services are given directly to the user. Rather, the mechanism of the service itself was created first and the costs are given to the service provider. There are various arguments about whether it is good to continue using this method or to give the costs of the service to users instead, but there is certain justifiability in what the latter say, and, if their idea prevails, the amount paid to ensure survival shall be the same for all.
  Also, although in the case of income protection - in Japan various items of expenditure are added up and the total is given to the user as public assistance - it is supposed to cover all the necessities of life, in the case of social services each grant is limited for one particular purpose. Thus, although the former gives certain freedom to the individual to decide what to use the money for, in the case of the latter there is no such freedom. When one thinks about it, there is a certain truth in the argument that an individual who has received a certain sum for the purpose of medical or nursing services (or this sum was added to the total supplied) should be free to use all (or a part) of it for other purposes, but there is also some justifiability in the argument that users should be supplied with the expenses needed for certain concrete medical or nursing purposes, and each user according to his circumstances should then apply for an increase, if needed. But even in the latter case - and such systems do in fact exist, though they are not widespread - it is possible to supply the same amount to all, with the expenses needed for medical and nursing purposes added to the basic cost of living.
  But in reality they are separated. There are no absolute arguments that would convince us that they need to be separated. But what I would like to stress here is not the problem of payment method per se, but rather the fact that there is no fundamental difference between them. And if we agree about it, then there are no reasons at all to treat the income part (which was left after the two sides of basically the same thing were separated) as a mechanism of "redistribution", while welfare and medical care (which are thus treated differently) are placed into a completely separate framework. Also, the two groups - of those who are different in physical (including mental) abilities and cannot thus earn much in our society's labor market, and of those who need a large amount of money to survive - often overlap. What is necessary is to take a lot from those, who under property regulations of our society acquire a lot from the market, and give from it to those needing it, and that includes the realms of medical care and welfare. And that, essentially, is my view of the matter". (Repairing the Tax pp.100-101)

5 Criticism and/or a course for solution 2: No need to call it a "minimum"

  "One point of view or a way of thinking often held by people who claim that they do not look so different from me is that if everyone needs the minimum living expenses, we should set the taxation system so that people, whose standard of living is not higher than the recognized minimum, do not have to pay taxes, since if they do, their standard of living will get below the recognized minimum.
  This argument is well made. However, if we accept it as right and, for example, set this level as the income requiring public assistance, then it will mean that those exceeding this level will have to pay. An argument against it would be that this standard is barely sufficient, and to take tax from those who exceed it only slightly would be too harsh. Be it as it may, this level will have to be established at a certain point that is not very high.
  The problem has thus to be solved from a different standpoint. And, as was described above [...], even though it would be difficult to establish it concretely, as a basic way of thinking we need to agree that there are no reasons for living standards between people to differ too much. Rather, it would be much better if there is not much difference among people. And the difference of the amount received that is often justified is the difference that is proportionate to the effort made, and it is generally approved of as unavoidable for the reason that it functions to motivate people, appropriately ordaining who engages in what kind of labor.
  As a result, the amount received by those who do not and/or cannot work inevitably becomes the "minimum", but it does not necessarily have to become the minimum that is calculated by adding up the minimum needed for food, medical services and so forth." (pp 100-101, Repairing the Tax)

(2) Regarding the "minimum". There is certain misery in this world and we are to blame for it. This argument is very persuasive. But at the same time it may arouse distrust to those labeled "miserable". There is probably (and hopefully) no such aspect to the phenomena serving as subjects of this book. But elsewhere there are often criticisms that certain arguments overemphasize misery. And those the criticism is directed at are often quite sensitive about it. At the same time, people's lives on the whole are often not actually miserable. Of course, sometimes the whole life is darkened by cold and hunger, but that is not at all common. There is no need to idealize the poor, but it is not at all necessary to paint their whole lives in black.
  And, naturally, it is better to take another standpoint: that it is good when people get what they need, no matter whether they are happy or not. And if they are in fact happy, the strength of appeal their situation has for us, who are usually more ready to sympathize with misery, is somewhat weaker. But if more take this standpoint, there will be less people searching for misery, people acting as though they are miserable, or entertaining suspicions that others merely act as if they are miserable to get our sympathy. And this would essentially be better for all. There is no doubt that we readily respond to misery, and as long as "using" this human trait leads to desirable results, there will inevitably always be people using it and misusing it. But, be it as it may, it would be better, if we understand that it is not really desirable." iPogge, Thomas W.@2008 World Poverty and Human Rights: Cosmopolitan Responsibilities and Reforms, second expanded edition, Cambridge, Polity Press.2010j Translation by ABE Akira, IKEDA Hiroaki, ISHIDA Tomoe, IWAMA Yuki, SAITO Hiroshi, HARA Yusuke, MATOBA Kazuko, and MURAKAMI Shinji under supervision of TATEIWA Shin'ya Japanese Version of World Poverty and Human Rights: Cosmopolitan Responsibilities and Reforms, second expanded edition, (Japanese) Seikatsu Shoin, Postscript by translation supervisor" p.398

6 Criticism and/or a course for solution 3: How to divide our world

  "One way to divide the world is by dividing everything in it by the total number of people. This serves well enough as a basis. But the important point here is not the amount received as such, but rather the standard of living that becomes thus available, and this standard of living shall be roughly the same for all. In other words, the distribution shall be done according the difference of the place people occupy and also the bodily difference between individuals. And in that sense "equality" is not necessarily a very large or pressing demand. However, there are no reasons to deny it. And this method of division should be used as a standard.
  Secondly, the "effort made in labor" shall be rewarded. In that case, the compensation paid in proportion to the labor effort or the income received as a result will be calculated my multiplying the basis by a coefficient . At the same time, we need to recognize the fact that there are various enjoyable aspects to labor, and also many additional gains attached to it, but, in essence, labor is about strenuous effort. And in exchange for that strenuous effort made, we receive rewards proportionate to it.
  Thirdly, the payment has to be differentiated to "motivate" people to engage in labor and creation, and thus another coefficient can also be accepted as unavoidable, though we need to be very attentive to what actual benefits we get from it.
  Therefore, although we started from the idea that everyone should receive the same amount, we have no choice but to add two coefficients to the principle of equality serving as the ultimate basis. Firstly, we add the coefficient (representing the effort made in labor) to the world divided by the number of people according to individual differences of needs - and at this point already there will be people who receive less than if the world were simply divided by number of people - and then, to get people to work and to get the right man in the right place, we adopt the coefficient ."
  And this degree of effort made in labor is to some extend reflected in the differences of pay we expect in the market. If tough and strenuous work as well as work that needs prior time and effort to master were paid the same as other kinds of work, less people would choose it, and as a mechanism to prevent it the former types of work are often valued higher in the market. Thus, we should accept that the difference between the actual price of work in the market and the payment calculated simply as the total divided by the number of people and multiplied by working time, is reflecting the existence of a just reward.
mcn
  And it is not as if nothing can be done except redistribution. The issues of possession of property needed for production, distribution and division of labor shall be described in Chapter 3mcn
  I believe that the above shall serve as the fundamental way of thinking, and we should use it to correct the present system first and then gradually expand it. The above was written primarily to show the fundamental direction, to give us one way to assess the present state, and not to be implemented as a concrete system as it is. And what should be done in the present situation simply has to be done". (Basic Income: A Possibility of Minimal Distributing State pp.16-21)

7 Criticism and/or a course for solution 4: Repairing the tax

  "Deputy Prime Minister / Finance Minister (Chairman of the Tax Commission) Naoto Kan has several times since February of this year suggested raising the highest taxation rate of the income tax. Prime Minister Yukio Hatoyama has also made remarks of the same purport.
  Up to that time the discussion has been largely structured as follows: we need the budget to implement our policies; but the budget is insufficient; thus we need to eliminate wasteful spending; but there is a limit to what can be eliminated; well, in that case, there is nothing we can do but to raise the consumption tax. I think that these remarks by Kan and Hatoyama that are clearly a step out of this framework are worth our support.
  One of the most important purposes of taxation is taking from those who acquired a lot in the market and giving from it to those who could not acquire so much but need to. Otherwise, there is no necessity to use the system, whereby government collects taxes by force. In the past twenty years or so, this function has declined in direct tax, and especially in income tax that is imposed progressively. It has often been said that this works better for the economy, also resulting in higher tax revenues. However, tax revenues declined and it has become impossible to implement the necessary policies at a satisfactory level.
  And thus, even before the change of government, it was understood in the Government's Tax System Study Council that the income tax system must be reorganized. However, there were also arguments against it. Not wanting to create enemies, the political parties did not raise the income tax issue during the election campaign. Media coverage has also chiefly focused on reduction of expenditures and the consumption tax. However, according to trial calculations, if the government restores the tax rates to what they were in 1987, the tax revenue from income tax shall increase by 1.5 times.
  Concrete moves have been made starting from the government change in the autumn of last year. There was a meeting of the Advisory Body to the Prime Minister in October, and the outline for tax reform was announced in December. The lineup of the experts participating in the Tax Commission including its chairman is largely made up of people who have taken a strong stand insisting on attaching more importance to the role of the income tax. The direction of the reform is thus very clear. However, there will be dissent too. There will be people saying that when the progressive aspect is stressed in the taxation system, high income brackets will stop working, that people will start to escape abroad, and that the economic situation in the country will aggravate. Although these arguments are not groundless, we should not accept them at their face value.
  There are both theoretical and evidential objections to the concerns regarding loss of incentive to work. One is that many people would actually take their work more seriously, if the gap is not too wide.
  On the other hand, the possibility of people escaping taxes abroad in fact should be taken into consideration. However, the plan as it is is merely to restore the tax rates to what they were not so long ago, so the possibility that the extent of the escape to other countries shall be such as to reduce the total amount of tax revenue is remote. Moreover, the stability of taxation system is also an international problem, systems curtailing tax evasion have already been effective for a long time, and (although it may not be sufficient) there is an international system of cooperation / collaboration regarding international tax evasion schemes.
  The choice that has to be made by the government is essentially what kind of society we want to create. It is whether we should advance towards fairness and equality, or not. The problem should be easier to understand if we clarify the axis of confrontation. If there really is a shortage in financial resources, we shall have to bear whatever we have to bear. But there simply can be no shortage. I would like to envisage the best way for the society of tomorrow to exist, based on this simple but sound basic understanding. And the reform of taxation system is one important part of the whole. " (Asahi Shimbun 2010-5-31, Morning Issue, "My Point of View")

8 Criticism and/or a course for solution 4: The "Standard" of Social Service

  "There probably are not many people who oppose the idea of supplying the resource to those lacking it as a whole. The question is the extent of such supply. Those who have demanded the supply were asking to be given the "regular" amount, to be given "what everybody else has". They argued that they should be given the extra they need when trying to do just what the others around them do. So what, in this case, is it that "everybody else has"?
  Let us again look into the situation described above. There definitely were limits there. These limits are already set by standards, which are already enforced in a very real way in reality, but I (we) have demanded these standards to be raised. And individuals should decide for what they use the resource within the limits of the total amount. Our society is not set up so that anyone can do anything he wants to do as many times as he wants to. It is thus left to individuals to decide how they want to use the resource available to them in total, decide whether they want to use a large part of it for something and not something else. And it is considered to be just. For example, one cannot go traveling abroad very often. There is a certain limit here.
  And our problem should essentially be treated in the same terms. Generally individuals are free to use the total amount as they please. It is left to them to decide what they spend it on. Within the limits imposed by the total amount received, some go traveling abroad twice a year, some go just once, and some do not go at all. Let us allow the same here. In that case, we should give those who go twice the amount they need for two times, and those who go only once the amount needed for one time.
  Naturally, we do not necessarily need to pay the amount directly to the individual. For example, we impose a duty on the airlines to accommodate people using wheelchairs or respirators and have the companies bear the expenses. If this duty is imposed on all the companies, it will make no differences in terms of competitive power. And this way, in the long run, it is the users in total who pay the expenses according to what services they use. In yet other cases, the environment may be created using tax revenues. On the other hand, sometimes it may be more appropriate to give the resource to the individuals. For example, if an individual needs assistance, there is a payment according to the amount of assistance used.
  This way, in our present society, there are times when some need to spend more than others to achieve the same, and there is a need to supply the additional amount thus needed. This way, they can get the same result (or, rather, the means to get the same result) as those who do not need these additional expenses. They do not get more done for them than what is done and allowed for others. And isn't it exactly what we need? If it is, shouldn't we provide the extra expenses some people need - in the society that is made so as to suit the majority and nobody else - in order to do ordinary things accessible to other people, who receive income on the level that has been set as preferable?" ("How to Get Along with the Differences (2)" Gendai Shiso 2010-4)

Translation by OKAMOTO Yura
Proofread by KATAOKA Minoru

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