1. Introduction
Comparative study and case studies of other countries are sometimes done to define a certain cause-and-effect relationship, such as, for example, reason behind the development of a welfare state or retreat of it. However, the foremost important reason of such studies would be to find a lesson from other countries' cases. Korea indeed looked into the various experiences that other countries went through in providing welfare services in order to learn and find what welfare policies and strategies were necessary to the nation.
However, in the process, polices of other countries were indiscreetly introduced to Korea, giving rise to various adverse side effects. So in reviewing overseas cases, what is more important than anything is to check the conditions and foundation that were laid in the country for such policy to be realized, how the policy is evaluated for its effect and what task remains after the policy and then assess whether the policy could be applied to Korea.
In the symposium, various cases of other countries are being introduced, and I would like to look into Japan's welfare delivery system in this discussion. Especially, I would like to focus on Japan's Community General Support Center and other elements in the delivery system, from which Korea can learn a lesson for its welfare delivery system development and check whether such elements can be applied to the nation.
2. Community General Support Center
In Japan, in the process of amending Long-Term Care Insurance Law, Community General Support Center was set up in each town. In Community General Support Center, support for the elderly with mild illness whose conditions are recognized not so serious is also provided and other various services are offered such as Protection of the Rights of the Elderly including comprehensive counseling service and abuse prevention. (For such services, the Center has built a system for information provision.) The Community General Support Center also does Case Management on preventing the needs for care as well as preventive care and offers Case Management Support.
Japan's Community General Support Center gives an important lesson to Korea.
First, network building at each level of the region. To ensure various resources are closely linked for the elderly service, Community General Support Center is supported by Comprehensive Care Council at town level, Municipality Care Council and prefectural government network. So with Community General Support Center as a base point, a strong network is formed at each level, ensuring a variety of resources would be tightly linked in the region.
Second, in the Community General Support Center, nurses and doctors work together with social workers, offering well-connected health and welfare services required by the elderly. Since most of those who need welfare service also have medical service needs, linking welfare service and medical service should be seriously considered in building a welfare delivery system in Korea.
However, it is necessary to check whether it is better or worse to build welfare delivery system by each target group.
In Japan, since Community General Support Center was set up in implementing Long-Term Insurance Care, the
center only focuses on the elderly. When welfare delivery system is separately operated for each target group, it is easier to offer more specialized service with expertise and meet certain needs that the target group specifically has.
However, aside rom the elderly, people with disabilities, children and women are excluded from the Community General Support Center, and subsequently it necessitates other welfare delivery systems. In addition, given the fact that the needs of the elderly who are exposed to risks are various and often linked to other family members as well, it is required to review the delivery system that is currently limited to the elderly.
In addition, the performance of the Community General Support Center varies by each prefectural government and municipality. In fact, many came up with different evaluation on the network building and the performance of workforce as well. So I would like to listen various opinions within the Japanese society on how they evaluate the Community General Support Center.
3. Social Insurance and Social Welfare Service
One-stop service in offering Cash benefits and welfare service to the recipient is necessary. Maybe it is hard to integrate physical or spatial welfare resources, at least for cash benefits and welfare service, one-stop service is a better way to guarantee easy access, comprehensiveness and efficiency.
Japan's Community General Support Center is a good example to comprehensively approach to the insurance and welfare service at the same time. In Japan, municipalities do the management of the insured, present care plan for the insured and provide welfare service accordingly. Subsequently, it is possible to coordinate insurance and welfare service at municipality level. Such mechanism is possible in Japan as the nation runs insurance in multiple-payer system, allowing municipalities play an central role in running the insurance.
Meanwhile, Korea has a single-payer system for its social insurance, in which the central government manages social insurance and National InsuranceCooperation does the management of the insured as well as offers cash benefits. Long-Term Care Insurance in Korea provides services similar with Japan's, however, management of service providers & the recipients is done not by cities, counties and districts but by National Health Insurance Cooperation.
Aside from social insurance, other social welfare service and cash benefits (that is not from social insurance) are provided by sub-district offices. So social insurance and welfare delivery system is separated from each other in Korea, not only causing inconvenience to the recipients but also making it impossible to coordinate welfare resources at municipality level. In fact, it is very far and between for welfare resources of Insurance Cooperation and sub-district office are linked to each other.
Korea's single-payer social insurance system is constructive in that it eliminatesthe possibility of causing unfairness among different payers and good to build economy of scale for risk diversification. However, unlike in Japan, it is inevitable in current delivery system of Korea for central government's social insurance and welfare service of sub-district office to be kept separated.
Therefore, as the delivery systems of social insurance and social service are kept separated in the current structure, it is necessary to build a system to enable municipality or local community would coordinate different welfare resources and recipients have one-stop welfare service. I think it is necessary toconsider sharing insurance-related information, holding case study meeting at and dispatching workforce to the base center such as the Gyeonggi Muhandolbom Center and Network Team.
4. Participation of residents
As the speaker said, in building recipient-oriented welfare delivery system, participation of residents in the community is essential. However, Participation of the residents is hard to be achieved in a short period of time.
So, I would like to listen more about what kinds of strategies and measures are being employed in Japan to encourage the participation of the residents.
5. Symbiotic Care
What the speaker meant by Symbiotic Care, seems to me, is forming a new community within the local community.
Please explain more specifically.
약력 | Biography
■주 요 학 력
2003. 3. ~ 2010. 2. 이화여자대학교, 사회복지학 석사(사회복지학 전공, MSW) 1989. 8. ~ 1994. 8. Purdue University, 철학 박사(사회학 전공)
1987. 5. ~ 1992. 5. University of Akron, 문학 석사(사회학 전공) 1981. 3. ~ 1983. 2. 이화여자대학교, 문학 석사(사회학 전공) 1977. 3. ~ 1981. 2. 이화여자대학교, 학사(사회학 전공)
■주 요 경 력
2008.11. ～ 2010.8 한국보건사회연구원 복지서비스연구실장 2009. 8. ～ 2009. 12 지역아동센터 평가운영지원단 위원 2008. 8. ～ 2008. 12 중앙가정위탁지원센터 평가위원 2007. 3. ～ 2007. 8 국민대학교 행정대학원 강사 2006. 3. ～ 현재 은평구 건강가정지원센터 운영위원 2006.11. ～ 현재 한국보건사회연구원 연구위원(직제변경) 2003. 4. ～ 2006. 10. 한국보건사회연구원 부연구위원 2003. 1. ～ 2004. 12. 서울특별시청 투자심사위원 2003. 3. ～ 2004. 12. 중앙인사위원회 심사평가위원 2001. 3. ～ 2003. 2. 국민대학교 행정대학원 겸임교수 1999. 3. ～ 2002. 12. 서울특별시청 시민평가단 평가위원 1999. 9. ～ 2000. 12. 국민대학교 행정대학원 강사 1999. 3. ～ 1999. 8. 서울시립대학교 강사 1996. 5. ～ 1997. 3. (주)리서치 앤 리서치 연구원 1996. 3. ～ 1997. 2. 인하대학교, 서울여자대학교 강사 1994. 3. ～ 1995. 8. Purdue University 연구원 1989. 8. ～ 1992. 5. Purdue University 학생조교 1987. 5. ～ 1989. 5. University of Akron 연구조교 1984. 8. ～ 1986. 12. 이화여자대학교 강사 1984. 3. ～ 1987. 5. 덕성여자대학교 강사 1982. 3. ～ 1982. 12. 이화여자대학교 학생조교
김미숙
한국보건사회연구원 복지서비스연구실 연구위원
Meesook Kim
Research Fellow at Korea Institute for Health and Social Affair
■수 상 경 력
1992. 6.～1994. 8. 박사학위 논문을 위한 2년간의 연구기금을 받음.
Purdue Research Foundation, Purdue University.
1981. 2. 우수학부논문으로 선정됨. 이화여자대학교
■Education
2003. 3. ~ 2010. 2. Ewha Woman's University, MSW 1989. 8. ~ 1994. 8. Purdue University, Ph.D. (in Sociology) 1987. 5. ~ 1992. 5. University of Akron, MA (in Sociology) 1981. 3. ~ 1983. 2. Ewha Woman's University, MA (in Sociology) 1977. 3. ~ 1981. 2. Ewha Woman's University, BA (in Sociology)
■Work Experience
2008. 8. present Research Fellow at KIHASA 2008.11. 2010.8 Director at KIHASA
2010. 3. 2011. 2 Board Member of IOM MRTC
2009. 8. 2009. 12 Evaluation Board of Community Child Welfare Center 2008. 8. 2008. 12 Evaluation Board of Foster Care Center
2007. 3. 2007. 8 Lecturer at Kookmin University
2006. 3. present Board of Eunpyeoung-Gu Healthy Family Support Center 2006.11. present Research Fellow at KIHASA (Change of title)