SUM M ARY. The implementation o f Japan’s Long-Term Care Insur­ ance Scheme in April 2000 was the culmination of some 30 years of pol­ icy deliberation on aged care. Understanding the policy debate surround­ ing the Long-Term Care Insurance scheme and its financing arrange­ ments requires an appreciation of rapid demographic and social change, especially in family structures and attitudes to caring for aged parents; but the pressures that population aging and economic downturn are plac­ ing on Japan’s pension and health insurance systems also must be recog­ nized. Even more generally, the delicate balance of political interests in Japan’s central governing body, the Diet, has shaped the implementa­ tion of Long-Term Care Insurance as a forerunner to other reforms in

Dr. On-Kwok Lai is Associate Professor in Policy Studies, Kwansei Gakuin Uni­ versity, Japan. He received his Dr.rer.pol in Sociology/Policy from the University of Bremen, funded by the German Academic Exchange Fellowship (DAAD) in 1991. He has taught and conducted comparative research in social and public policy in Germany, Hong Kong, and New Zealand. His research interests are in comparative sociopolitical aspects of public policy, with special reference to health and welfare reform. In Spring 2000, he was visiting scholar at the Social Science Division, Hong Kong University of Science and Technology.