Gallery: Disability-Japan 2005-03
The previous shienpi system enabled a great number of people with severe disabilities to live independently for the first time, as well as allowing for the creation of many small centers for independent living (CILs) across Japan. Run by people with disabilities themselves, the CILs managed the attendant care programs for their clients.
Prior to the shienpi system, people with severe disabilities in Japan mostly lived either in institutions or with their families. It was very difficult under the older system (the sochi-seido) to receive attendant care.
I should mention here that the United States does not have adequate long-term attendant care for people with severe disabilities, aside from coverage under Medicaid which has stringent income and asset requirements. The U.S. system is very primitive compared to what is found in Europe.
In many ways, the Japanese shienpi system was one of the leading models for disability care in the world. But it costs to be a leader and the Ministry of Health, Labor, and Welfare was not willing to pay the price.
