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This chapter will review the evaluations of the newly developed elderly care system in Japan, Long Term Care Insurance, and its social implications with the focus on demographic change.

By reviewing literature, this chapter will examine how demographic and social change over the years has impacted the features of caregivers. Then, how this policy change has demedicalized the aging process will be described. Finally, this chapter will evaluate whether this insurance has shifted the responsibility for elderly care from the family to society as the governmental slogan advertised.

The new insurance has offered more options in different services and established a new norm of self-reliance and determination for one’s own aging however it is doubtful if this new insurance has shifted the responsibility from family to society.

Applying the implications of policy reforms for elderly care in Japan to the United States, one can assume the traditional U.S. norms and values can facilitate effective utilization of the elderly care system. However, since each nation faces different problems with its specific condition, continuous studies and observations on the relationship between elderly care, immigration issues, and demographic changes will be necessary in order to offer more specific suggestions for each aging nation.

As Japan’s new insurance scheme for the elderly has been studied by many aging nations, recommendations for more comprehensive plans are suggested including building a community-based support system into the Long Term Care Insurance scheme to prevent social isolation and respond to emergency situations for the elderly.

This chapter discusses two California policies that unintentionally promote development in fire-prone areas. First is the state's Fair Access to Insurance Requirements (FAIR) Plan, a state-regulated statutory insurance industry association that provides basic insurance to property owners who are unable to obtain it in the private market. FAIR Plan was intended to be an insurer of last resort for rare cases when the private sector was unwilling to provide coverage. A functioning insurance market should discourage development in hazardous lands by charging appropriately priced premiums or denying coverage where hazards are extreme. The FAIR Plan short circuits this mechanism and subsidizes development in highly hazardous environments by forcing insurers to provide coverage at a price that is far below what the market would charge. While FAIR Plan was envisioned to fill a need for a small number of homeowners who could not otherwise obtain insurance, instead enrollment in this program has skyrocketed. The second policy relates to how the state maps very high fire hazard severity zones (VHFHSZ), statutory zones designed for designating hazardous lands in urban and suburban jurisdictions with their own fire departments. Numerous legal loopholes have given communities wide leeway to keep land within their boundaries from being designated as VHFHSZ for disclosure and fire zoning purposes, even if those lands are objectively hazardous according to the state's criteria. Of most concern with these loopholes is the fact that California's natural hazard real estate transfer disclosure standard relies on these maps, meaning that homebuyers in communities that use these loopholes may be led into a false sense of security when purchasing a home because the statutory Natural Hazard Disclosure form presented prior to transfer asserts that no known wildfire hazard exists.

The Dim Sum bond market in Hong Kong, which allows China to regulate the amount of offshore yuans that flow back into the mainland, has grown steadily since its inception in 2007 and is expected to surpass in 2013 the threshold level that would attract insurers and long-term issuers to the market. Yet, the market has not matured sufficiently relative to the yuan deposit market in Hong Kong that has grown at a much faster pace on account of trade liberalization and the use of yuans in China’s international trade settlements. Even though Hong Kong has fulfilled its role as an offshore currency center for the yuan, it is being challenged by Taiwan, Singapore, and London in terms of being the premier location for the issuance of yuan-denominated bonds outside of Mainland China.

The City of New York was suddenly and deliberately attacked on September 11, 2001, killing thousands of people and leaving unbelievable destruction. Thirty-eight buildings and structures were destroyed or damaged, including seven buildings in the World Trade Center site completely leveled. Almost five years later, two very large contaminated buildings, Deutsche Bank at 130 Liberty Street and Fiterman Hall of Borough of Manhattan Community College, have yet to be cleaned up and demolished. Some 30 million square feet of commercial space was lost. Transportation was disrupted, including the loss of the World Trade Center PATH station, the 1/9 subway line and portions of Route 9A and Church Street. Cars were not allowed south of Canal Street for a week. For Americans this was a terrorist attack and a crime. It was a time for mourning losses and responding to disaster. There was the shock that something like this could happen. And there was more. The destruction of the WTC also posed competing environmental, economic and social threats.

Non-traditional performance indicators have gained broad acceptance in recent years. We continue this discussion and contribute to the knowledge base by employing trust and commitment as two critical intangibles existing between organizations that directly and indirectly influence performance metrics. Each interorganizational contact creates a transactional history that influences cumulative perceptions of trust, that then guide outcome behavior. Using an interdisciplinary foundation, we test a causal model where formal and informal interorganizational relationship structures impact trust and commitment, which then stimulates performance outcomes. The healthcare industry provides the field context where we empirically test our model. A survey was administered to physician practice professionals to measure the theoretical dimensions of the dyad's relationship structure, including antecedents to the mediating variables, trust and commitment, and the resulting outcome constructs. Results demonstrate that relationship dynamics are vital drivers of tangible outcomes. Trust and commitment emerge as variables to be explicitly managed to improve performance.

Performance measurement has benefited from several management accounting innovations over the past decade. Guiding these advances is the explicit recognition that it is imperative to understand the causal linkage that leads a firm to profitability. In this paper, we contend that the relationship quality experienced between two organizations has a measurable impact on performance. Guided by prior models developed in distribution channel and relationship marketing research (Cannon et al., 2000; Morgan & Hunt, 1994) we build a causal model of relationship quality that identifies key relationship qualities that drive a series of financial and non-financial performance outcomes. Using the healthcare industry to illustrate its applicability, the physician practice – insurance company relationship is described within the context of the model’s constructs and causal linkages. Our model offers managers employing a causal performance measurement system such as, the balanced scorecard (Kaplan & Norton, 1996) or the action-profit-linkage model (Epstein et al., 2000), a formal framework to analyze observed outcome metrics by assessing the underlying dynamics in their third party relationships. Many of these forces have subtle, but tangible impacts on organizational performance. Recognizing them within performance measurement theory adds explanatory power to existing performance measurement systems.

The procedures and rules the insurance industry writes in the polices it sells amount to a form of private legislation enforced by the state. Such authority creates a powerful lever for social change, from easing the diffusion to new technologies to slowing climate change. What maintains a sense of fairness in the way insurance firms shape society is an informal but stable network that interconnects them around the globe. A handful of specialist firms occupy key notes in maintaining this network. While these specialists aggressively compete over market share and profits, they also prioritize long-term relationships with their clients and competitors.