Priorities for the Japanese Economy in 2020 (January 2020)

The Ideal Industrial Promotion in a (Super-aged) High-Death-Rate Society

FUJI Kazuhiko
Senior fellow, RIETI

Advent of humanity's first "High-Death-Rate Society"

Japan has long been a super-aging society, but it is now moving to the next stage (Note 1). The advent of the first "high-death-rate society" in the history of mankind, in which long and slow death occurs more often than sudden death, has arrived. In 2018, the number of deaths in Japan was 1.36 million (the number of births was 920,000). Looking at the number of deaths by age, 90% of those who die are elderly. It is predicted that this rate will reach 95% in 30 years. In Japan, people are unaware of this increase in the death rate, as death is considered a taboo topic in society. However, its societal effects are gradually beginning to appear.

The importance of end-of-life care, such as nursing care, is increasing with the advent of a high-death-rate society. However, the value of end-of-life care in the market remains low, as death is considered a taboo topic in postwar Japan. Although the source of growth in developed economies is the advent of new goods and services (innovations) that draw out potential demand, innovation is easier said than done. However, if society's perception of death changes, end-of-life care may become one of Japan's growing industries as we move forward.

A new business involving "deathbed care"

Owing to this problem, in a previous article, the concept of "accepting death," focusing on the activities of "deathbed caregivers" who are creating new value in end-of-life care. The characteristics of the caregiving services promoted by Kumiko Shibata, president of Mitorishikai, which was established in June 2012, center around "making a person's remaining time comfortable and joyful with loving embraces while relatives care for them." This eliminates the need for excessive, lasting feelings of loss due to bereavement (grief management) and presents a positive view of life and death.

It is worth noting that deathbed care is expensive (8,000 yen per hour). While the service is not covered by insurance, a Living Needs clause is available in life insurance policies (if the insured only has less than six months to live, regardless of the cause, most life insurance companies will grant the money stipulated as the insurance amount to be received in the future). President Shibata expects that "the last moments of people who are alone" will be the initial market for this industry. There are 6.8 million single, older-person households in Japan (as of 2018). It is important to cooperate with local governments (such as Yamato City in Kanagawa Prefecture) that are taking measures to address the increasing number of single, older-person households (through measures such as "end-of-life" plans and support).

The number of qualified deathbed caregivers in Japan is close to 900, but Shibata's goal is to "increase this to 30,000 by 2025." If realized, it could be a catalyst for change in the social paradigm (improving the perceived value of death), but to achieve this, the value provided by the service should be enhanced and organizational capabilities should be strengthened.

The effect of reincarnation on the value of care

In order to ensure the effectiveness of care through physical contact, the guidance of a physical contact specialist is required. In determining the value of caregiving services, it is no exaggeration that a thorough knowledge concerning people's outlook on life and death is also an important issue. As Kunio Yanagita once pointed out, the Japanese originally viewed life and death through the concept of reincarnation. A 2008 survey by the NHK and other ISSPs (International Comparative Study Groups) found that [1]42% of the Japanese believe in reincarnation, and [2] those who believe in reincarnation have higher average levels of happiness.

"Children with memories of past lives" are considered to be a strong basis for the belief in reincarnation. Although not well known in Japan, for more than 60 years, the University of Virginia has been conducting research and analysis on "children with memories of past lives" from around the world. Surprisingly, the person remembered from the past life was found to have actually existed in more than 70% of cases (more than 2,600 in total). Whether or not reincarnation is true, it has started to gain ground in the field of medicine as "medicine for the heart and mind." Believing in reincarnation creates a medium- to long-term perspective, bringing meaning to life and peace of mind. Japanese people are said to have a low level of happiness internationally, but if we grasp the concept of reincarnation, happiness may increase even in a high-death-rate society. Shibata is a strong advocate for a new profession known as a "deathbed caregiver." From the perspective of industrial promotion in a high-death-rate society, the author believes it is strategically important to support the establishment of the study of life and death centered on the idea of reincarnation in terms of a political measure.

Birth of motherly capitalism

In Japan, the proportion of healthcare and nursing care workers is only expected to increase, with the potential of changing the way capitalism works. Due to this, the "motherly compassion" which inspires some to take action to help people in need is in greater demand than ever before. The focus of 2020 is on the Tokyo Olympics and Paralympics, but beyond this the next goal may be to take the first step toward achieving a society with an abundance of "good deaths," by incorporating "motherly compassion" into the driving force of capitalism.

January 9, 2020
  1. ^Ministry of Health, Labour and Welfare "Vital Statistics of Japan 2017"

March 16, 2020

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