Problems and Consequences of "Contract Welfare"

Given that some major problems at Fuji-no-Sato appear to have been caused by well-intentioned but inexperienced management, the residents' reactions may seem somewhat uncompromising, rigid, and unrealistic. A sense of betrayal, disappointment, and distrust of the management prevailed among them. They were highly intellectual people and generally aware of what the management could and could not do in a realistic sense. Why, then, did they continue to make unrealistic demands?

Meanwhile, the management was bewildered that its good intentions could not be seen by the residents. The staff admitted their mistakes and took action to correct them. But the senior staff complained privately that the more they did for the residents, the more strongly they were criticized. The director and others sometimes tried to discredit the residents association and some of its outspoken residents, portraying them as too demanding. Mr. Baba and the staff did not seem to realize that this made further communication with the residents difficult.

During the early years of operation, the relationship between the management and the residents was deadlocked, each side interpreting events so as to reinforce its negative image of the other. For both sides, the issue was one of good faith—of sincerity—unfortunately, something that was nearly impossible to measure. The residents saw their attitude toward the management as one of self-defense, having come to the conclusion that the management was not sincere. The management, too, saw a lack of good faith in the residents' harsh criticisms and demands. In order to understand what sincerity meant for both sides, we must first understand what each expected of the other; these expectations grew partly out of the Japanese meanings of the words "contract," "welfare," and "contract welfare." Clear explication of this linguistic problem will help reveal some of the culturally based problems of retirement communities and other forms of contract welfare in Japan.

Japanese Meanings of "Contract"

"Contract" means something quite different for Japanese and for Americans. Wagatsuma and Rosett (1983:2) summarize this difference as follows: "While in the American mind the function of a contract is to predetermine strife and trouble in the future, pre-define dispute, and enunciate rights, a contract in the Japanese mind is a symbolic expression or reflection of mutual trust that is expected never to break down and that will work favorably for both parties in case of future trouble. . . . [The] 'confer-in-good-faith' and 'harmonious-settlement' clauses reveal the basic nature of the Japanese contract." Thus, for the Japanese, a contract means far more than what is stated on paper. It is a ritual, establishing a new relationship and a mutual commitment to that relationship on the basis of mutual trust. Mutual trust is not possible unless both parties take the relationship seriously—that is, unless they are "sincere." Put another way, the American style of contract may be excessively cut and dried and "cold" for the Japanese because, although it may be based primarily on the mutual trust of two parties, it also takes into account their possible distrust in the future.

The contract offered by Fuji-no-Sato is no exception to the Japanese style. For instance, it has only one short item each on such

crucial issues as the management of the residents' health and their medical care:

Item 8: Health Management

The organization constantly monitors the health condition of the resident and provides professional consultations on health, and professional health checkups.

Item 9: Care

When the resident requires care due to illness, injury, or other reasons, and when the physician determines that care is necessary, the organization provides the necessary care at Fuji-no-Sato.

Although the contract is not specific, "care" in item 9 is taken to refer to both acute and long-term care and "the physician" to mean a physician on contract at Fuji-no-Sato, not other physicians. These items simply state goals and do not anticipate problem situations concerning the health management and medical care of the residents, There is no need for further specification because, like any contract in Japan, the Fuji-no-Sato contract includes the good faith and harmonious settlement clause at the end:

Item 35: Others

For issues not specified in this contract, and for interpretations of each item in this contract, both the organization and the resident, in accordance with relevant laws, will mutually confer and deal in sincerity.

Thus, both parties expect that the definition of health management and medical care, as well as whatever problems may arise in the future, are to be dealt with on an ad hoc basis and with mutual trust and sincerity.

Americans may be surprised that not one of the well-educated residents at Fuji-no-Sato was familiar with the terms of his or her contract. Many did not even bother to look at it. The residents felt there was no need to be familiar with its terms; they assumed they would be able to live at Fuji-no-Sato throughout their lives and would be taken care of in the community when they needed skilled nursing care as long as they were paying the monthly fee. The contract means to them the organization's commitment to these as-

sumptions in exchange for their payment of the entrance fee and the monthly rate.

Japanese Meanings of "Welfare"

On the one hand, welfare for the Japanese still means public support for the needy. On the other hand, it is coming to include public well-being—the welfare of a "welfare state." Both meanings are reflected in social policies, but the term has an underlying cultural dimension that distinguishes the Japanese and Western meanings. The Japanese use the expression fukushi no kokoro , "the welfare spirit," a phrase that denotes an altruistic devotion of welfare workers to their clients. This is a highly emphasized cultural value among the Japanese, particularly when the clients are destitute. For instance, if a welfare worker is a young woman, she is often referred to as an "angel," serving the needy out of true devotion, usually working under inferior conditions and pay. Her self-sacrifice for others has strong cultural support, being one of the core values of the Japanese. If the worker is a middle-aged man, the Japanese expect him to be a highly moral person because they assume that anyone who devotes his life to the well-being of others does so out of desire and must have superior qualities as well.

These images may reflect an earlier reality, but today they are often stereotypes and mythifications. Still, images are important. Because of them, the working conditions of many welfare workers continue to be poor. After all, such outstanding people should be able to endure hardship!

The residents of Fuji-no-Sato like the phrase fukushi no kokoro very much. They perceive themselves as the beneficiaries of the welfare spirit. Fuji-no-Sato is a "welfare community," and the sponsoring corporation has the word "welfare" in its name.

But the builders of Fuji-no-Sato advocate something called "new welfare," which they take to be different from the traditional welfare and which does not entail the "welfare spirit." For the management, the new welfare defines the relationship between the service provider and the recipient in terms of a contract. It is an equal relationship in which the recipient is expected to be an independent individual. In short, a wide gap separates the residents' and the management's understandings of the word "welfare."

Intrinsic Problems of Contract Welfare

The lack of consensus on interpretations of contract welfare was an important reason for the poor relationship between residents and management. This issue is part of a larger cultural and historical problem for Japanese society. Using Western, individualistic suppositions rather than traditional Japanese ones, the management assumed that its relationship with the residents was ultimately determined by the terms of the contract that the residents had freely signed. Residents were taken to be intelligent people who comprehended the nature of their relationship with the management and were independent enough to take responsibility for their part in it. Management's responsibility was taken to be finite and based on reciprocity.

But the management was at first not successful in communicating this new notion, and the traditional meanings continued to dominate the residents' thinking. This communication failure can be seen in the language of the contract used by Fuji-no-Sato. It is a typical Japanese contract that simply states the commitment of the management to certain goals, with the assumption that they and the residents will negotiate, with sincerity and mutual trust, the best possible solutions of unforeseen problems. It can be read in the traditional way, and there is no wording to clarify nontraditional intentions.

The strength of the residents' position vis-à-vis management derived from their straightforward use of the traditional meanings of the terms. They viewed the contract as a symbol of the management's commitment to their comfort, health, and long-term care. They expected that because the management would respond to future problems with sincerity, it could not do anything contrary to their wishes. This expectation was amplified by their view that the contract is not merely a guarantee of good faith, but a welfare contract: namely, a contract that guarantees the "welfare spirit" on the part of the management. In other words, they did not perceive their relationship with the management as an equal one at all, but thought of themselves as the recipients of altruistic services, the traditional dependent position vis-à-vis the service providers. They thereby gained a moral upper hand, emphasizing their weak posi-

tion and mobilizing moral rather than legal pressure. The residents' strength was further consolidated by their strong moral position as old people in Japanese society.

The residents, then, did not need to care too much about the terms of the written contract. Any information about Fuji-no-Sato, even the promotional brochure or a verbal explanation given by some staff member, was taken to be as legitimate as the contract itself, given the traditional "sincerity" interpretation. When they discovered that the management did not adhere to this assumed spirit behind what they had heard or read, the residents felt betrayed and became suspicious of all the management's motives. This suspicion grew through neglect and was seemingly confirmed when the management failed to respond satisfactorily to developing problems. The fatal blow to their trust was the imputed "money-making policy" because money making is exactly the opposite of the welfare spirit.

Once either side is convinced that sincerity has been lost in a relationship, its foundation has disintegrated, and it is extremely difficult to restore good faith. We believe this was the background of the residents' behavior, which had grown wary and demanding even to the point of irrationality.

This dilemma was just as much a hardship for the residents as for the management. The residents sought to exchange money for a kind of traditional, paternalistic goodwill. But can money buy the welfare spirit? Traditionally, devoted service by welfare workers was valued because its recipients were socially disadvantaged people; the welfare spirit was an altruistic spirit, directed toward the needy. The residents of Fuji-no-Sato are neither poor nor socially disadvantaged, but from a better than average social stratum. The question has a definite answer in Japanese culture: Money cannot buy the welfare spirit; it is an ethical value contradictory to the pursuit of money. The residents, who sensed this at some level, therefore felt uneasy in their self-righteous claims. They were not sure to what extent they could legitimately demand self-sacrifice in return for cash.

The very strength of the residents' logic on contract welfare, nonetheless, produced a kind of double-bind. The management felt they could not satisfy demands based on the traditional meanings of "contract" and "welfare" because such demands have no clear

limits and could result in bankruptcy. But their sincerity would always be questioned if they rejected these meanings. As part of their effort to explain their operating policies and restore good relations with the residents, the management proposed the idea that the residents should send a representative to the board of directors during these negotiations. The residents declined the offer.

The difficulty for the management can be seen when one realizes that culturally rooted meanings are very difficult to change and that such changes take a long time. Unless and until a new generally accepted meaning of "contract welfare" emerges, problems like this will persist, and the management of Fuji-no-Sato will continue to bear not only its legal responsibility under the contract, but also its social responsibility as a welfare facility in the traditional sense.