44 EROPA Bulletin
Governance (Policy Issues)...
(From page 43)
residence certificate, he found that reliability has a
negative effect on satisfaction, which runs counter to
the theory. He highlighted the different values that are
central to different concepts: i.e., impartiality in the
quality of government, quality of life in the quality of
governance, and good public service in the quality of
public service. As enhancement of QoG is imperative
for the future shape of government, he stressed the
need to invest more in the investigation of the concept.
Achievements after 20 years of Health Park Scheme
Mr. Tadahiko Fujiwara
is the mayor of
Kawakami village
in Nagano, which is
known for its lettuce
production, for having
the healthiest elderly in
Japan, for having the
lowest medical cost in
Nagano, and for having
the highest subscription rate to insurance in Japan.
Historically, Nagano had not been a suitable place to
growing agriculture due to its topography and climate,
but Kawakami has been able to successfully produce
lettuce and cabbage even in summer. He stated that,
to achieve a higher level of overall satisfaction, there
must be a shift from an agriculture-based to a lifebased community, thus the adoption of a health park
scheme.
The effectiveness of the scheme is a function of
four factors: 1) advanced medical care, 2) natural
environment, 3) human relationship, and 4) integration
of public health, welfare, medical and nursing
services. He then showed how different professionals
integrate and collaborate through a unique daily
health park liaison meeting. The other salient
feature of the scheme is its comprehensive support
on care prevention, which is implemented through
the promotion of care prevention, enhancement of
home-care services for the elderly, and the provision
of nursing-care insurance. After two decades of
continuing efforts, the rate of healthy elderly has
Vol. 34 Nos. 3-4 (July-December 2013)
increased (many people in their 70s are still active
farmers). Similarly, there has been an increase in
the rate of people who spend their last days of life at
home. Moreover, medical costs were reduced, and the
health park can function as an alternative to a regional
core hospital. He concluded by saying that there is no
best way to provide health services to citizens, and
that local governments must continue to innovate in
this area.
Policies for Public Transportation in an Aging
Society: Case Studies of the US Federal Government
and the Commonwealth of Massachusetts
Dr. Hiroka Mita’s study seeks to ascertain factors that
promote public transport policies to respond to local
needs through case studies of public transportation
in the US. The US federal government has allocated
funds to transit systems in states and local areas since
the Intermodal Surface Transportation Efficiency
Act of 1991 (ISTEA) was enacted during the Bush
administration. This policy direction of the federal
government has been largely continued despite
administration change in 2008. Also, states like
Massachusetts have
lessened their roads
Why has the federal
construction budget,
government continually
while increasing
supported the investment
allocations for
in and the rehabilitation
alternative public
of public transportation
transport modes.
in states and local areas?
Why did the ratio of
transit budgets change?
Why has the
federal government
continually supported
the investment in and
the rehabilitation of public transportation in states
and local areas? Why did the ratio of transit budgets
change? Dr. Hiroka Mita showed her hypotheses to
analyze the policy change in public transportation. She
also discussed case studies of the process of ISTEA
ena