Facing the severe shortage of day care centers for children, Tokyo Gov. Yuriko Koike has proposed increasing the total budget for child rearing to ¥110 billion. But if the experience in the United States is any guide, the 8,466 children on waiting lists in the capital need more than additional facilities to derive the full benefits.

A survey by the U.S. National Institute of Child Health Development found the majority of operations to be "fair" or "poor." Just 10 percent provided high quality care. Only one-third of children were in settings that met the ratio of one caregiver for every three infants between the ages of 6 months and 18 months.

Equally troubling was that providers in most states needed minimal or no training in safety, health or child development. Low salaries acted as a disincentive in recruiting and retaining those with more education.