The increasing number of ‘trading non-profit organizations (NPOs) _ which means that NPOs rely on much of their resources on sales of services and products and business outsourcing income _ has led to criticism by academics in Japan. Some have criticized the commercialization of NPOs, other authors have claimed that social enterprises in Japan may have reduced their capacity to mobilize volunteers or social capital within civil society. Examining the case of elder care, or the public long-term care insurance system for the elderly in Japan, this chapter aims to identify gaps in behaviour between non-profit and for-profit providers from the perspective of service quality and cream skimming. This chapter also highlights the role of NPOs in the recovery after the Great East Japan Earthquake (the ‘3.11 Quake’) to examine the possibility that NPOs have suffered from a diminished capacity to mobilize volunteers and donations. The reported survey found that non-profit corporations in Japan are not commercialized.