The Yomiuri Shimbun (Dec. 26, 2012)
Intergenerational fairness in medical expenses needed
The fiscal conditions of public health insurance programs for corporate employees have worsened, resulting in an increase in insurance premiums. This is attributable to the huge expense in providing medical services for elderly people. The working generation should not have to bear an even heavier burden.
Medical expenses for people aged 65 or older are covered by premiums and medical fees paid by elderly people themselves, as well as contributions from public coffers, health insurance societies and other entities. The contributions rose sharply with the launch of a new health care system for elderly people in 2008, causing many health insurance societies to fall into the red.
Due to this dire financial situation, health insurance societies have no choice but to raise insurance premiums shouldered both by employers and employees. The Japan Health Insurance Association (Kyokai Kempo), to which employees of small and midsize companies belong, has raised the premium rate from 8.2 percent to 10 percent. Health insurance societies of larger companies also raised their rates from a range of between 7 percent and 8 percent to an average 8.3 percent.
Baby boomers began turning 65 this year, and medical expenses for elderly people are expected to grow. There are fears that premium rates will continue to be raised endlessly.
Heavier burden for elderly
This would impose a heavy burden on corporate managements and slash the net wages of employees, with the resulting adverse effects on the nation's economy and consumption.
To prevent this from happening, we believe it is inevitable to have senior citizens shoulder a more appropriate portion of the burden.
Fees paid at medical institutions by patients aged 70 to 74 are set by law at 20 percent of their medical bills, but in reality remain at 10 percent. This is attributable to the government response to harsh criticism from then opposition Democratic Party of Japan Secretary General Yukio Hatoyama and others on the newly introduced health insurance system for those aged 75 or older. The opposition at that time used the new system for their own political benefits, criticizing it as "ubasuteyama," a folklore term meaning abandonment of old people in the mountains.
Such criticism missed the point as the new system was designed to have the working generation bear much of the expense. However, then Prime Minister Yasuo Fukuda's Cabinet, fearing a backlash from elderly people, took special measures to keep the level of the burden on those aged 70 to 74 the same as for those 75 or older.
We suggest the special measures be abolished, so those aged 70 to 74 pay 20 percent of their medical expenses at medical institutions as stipulated by law. Consideration also should be given to raising the current 10 percent of the burden paid by those aged 75 or older at medical institutions.
What is important is to curb the continuing rise in medical spending.
Introduce medical data system
A number of elderly people who suffer from more than one illness visit many medical specialists, resulting in a duplication in consultations, tests and medication in many cases.
We think information on individual patients that is maintained by each medical institution should be collected under a unified management system so overlapping medical services can be eliminated. We also suggest the early introduction of a new personal identification number system, called My Number. It is indispensable to nurture general medical practitioners who can treat a variety of diseases so that duplicating medical examinations can be avoided.
Drug costs also should be reduced by using, in principle, cheaper generic drugs.
The policy pledges of the Liberal Democratic Party and New Komeito, which are set to return to power, included such proposals as making medical treatment for young children free, which would result in further increases in medical spending. We are concerned these measures will make the current health insurance system unsustainable.
Given the graying of society, it is inevitable to increase public spending on medicine for elderly people. To secure fiscal resources, increases in the consumption tax rate must proceed as planned.
(From The Yomiuri Shimbun, Dec. 25, 2012)