社会保障会議 制度維持に全世代の負担必要

The Yomiuri Shimbun August 8, 2013
All generations must bear costs to maintain social security system
社会保障会議　制度維持に全世代の負担必要（8月7日付・読売社説）

　◆民主の３党協議離脱は無責任だ

How can a sustainable social security system be built? Part of a prescription has been presented to achieve this objective, but there is still much to be done.
　持続可能な社会保障制度をどう築くのか。処方箋の一端は示されたが、課題は山積している。

The government’s National Council on Social Security System Reform compiled a final report and submitted it to Prime Minister Shinzo Abe on Tuesday. The government plans to submit a bill that sets forth a road map for the reform to the Diet during an extraordinary session this autumn.
　政府の社会保障制度改革国民会議が報告書をまとめ、安倍首相に提出した。政府は、改革の工程を定めた法案を秋の臨時国会に提出する。

The council discussed the direction of reform to the nation’s pension, medical care and nursing care systems in time for the planned consumption tax increase.
　国民会議は、消費増税に合わせた年金、医療、介護などの改革の道筋を検討した。

A notable feature of the report is that it calls on higher-earning elderly people to shoulder a greater burden of medical costs and taxes. The report called for a change of the current system in which costs are shouldered based on age to one in which costs will be borne based on financial ability.
　報告書の最大の特徴は、所得の高い高齢者に医療費や税の負担増を求めた点にある。現行の「年齢別の負担」から「能力に応じた負担」へと方向性を転換した。

Support from elderly needed
　◆高齢世代も支え手に

Due to the nation’s low birthrate and rapidly aging population, pension, medical care and nursing care benefits have increased, causing government debt to balloon. It is clear that the principle of the current social security system--according to which the working generation bears the financial burden of supporting the elderly--is no longer feasible.
　急速な少子高齢化で、年金、医療、介護の給付費が増大し、政府の借金は膨らんでいる。現役世代の負担で高齢者を支える現行の社会保障の原則では、もはや制度を維持できないのは明らかだ。

The council naturally recommended that the nation’s social security system be changed to one in which such expenses are shouldered by all generations, including elderly people who can afford it.
　国民会議が、負担を支払い能力のある高齢者を含めた「全世代型」に転換するよう提言したのはやむを得ない。

It is a point of concern, however, whether the government can steadily carry out the reform.
　問題は、政府が着実に改革を実行できるかどうかである。

One problem the government must work on is medical expenses that people aged 70 to 74 pay at hospitals. Medical expenses to be paid by people in this age bracket were set at 20 percent of hospital treatment fees under the Health Insurance Law and other laws revised in 2008. However, the then coalition government of the Liberal Democratic Party and New Komeito kept this figure at 10 percent as a special measure, which is still in effect. As much as 200 billion yen in taxpayer money is spent every year to cover these costs.
　例えば、７０～７４歳の医療費の窓口負担だ。２００８年の健康保険法などの改正で２割と定められたが、当時の自公政権は特例で１割に据え置き、現在も続いている。穴埋めに年間約２０００億円もの税金が投入されている。

It is only natural that the council called for raising this figure to 20 percent as stipulated by law by abolishing the special measure--a prime example of unfairness among generations.
　国民会議が、世代間の不公平の典型と言える特例措置を廃止し、法定の２割に引き上げるよう求めたのは当然である。

The council also called on higher-income earners to shoulder a greater portion of nursing care expenses, which is currently set at a uniform rate of 10 percent. We think the proposed measure is realistic. The government should quickly review this rate of self-contribution.
　現在は一律１割である介護保険の利用者負担について、国民会議が高所得者の負担増を求めたことも現実的な方策と言える。政府は負担割合の検討を急ぐべきだ。

The council proposed transferring the management of the national health insurance program, which is mainly used by self-employed people, from municipal to prefectural governments. It also called for raising contributions by health insurance unions of large companies and mutual aid associations for public servants, so they can be used as a resource to rehabilitate the finances of the national health insurance program.
　自営業者らが加入する国民健康保険の運営主体を、現在の市町村から都道府県に移管することも打ち出した。国保財政の健全化の財源とするため、大企業の健康保険組合や公務員の共済組合の拠出金を増やすことも求めた。

However, many corporate health insurance unions have already fallen into the red due to such contributions. It would defeat the purpose if a sharp increase in their burden resulted in the collapse of these unions. It is necessary to design a national health insurance system that will not cause confusion.
　だが、拠出金によって既に赤字に陥っている健保組合は多い。急激な負担増で破綻を招けば、本末転倒だ。混乱が生じない制度設計が必要である。

Benefits must be curbed

To put this nation’s limited resources to effective use, an increase in social security benefits must be curbed.
　限られた財源を有効活用するには、社会保障給付費の伸びを抑えることも不可避だ。

　◆給付の抑制が急務だ

The ballooning of medical expenses is partly attributable to bills incurred by people who suffer a variety of diseases due to their advanced age and visit more than one medical institution for examinations and treatment, according to observers.
　高齢化で様々な病気を持った患者が、複数の医療機関を重複受診していることが医療費を押し上げている要因の一つとされる。

To prevent this, the council proposed increasing the number of doctors known as general physicians who can diagnose a wide range of illnesses. However, the panel fell short of addressing a key question begged by its proposal--namely, how to train such doctors.
　国民会議はこれを防ぐため、幅広い診療能力を持つ「総合診療医」の普及を提唱した。だが、そうした医師をどう育成するかという肝心な点には言及していない。

Among the issues covered by the council’s report is the starting age for benefit payments under the state-run pension system. However, the report only described the issue as a medium- and long-term task that should be discussed together with what mode of employment could be adopted by elderly people.
　年金の支給開始年齢については、「高齢者の働き方と合わせて議論すべき中長期的課題」とするにとどめた。

It is necessary to push back the starting age for receiving pension payments from the current age of 65, given the higher average life expectancy of Japanese and the deteriorating financial condition of the pension program. The United States and major European countries have already decided to push back their respective pensionable ages to 67 or 68. Japan is aging the fastest among advanced nations in the world. With this in mind, the government should begin considering implementing a similar reform as early as possible.
　平均寿命の延びと年金財政の悪化から、６５歳からさらに引き上げる必要がある。欧米主要国は、既に６７～６８歳への引き上げを決めている。日本は先進国で最も早く高齢化が進んでいるだけに、早期に検討を始めるべきだろう。

The national council also emphasized the need to transform the current social security system into one under which people of all generations would be entitled to benefit. For example, the panel insisted on proactively financing child-rearing support plans and other projects to address various problems arising from the chronically low birthrate.
　国民会議は、社会保障給付の面でも「全世代型」を目指し、子育て支援など少子化対策への積極的な投資が必要と強調した。

Specific measures proposed by the panel include increasing the number of day care centers and improving the quality of their services. The council also suggested setting up centers that offer consultations to pregnant and nursing women.
　具体的には、保育所の拡充に加え、妊産婦に対する相談・支援拠点の設置を掲げている。

This proposal is aimed at extending continuous assistance to such women, not only during their pregnancy but also during child-raising. In promoting this idea, the panel noted the fact that such women begin to worry about how to raise their children and provide other forms of parental care even while pregnant. An important task in this regard is to work out how to ensure such child care support centers help them realize their purposes.
　女性が妊娠時から育児などに不安を持っている点に着目し、子育てまで切れ目なく支援するのが狙いだ。拠点をいかに機能させるかが課題である。

Discussions at the national council coincided with a round of debates among three major parties--the LDP, Komeito and the Democratic Party of Japan--over social security system reform.
　国民会議と並行して、自民、公明、民主の３党は、社会保障改革に関する議論を重ねてきた。

However, the DPJ has decided to pull out of the talks.
　ところが、民主党は、３党協議からの離脱を決めた。

The leading opposition party took this step because of the LDP-Komeito ruling coalition’s refusal to discuss such matters as a DPJ proposal to adopt a minimum guaranteed pension plan. The DPJ also cited the fact that its pension proposal had not been incorporated into the panel’s report.
　民主党が主張する最低保障年金制度の導入などについて、自公両党が議論に応じず、国民会議の報告書にも盛り込まれなかったことを理由に挙げている。

All parties should help out
　◆改革は与野党の責任で

However, it would not be enough to raise the consumption tax rate to 10 percent if the DPJ-proposed minimum guaranteed pension program was translated into reality. The DPJ plan also requires a large tax increase besides the consumption tax hike.
　しかし、民主党が掲げる最低保障年金の実現には、消費税率の１０％への引き上げとは別に、大幅な追加増税が必要となる。

The main opposition party has also insisted on scrapping the health care program for persons aged 75 and over, known as people in the latter stage of advanced age. However, there is little need to abolish the system, given that it has already taken root.
　後期高齢者医療制度の廃止を唱えているが、既に制度は定着している。廃止の必要性は乏しい。

The pension reform plan trumpeted by the DPJ is unrealistic. The party has defended its decision to quit talks with the LDP and Komeito, citing the ruling parties’ refusal to discuss its pension proposal. The DPJ’s stance must be criticized as too self-righteous.
　現実離れした改革案を振りかざし、受け入れられないからといって協議から離脱する。それではあまりに独りよがりだ。

It should be noted that the national council was launched when DPJ senior leader Yoshihiko Noda held the reins of government as prime minister. The opposition party should not shirk its responsibilities.
　そもそも野田政権時代に始まった会議である。民主党は責任を放棄すべきではない。

The ruling and opposition parties should join hands in reforming the social security system--a linchpin of national welfare. Such reform is imperative to ensure that the system is not shaken from its foundations even in the event of a change in government.
　国の根幹である社会保障制度については、政権交代があっても揺るがぬよう、与野党が共に改革に取り組むことが重要である。

(From The Yomiuri Shimbun, Aug. 7, 2013)
（2013年8月7日01時39分  読売新聞）