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2008年5月18日 (日)

スラチャイと英語を勉強しましょう!

05/17/2008

EDITORIAL: Health care for the aged

高齢者医療―筋の通った見直しを

The government and the ruling coalition are finally beginning to consider specific ideas on how to reform the hugely unpopular new health care insurance program for people aged 75 or older.

 75歳以上を対象とする後期高齢者医療制度をどのように見直すか。政府・与党の検討作業がようやく具体的になってきた。

hugely=大いに)

As part of efforts to develop a more effective program, the Ministry of Health, Labor and Welfare recently organized a meeting of officials involved in the daily operation of the system across the nation to hear their accounts of the type of complaints they receive. The idea was to give the ministry a better handle on ways to improve the program. These officials are bearing the brunt of discontent among senior citizens about the system, which was introduced in April.

In spontaneous outbursts of anger and frustration, many participants in the meeting accused the health ministry of starting the program without doing the necessary legwork first.

 その一環で、厚生労働省が全国の実務担当者を集め、どんな苦情が寄せられているのか、制度のどこに問題があるのかを聞いた。現場でお年寄りから直接、不満の声をぶつけられている人たちだ。

account=談話、記事、報告)(brunt=主力、ほこ先)(spontaneous=自然発生的な)(legwork=足で行う取材調査、探訪)

"We have been unable to provide complete explanations about the system (to the aged) because vital information about the details has been so slow in coming to us," one participant fumed. "Frequent changes, such as a temporary freeze on premium payments (for some people) and the change of the name of the program, have created confusion," said another.

「説明しようにも、制度の詳しい中身を知らせてくるのが遅すぎて対応できない」

 「負担を凍結したり、名前を変えたり、くるくる変わって混乱している」

fume=腹を立てる、怒る、いきまく)(confusion=混乱)

The barrage of criticism directed at the health ministry at the meeting underscored its ignorance of the realities of health care for the aged while planning and implementing radical changes to the system.

 出席者たちからは、準備不足のまま見切り発車した厚労省への怒りの声が噴出した。制度を抜本的に変えようというのに、いかに現場の事情に疎かったか、改めてあきれさせられる。

(Barrage=連発)(underscore=アンダーラインを弾く、強める)(radical=基本的な、根本的な、基盤をなす)

                                              

The key proposals being considered by the government and the ruling camp to improve the system include: reducing the premiums paid by low-income beneficiaries; taking a new look at the deduction of premiums from pension benefits; reviving municipal subsidies for thorough physical examinations.

 政府や与党の検討のなかで、焦点となっているのは、低所得者の保険料負担の軽減▽年金からの保険料天引きの見直し▽自治体が独自に実施していた人間ドックなどの助成事業の復活――などだ。

thorough=完璧な、徹底的な)(thorough physical examinations=人間ドック)

A particularly serious problem concerns the increase in premium payments by some low-income beneficiaries. Much of this problem can be traced to the transfer of the system's operations from the hands of municipalities to new prefecture-based regional units. This administrative change resulted in the removal of relief measures for low-income elderly people that were financed independently by cities, towns and villages.

 なかでも、所得の低い層で保険料負担の増えるケースが出てきたのは深刻な問題だ。保険制度の運営を都道府県単位の広域連合という新組織にしたため、これまで市区町村が独自に税金を投入して講じていた軽減措置がなくなった影響が大きい。

beneficiary=受益者、利益を受ける人、受取人、受給者)

The new system has even introduced a penalty for continued arrears in premium payments: invalidation of the health insurance card. That makes it all the more urgent to change the system in this regard.

 新制度では、保険料の未納が続くと保険証が取り上げられる罰則まで導入された。それを考えると、この点での手直しは急がねばならない。

(Arrear=遅れ、遅延、滞り)

The fuzzy character of the new operators of the program, which are neither municipal nor prefectural governments, is also creating problems. Most of the insured don't know where they should go when they want information, for instance. The new entities may be less conscious of their responsibility for the smooth operation of the system than they should be. These new organizations and the efforts to make them known to the public may need to be reconfigured.

 市でもなければ県でもない広域連合というのも分かりにくい。窓口がどこなのか利用者には戸惑いがあるし、当事者意識に欠ける面はないか。組織のあり方や周知を考える必要がある。

fuzzy=不明瞭な、ぼやけた)(insured=被保険者)(entity=法人、実体)(reconfigure=形を変える、変化させる)

Saying all this, however, doesn't mean supporting the growing chorus of calls for simply reducing the financial burden or postponing its imposition. These calls are coming from lawmakers who have been surprised by the strong public backlash against the new system.

 その一方で、この制度に対する反発のあまりの強さから、とにかく負担を減らすか、先送りしさえすればいいという考え方には賛成できない。

Saying all this=前述のこれらすべての発言は)(imposition=押し付け、賦課)(backlash=反発、反動)

One typical proposal from this camp would extend the current freeze on premium payments by senior citizens who are dependents of corporate employees.

サラリーマンの扶養家族になっているお年寄りの保険料凍結を延長しようという案は、その最たるものだ。

That would be unfair to the dependents of self-employed workers who have long been paying premiums for their national health insurance coverage. If this inequity is maintained, this health care reform cannot achieve one of its fundamental objectives.

 自営業の家族に扶養されている人は、これまでも国民健康保険の保険料を負担してきた。この不公平を再び認めるというのでは、新制度が目指した理念の根幹がゆがんでしまう。

It is vital to make a sharp distinction between the unpopular but necessary components of the reform that the government must persuade the public to accept and the system's outright shortcomings that must be fixed as quickly as possible.

 不評であっても政府が説得を尽くすべき問題と、早く手直しすべき問題とを峻別(しゅんべつ)すべきだ。

outright=明快な、完全な)(shortcomings=短所、欠点、不十分な点)

The opposition camp plans to submit a bill to the Diet shortly that would scrap the system. But what would happen after it is done away with? The opposition bloc wouldn't be able to win public support for a simple return to the old health care system for elderly people, which was harshly criticized. It must be remembered that all the opposition parties except for the Japanese Communist Party agreed with the ruling coalition to create a new health insurance scheme for the aged.

 野党は近く、新制度の廃止法案を国会に提出するという。しかし、廃止した後にどうするのか。批判の強かった以前の老人保健制度に戻るだけというのでは、国民的な納得は得られまい。新制度の創設は、共産党を除く与野党の合意事項だったことを忘れてもらっては困る。

harshly=厳しい、過酷な)(the ruling coalition=与野党連合)

We hope the ruling and opposition camps will engage in constructive, forward-looking debate on how to make the system better.

 与野党の建設的な議論を期待する。

--The Asahi Shimbun, May 16(IHT/Asahi: May 17,2008)

朝日新聞 5月16日号 (英語版 2008年5月17日発行)

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