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2008年10月25日 (土)


2008/10/25 --The Asahi Shimbun, Oct. 24(IHT/Asahi: October 25,2008)

EDITORIAL: Social security expenses



The national council on social security, an advisory panel to the prime minister, on Thursday publicized its forecast of medical and nursing care expenses in 2025 and estimates of revenues needed to cover them.


The report calls for a drastic increase in the number of hospital doctors and staff, the doubling of nursing facilities and group homes from the current level and improvements in the quality of medical and nursing care. As the aging of society advances, more money will be needed for health care.

The report estimates that an additional 14 trillion yen in public funds would be needed to cover such expenses. If the increased cost is to be covered by revenues from the consumption tax, a rate hike by 4 percentage points is needed, according to the report.


Traditionally, estimates of medical expenses tended to focus mainly on future prospects based on past trends and demographic changes, as well as how to curb expected growth in the expenses.


This time, the panel turned its attention to how medical and nursing care systems should be and what services will be needed. We welcome this major shift from past policies that focused only on curbing expenses.


Of course, the recently released estimates also took into account measures to check medical expenses. In exchange for reinforcing medical personnel at hospitals and strengthening rehabilitation functions, the report calls for halving hospital stays, which now stand at an average of 20 days.

The proposal is based on the assumption that the trend to shift emphasis from medicine to nursing and from care at facilities to care at home will be further promoted.


Even with such restrictive measures, the council estimates that total medical and nursing care expenses would go up to 91 trillion to 94 trillion yen in 2025, requiring public funds to cover 30 trillion yen of the total.


The latest estimates do not include the proposal by the government and ruling parties to re-examine the newly introduced health-care insurance system designed for people 75 or older. Depending on the content of the revision, it is possible that more public funds will be needed.


According to the estimates, an additional 12 trillion yen would be needed in health and nursing insurance premiums. Although it is unclear which age groups would be required to shoulder how much, there are limits on hiking insurance premiums. Again, an injection of public funds may be needed to curb the increase in premiums.


Given these factors, we cannot help but worry whether a 4-percentage-point increase in the consumption tax rate can really meet swelling medical and nursing expenses. But the biggest problem is the report offers no clues on how to come up with the money.



Prime Minister Taro Aso appointed council chairman Hiroshi Yoshikawa, a University of Tokyo economics professor at the Graduate School of Economics, as a private-sector member of another key panel, the Council on Economic and Fiscal Policy.

By doing so, Aso aims to advance the argument for social security issues and tax and fiscal reforms as one. Meanwhile, however, he has also indicated he would not raise the consumption tax rate for three years based on his belief that it would take three years for the nation's economy to fully recover.


We understand how difficult it is to seek public approval for requiring citizens to immediately shoulder a heavier burden under the current economic situation. But avoiding the issue does not solve the problem.

The government should at least show a future vision of the social security system and present a concrete plan on how to financially achieve the stated goal. The same goes for opposition Minshuto (Democratic Party of Japan).


In advancing the policies, the government must also not forget to deal with the shortage of doctors and nursing care providers, which is already starting to affect everyday life. If it only speaks about future visions without properly dealing with the problem, it lacks persuasiveness.



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