健保財政悪化 医療費負担の世代格差是正を

The Yomiuri Shimbun (Dec. 26, 2012)
Intergenerational fairness in medical expenses needed
健保財政悪化　医療費負担の世代格差是正を（12月25日付・読売社説）

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.
　サラリーマンが加入する健康保険の財政が悪化し、保険料の上昇を招いている。高齢者医療への巨額の支出が原因だ。これ以上重い負担を現役世代に求めるのは避けるべきだ。

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.
　６５歳以上の高齢者の医療費は、高齢者自身の保険料や窓口負担のほか、公費と健保組合などからの拠出金で賄われている。その拠出金が、２００８年にスタートした高齢者医療制度で急増したため、多くの健保は赤字に転落した。

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.
　財政難から、健保は労使で負担する保険料を上げざるを得ない。中小企業の従業員が加入する協会けんぽでは従来の８・２％から１０％に、大企業の健保組合も７％台から平均８・３％に上昇した。

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.
　団塊世代が今年から６５歳にさしかかり、高齢者の医療費は今後さらに増えるだろう。保険料率は際限なく上昇する恐れがある。

===

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.
　企業経営の重荷になる上に、賃金の手取りが減り、景気や消費に悪影響を与えかねない。

To prevent this from happening, we believe it is inevitable to have senior citizens shoulder a more appropriate portion of the burden.
　それを防ぐには、高齢者にも応分の負担を求めざるを得まい。

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.
　７０～７４歳の医療費の窓口負担は法定では２割なのに、１割に抑えられている。７５歳以上を対象にした後期高齢者医療制度の導入に際し、当時の民主党の鳩山幹事長らが「うば捨て山」と酷評し、政争に利用したことの反動である。

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.
　費用の多くを現役世代が賄う制度であり、的外れの批判だったが、福田内閣は高齢者の反発を恐れ、７０～７４歳の負担を７５歳以上並みに抑える特例措置をとった。

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.
　この特例を廃し、本来の２割負担に引き上げるべきだ。１割となっている７５歳以上の窓口負担の引き上げも検討課題になろう。

What is important is to curb the continuing rise in medical spending.
　重要なのは、増え続ける医療費の伸びを抑えることだ。

===

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.
　複数の病気を抱える高齢者は、多くの専門医にかかり、受診や検査、投薬の重複が目立つ。

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.
　各医療機関の患者情報を一元的に管理し、無駄をなくすべきだ。共通番号制度（マイナンバー）の導入を急いでもらいたい。様々な病気を診る「総合医」育成も、重複受診の解消に欠かせない。

Drug costs also should be reduced by using, in principle, cheaper generic drugs.
　価格の安いジェネリック医薬品（後発薬）の使用を原則とし、薬剤費の抑制を図る必要もある。

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.
　政権に復帰する自民、公明両党の公約には「小児医療費の無料化を検討」など医療費増大につながる内容が目についた。これでは制度の維持が困難にならないか。

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.
　高齢者人口の増加で、高齢者医療に公費投入を増やすのは不可避だろう。財源確保のため、消費増税を着実に進めねばならない。

(From The Yomiuri Shimbun, Dec. 25, 2012)
（2012年12月25日01時17分 読売新聞）