敬老の日 安心できる超高齢社会に

The Yomiuri Shimbun(Sep. 21, 2009)
Assuage people's fears over hyper-aging society
敬老の日　安心できる超高齢社会に（9月21日付・読売社説）

Respect-for-the-Aged Day falls Monday, a few days after the administration of Prime Minister Yukio Hatoyama took office.
　鳩山政権が発足して間もないきょう、敬老の日を迎えた。

This nation is aging faster than any other in the world.
日本の高齢化は、世界に類を見ないスピードで進行している。

In 1966, when Respect-for-the-Aged Day became a national holiday, the average life span of Japanese males was 68 and that of females 73. Currently, men live an average of 79 years and women 86 years, and life spans are bound to continue to lengthen. We live in an era in which about 1.3 million, or one in 100, of the nation's population are aged 90 or older.
　敬老の日が祝日となった１９６６年、日本人の平均寿命は男が６８歳、女は７３歳だった。それが今では男７９歳、女８６歳となり、年々延び続けている。１００人に１人、約１３０万人が９０歳以上という時代である。

Of course, graying itself is not something to feel anxious about. It is gratifying that many people live long.
　無論、高齢化それ自体は憂うべきものではない。多くの人が長寿であるのは喜ばしいことだ。

Nevertheless, our hyper-aging society tends to be described in gloomy terms, no doubt due to concern that the social security system is unsustainable.
　にもかかわらず、超高齢社会が暗いイメージで語られがちなのはなぜか。社会保障制度が十分に対応できていないからだろう。

To dispel such anxieties, the new administration faces a mountain of tasks related to reconstructing and maintaining the pension system and medical and nursing care services, all of which are vital to support elderly people's lives.
　新政権はこの不安を払拭(ふっしょく)するために、老後の生活を支える年金、医療、介護をどう再構築し、維持していくのか。山積する課題に取り組まねばならない。

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DPJ must make right decision

The first daunting challenge facing the new administration is overhauling the medical insurance system for elderly people.
　まず、直面する難題は高齢者医療である。

At a press conference he gave after assuming his post, Health, Labor and Welfare Minister Akira Nagatsuma reiterated that the medical insurance system for those aged 75 and older would be abolished. He did not say when the current system would be scrapped. As for a system that would replace the existing one, Nagatsuma said it would be designed to reflect realities. This was a pragmatic choice.
　長妻厚生労働相は就任会見で、改めて「後期高齢者医療制度は廃止する」と表明した。ただし廃止時期には触れず、その後については「現状を把握した上で制度設計する」とした。これは現実的な選択と言えよう。

The medical insurance system for those aged 75 and over was crafted to resolve the severe strain that the health insurance system for elderly people had come under. It clarified the burden that working generations must shoulder to pay the medical expenses of those aged 75 and older. It also removed the disparities in premiums that existed within individual prefectures by setting up prefectural-run insurers.
　後期高齢者医療制度は、老人保健制度の行き詰まりを打開する目的で作られた。７５歳以上の人の医療費を現役世代がどれだけ負担するかを明確にし、県単位の保険者を作って保険料格差を縮めた。

Although it is true that the current system is flawed and was never explained properly, the emotional backlash over its name--its reference to elderly people aged 75 and older as koki koreisha (late-stage elderly people)--and other elements predominated during discussions over the new system, with the result that it was never discussed in a calm manner.
　新制度には様々な欠陥や説明不足もあったが、呼称などに対する感情的反発が先行し、冷静な議論が行われたとは言い難い。

When the DPJ was an opposition party, it was all right to press the government on the system's defects and parrot the slogan "Abolish the new system immediately and reinstate the old medical insurance system for the elderly."
But since it has become the ruling party and taken over the reins of government, it will not be forgiven if it makes a decision that could invite confusion.
　野党なら政策の欠点だけを追及し、「ただちに廃止して老健制度に戻せ」と唱えればよかったが、政府・与党となったからには、いたずらに混乱を招くだけの選択は許されまい。

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Have sales tax fund welfare

Weighing up the merits and demerits of the medical insurance system for those aged 75 and older and then reconstructing it would not mean breaking the DPJ's election campaign pledge to abolish the existing system.
　後期高齢者医療制度の利点と欠点を適切に評価し、発展的に再構築することは、「現制度を廃止する」との公約に反しない。
We hope the DPJ formulates a blueprint for the medical insurance system for the elderly calmly and constructively.
冷静かつ建設的に、高齢者医療の将来像を練ってもらいたい。

In doing so, if increases in health insurance premiums and over-the-counter payments by patients are seen to have reached their limit, there is no option but to increase the injection of public money. That is true not only in the case of medical services, but also for pension and nursing care insurance systems.
　その場合、保険料や窓口負担が限界と見るならば、公費の投入を増やすしかない。医療に限らず、年金も介護保険も同様だ。

But can the DPJ fund measures for elderly people without increasing taxes at a time when securing financial resources for other new policies, such as the monthly child-rearing allowance, is in question?
　だが、子ども手当など他の新規施策だけでも財源確保に疑問符がつく中で、増税なしに高齢者施策の財源は見いだせるだろうか。

If the consumption tax is transformed into a social security tax so that financial resources can be properly secured, the government will have more choices in formulating policies for this hyper-aging society. The new administration should make a decision on the medical insurance system for elderly people without delay.
　消費税を社会保障税とし、きちんと財源を確保すれば、超高齢時代の施策は選択肢が広がる。新政権は一日も早く決断すべきだ。

(From The Yomiuri Shimbun, Sept. 21, 2009)
（2009年9月21日01時12分 読売新聞）