英字新聞

The Yomiuri Shimbun January 8, 2014
Editorial / Consumption tax hike must support stable social security
社会保障改革　消費増税を制度安定の契機に（1月8日付・読売社説）

　◆医療・介護費の抑制は不可避だ

In April, Japan’s consumption tax rate will be raised from 5 percent to 8 percent. The tax hike is placed as the main pillar of the nation’s integrated reform of the social security and tax systems, and the increase in tax revenues will be used exclusively for social security purposes.
　社会保障と税の一体改革の柱として、４月に消費税率が５％から８％に引き上げられる。増税分は全額、社会保障に充てられる。

We believe this is an opportunity to make 2014 the starting point to achieve the goal of building stable social security systems.
　今年を安定した社会保障制度の実現に向けた出発点としたい。

The rapid graying of society and the decrease in the working population have made our social security systems fragile.
　急速な高齢化と働く世代の減少により、日本の社会保障制度は揺らいでいる。

About a half century ago, about 10 working-age people supported each elderly person through our social security model. Now, just 2.4 working-age people shoulder the cost of supporting one elderly person. The scale of the human pyramid is expected to narrow even further by around 2050—when each elderly person will have to ride on the shoulders of one working-age person.
　約５０年前には、１０人の現役世代が１人の高齢者を支えていた。だが、今は２・４人で１人の「騎馬戦型」だ。２０５０年頃には、現役世代１人が１人の高齢者を支える「肩車型」社会が到来する。

Don’t let our children pay
　◆次代につけを回すな

The nation is highly dependent on debt, chiefly government bonds, to cover the ballooning cost of pensions, medical care and nursing care. This has become the main source of the government’s deteriorating fiscal condition. We should no longer neglect the problem by simply passing down the current burden to future generations.
　増え続ける年金、医療、介護費用の財源は、国債など借金に大きく依存し、国の財政悪化を加速させる主因になっている。将来の世代への負担のつけ回しをこれ以上、放置できない。

The consumption tax hike will enable the government—at least for a while—to finance social security costs such as basic public pensions. It will increase the sustainability of our social security systems, a step toward the goal of achieving the systems’ long-term stability.
　消費増税によって、基礎年金などの財源をひとまず確保できる。社会保障制度の持続可能性が高まることは一歩前進である。

The increase in consumption tax revenues will also be used in building a system in which medical care and nursing care services join hands in supporting the lives of elderly people who choose to continue living at home. The money will also be used to reduce national health insurance premiums.
　増税分は、在宅の高齢者を支える医療と介護の連携体制の構築や、国民健康保険の保険料軽減などにも充てられる。

The government’s social security reform measures will be implemented under the assumption that the consumption tax rate will be further be raised to 10 percent in October 2015. It will be an important task for the government to steadily realize the second hike to solidify our social security systems. To do so, the government needs to carefully scrutinize how the nation’s economy reacts after the April hike.
　一連の改革は、２０１５年１０月に予定される消費税率１０％への引き上げが前提となっている。社会保障制度を強固にするには、景気の動向を見極め、税率８％からの再引き上げを着実に実施することが課題となる。

However, it is impossible to fully cover ballooning social security costs through consumption tax hikes, even after the second hike goes into effect.
　ただ、消費税率を１０％に引き上げても、増大する社会保障費のすべてを賄うことはできない。

To realize the goal of achieving stable social security systems and putting the nation’s finances on a healthy footing, we cannot afford to put off trimming spending in the three fields of medical care, elderly care and pensions.
　安定した社会保障制度を実現し、財政健全化を図るには、医療、介護、年金の給付費抑制は待ったなしである。

The surge in medical care costs in particular is causing a headache. The government has decided to, in effect, decrease medical treatment fees paid from the national health insurance system to medical institutions for fiscal 2014, and we believe this judgment was appropriate.
　特に問題なのは、医療費の急増だ。政府が来年度の診療報酬の改定で実質的な引き下げを決めたのは適切な措置と言える。

It is also essential to improve efficiency and cut waste in medical services.
　医療を効率化し、無駄を省くことも欠かせない。

Currently, many elderly patients who have several diseases receive treatment at multiple medical institutions. As a result, the patients undergo unnecessary medical examinations and are administered drugs they do not need.
　複数の病気を持つ多くの高齢者が、いくつもの医療機関にかかり、検査や投薬を重複して受けている。

Not only is this is a waste of medical resources paid for by the government, but a considerable number of patients end up suffering from side effects of drugs excessively prescribed to them.
医療費の無駄遣いであるばかりでなく、薬の副作用により、かえって体調を悪化させているケースも少なくない。

Health insurance societies and other organizations that provide health insurance services should encourage subscribers not to seek unnecessary medical consultations. The medical expense statements of patients should be thoroughly examined, a possibility since record-keeping has improved through the use of computers.
　健康保険組合などの保険者は、電子化が進むレセプト（診療報酬明細書）の点検を徹底し、患者に重複受診の是正を促すべきだ。

In carrying out this plan, it will be advisable to take advantage of the “my number” system that will go into effect in 2016. The system will enable government offices in charge of three types of administrative duties and services—taxation, social security and disaster response—to manage the personal information of all individuals through 12-digit numbers.
　１６年に創設される共通番号制度（マイナンバー）も活用したい。

After it goes into force, the system will for some time be used to carry out procedures for tax and social security benefit payments. If the scope of its use is expanded to include records of medical services received by individuals, it would do much to prevent them from seeking needless treatment and medication.
当面は納税や社会保障給付の手続きに使われるが、診療情報に利用範囲を拡大すれば、重複受診・投薬の防止に役立とう。

To relax the financial burdens shouldered by corporate and other workers, it also will be inevitable to require well-off elderly people to share burdens commensurate with their financial means in receiving medical services.
　現役世代の負担を軽減するため、経済力のある高齢者に相応の負担を求めることも不可避だ。