The last Diet session approved a series of laws that will be detrimental to people. One of them is enactment to force some of the elderly over 75 years old of age to pay 20% of medical treatment cost, which is currently 10%. The law also allows the government to set up the norm for eligibility by issuing an order without parliamentary debates.
INCREASE PUBLIC BUDGET AND DECREASE PEOPLE’S PAYMENT
Currently approximately 18.15 million people over 75 years old join the medical insurance program, a special plan which covers only those older than 75 years old. They pay 10% of the cost at hospitals after having medical treatment and consultation. As an exception the elderly who have over 3.83 million Yen (per household, including pension income) a year owe 30% (7% of the total of insured, counting 1.3 million) as their income can be reasonably compared with that of the working generation.
The revision made in the last session provides: for a one-member household, if he/she has an income over 2 million Yen a year, and for a man-and-woman household, if they earn 3.2 million Yen, then they will share the 20% payment. Those in this category count 3.7 million people, occupying 20% of all senior citizens over 75 years of age.
Government orders will set minimum basis
According to the revision, the income norm for the 20% payment shall be set up by a government order. That means the government will be able to heighten the minimal income line for the application as it likes without asking for discussions in the Diet.
The Keidanren, the Japan Business Federation, demands the government to have tax-imposed households of elderly people, who count 9.45 million (excluding those 1.3 million who owe 30% of medical cost), pay 20% of the medical service. It is evident that the government and business circle will expand a scope of eligible persons in the absence of parliamentary debates.
From the year 2022 on those who were born between 1947 and 1949, a baby-boom generation, will be over 75 years of age. The government estimates this group of people will bring a rapid surge of medical cost. The administration explains that the elderly whose income is fairly high should owe a rational responsibility so that the working generation may not owe higher insurance premiums. It adds to say that the measure represents a first step to integrating the current social welfare programs to a comprehensive public service plan.
In fact the Appendix of the revised law stipulates: ‘a comprehensive review will be made immediately after implementation of the law in order to reform the current social service programs and to cope with a society of fewer births. Debates on the ‘reform’ stagger due to the pandemic at the moment, but they certainly will be accelerated soon.
In the name of mutual assistance
The administrations have surged the consumption tax rates in the name of mutual assistance, implementing policies that coerce people to pay more. In 2021 the government attributed to mutual assistance the reasons of heavier burden on the elderly. It explains, reportedly, that the working population can have a merit by the revision to save more or less 30 Yen on the monthly basis.
The governments have decreased corporate taxes for Big Business and income taxes of the rich, which, as a consequence, has caused sharper social inequalities. Their tax policy has undermined the basic rule that those who earn more should pay more; it has damaged a function to redistribute incomes and deteriorated public services.
In the past, until the decade of 1980, both of the working population and the elderly over 75 year-old enjoyed free-of-charge medical treatment thanks to the insurance programs. It is at this moment that we should have a social accord on the public role in which people enjoy equal services and the richer pay more tax as a principle.
現行の75歳以上の後期高齢者医療制度に加入する人は約１８１５万人で、原則１割の医療費窓口負担だ。そして、年収が３８３万円以上(世帯、年金含む)の現役並み所得がある人のみが例外として３割負担(全体の７％、１３０万人)となっている。
今回の関連法の成立で、単身では年収２００万円以上、夫婦世帯で３２０万円以上に２割負担の枠を作ったが、約３７０万人が該当する。後期高齢者の約20％になる。
政令で決められる
改定された法律では、２割負担の所得基準は「政令で定める」となっていて、所得基準(範囲)を国会に諮ることなく、政府の判断でどこまでも広げることが可能となっている。
経団連は、75歳以上の課税世帯に属する９４５万人(３割負担、１３０万人を除く)全員を２割負担にするよう求めており、今後、政府・財界が国会審議を経ずに負担対象範囲の拡大に動くのは目に見えている。
政府は今回の改定について、１９４７～49年生まれの団塊の世代が22年から後期高齢者となって医療費が急増することから、それを支える現役世代の保険料負担を抑えるために一定の収入がある高齢者にも応分の負担を求めるとした。そして、全世代型社会保障への転換の一歩と言っている。
事実、改定法付則には「法律の公布後速やかに社会保障制度の改革及び少子化に対処するための施策について、総合的な検討に着手する」と書き込まれている。「改革」論議はコロナ禍で減速しているが、今後加速することは必至だ。
｢支え合い｣名目に
政府は、「支えあい」を名目に消費税増税など国民負担の強化を強行してきた。今回は後期高齢者の医療費負担増の理由づけにしたが、改定による現役世代一人当たり抑制額は月約30円という。
政府はこの間、大企業の法人税や高額所得者の所得税を減税し、格差をより拡大させてきた。税制は応能負担原則を形骸化し、所得再配分機能を喪失させ、公共基盤を劣化させてきた。かつて、１９８０年代まで健保本人の医療費と老人医療費は無料だった。サービスの平等と応能負担を原則とする「公共の役割」について、社会的合意が今こそ求められる。
英訳版↓
No. 1217 Elders Will Owe 20% of Medical Cost
The last Diet session approved a series of laws that will be detrimental to people. One of them is enactment to force some of the elderly over 75 years old of age to pay 20% of medical treatment cost, which is currently 10%. The law also allows the government to set up the norm for eligibility by issuing an order without parliamentary debates.
INCREASE PUBLIC BUDGET AND DECREASE PEOPLE’S PAYMENT
Currently approximately 18.15 million people over 75 years old join the medical insurance program, a special plan which covers only those older than 75 years old. They pay 10% of the cost at hospitals after having medical treatment and consultation. As an exception the elderly who have over 3.83 million Yen (per household, including pension income) a year owe 30% (7% of the total of insured, counting 1.3 million) as their income can be reasonably compared with that of the working generation.
The revision made in the last session provides: for a one-member household, if he/she has an income over 2 million Yen a year, and for a man-and-woman household, if they earn 3.2 million Yen, then they will share the 20% payment. Those in this category count 3.7 million people, occupying 20% of all senior citizens over 75 years of age.
Government orders will set minimum basis
According to the revision, the income norm for the 20% payment shall be set up by a government order. That means the government will be able to heighten the minimal income line for the application as it likes without asking for discussions in the Diet.
The Keidanren, the Japan Business Federation, demands the government to have tax-imposed households of elderly people, who count 9.45 million (excluding those 1.3 million who owe 30% of medical cost), pay 20% of the medical service. It is evident that the government and business circle will expand a scope of eligible persons in the absence of parliamentary debates.
From the year 2022 on those who were born between 1947 and 1949, a baby-boom generation, will be over 75 years of age. The government estimates this group of people will bring a rapid surge of medical cost. The administration explains that the elderly whose income is fairly high should owe a rational responsibility so that the working generation may not owe higher insurance premiums. It adds to say that the measure represents a first step to integrating the current social welfare programs to a comprehensive public service plan.
In fact the Appendix of the revised law stipulates: ‘a comprehensive review will be made immediately after implementation of the law in order to reform the current social service programs and to cope with a society of fewer births. Debates on the ‘reform’ stagger due to the pandemic at the moment, but they certainly will be accelerated soon.
In the name of mutual assistance
The administrations have surged the consumption tax rates in the name of mutual assistance, implementing policies that coerce people to pay more. In 2021 the government attributed to mutual assistance the reasons of heavier burden on the elderly. It explains, reportedly, that the working population can have a merit by the revision to save more or less 30 Yen on the monthly basis.
The governments have decreased corporate taxes for Big Business and income taxes of the rich, which, as a consequence, has caused sharper social inequalities. Their tax policy has undermined the basic rule that those who earn more should pay more; it has damaged a function to redistribute incomes and deteriorated public services.
In the past, until the decade of 1980, both of the working population and the elderly over 75 year-old enjoyed free-of-charge medical treatment thanks to the insurance programs. It is at this moment that we should have a social accord on the public role in which people enjoy equal services and the richer pay more tax as a principle.
July 13, 2021