Editorial: Facing consequences of putting off additional senior financial burden

Warmer weather may have arrived, but there isn't much of a spring in the steps of Japan's senior citizens. Copayments for medical fees among those aged 70 to 74 has been raised from 10 percent to 20 percent, and starting this month pension payouts will go down 0.7 percent to adjust for the past decline in consumer prices. Some legislators argue that such changes make the consumption tax hike pointless, but we must take heed of what brought us here. The shift is a part of social security reforms that took political parties years of deliberation. Making political capital of it will only generate a renewed stalemate.

A 20-percent copay for those aged 70 to 74 was decided in health care reforms under the administration of Prime Minister Junichi Koizumi. It had been set for implementation in fiscal 2008 but was postponed after the Liberal Democratic Party's overwhelming defeat in the 2007 House of Councillors election, and was also put off by the following Democratic Party of Japan (DPJ) administrations. As a result, the government has been forced to set aside a supplementary budget of 200 billion yen every year to secure funds.

The public pension system is subject to revision every fiscal year based on fluctuations in consumer prices and wages. But because pension payouts stayed fixed in the past when consumer prices fell, they are currently 1.5 percent higher than what they should be. In light of this situation, a legal amendment was made during the DPJ administration to redress the extraordinary payout levels in stages.

Past administrations who feared criticism failed to implement measures that would increase the burden on seniors, but we can no longer continue to put them off. Members of the baby boomer generation are already receiving pensions, and will start turning 70 in another three years. While medical costs vary from individual to individual, on average they tend to increase significantly at age 75. In other words, the reforms must be implemented before a large population reaches that age.

Since the 1960s when universal health care and pension coverage began in Japan, the average life expectancy of both men and women has climbed by around 10 years, and the age until which people stay healthy has also risen. Considering the sharp decline in the number of young people who support society, it is only natural to change the health care and pension systems to account for changes in how long people stay healthy. Additionally, economic disparities are especially pronounced among seniors. Many are on welfare, but unless those who are well off take on their share of the burden, society as a framework cannot be sustained. We must come up with a system of burdens, including taxes, that a wide range of generations can accept as reasonable.

Another point to consider is our attitude toward medicine. While alleviating dementia's peripheral symptoms, such as hallucinations and depression, is possible, contemporary medicine does not have a cure for dementia itself. Nursing care and supporting the day-to-day lives of those with dementia is not a medical issue. And yet, because of a lack of community support for people with dementia, many are hospitalized.

What is often necessary for seniors with multiple chronic conditions -- not limited to dementia -- is not so much medical care, but nursing care. Perhaps we've been too dependent on medicine. The copay hike gives us a good opportunity to reflect on that.

April 07, 2014(Mainichi Japan)

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