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Editorial: Elections shouldn't hinder Japan's plan to raise medical fees for seniors

The leaders of Japan's ruling Liberal Democratic Party (LDP) and its junior coalition partner Komeito have agreed that those aged 75 or older who live alone and have an annual income of 2 million yen (about $19,200) or more will be subject to higher medical bills when they visit doctors. The new payment bracket will cover some 3.7 million people in the country.

    These people in principle currently shoulder 10% of actual medical costs out of pocket. The Japanese government decided at the end of 2019 to raise this percentage to 20 for those who make a certain level of income or higher, but it had remained undecided as to what income level the out-of-pocket payment would be raised.

    The LDP and Komeito had faced challenges before reaching an agreement, so much so that the government's review panel chaired by Prime Minister Yoshihide Suga postponed its meetings twice.

    In November, the Ministry of Health, Labor and Welfare presented five suggestions regarding the income brackets for those who will be subject to higher medical payments -- from an annual income of at least 1.55 million yen in a single-person household, up to 2.4 million yen or more.

    Komeito had pushed for the proposal covering people who make 2.4 million yen or more annually, which would have the least effect. Prime Minister Suga, on the other hand, reportedly wanted to have people who make 1.7 million yen or more in annual income be subject to higher medical fees. Komeito's choice would cover some 2 million people, while Suga's would affect 5.2 million.

    Initially, the LDP's junior coalition partner even requested that the decision on the income level be shelved until next year on the grounds that coronavirus infections were spreading.

    But what actually affected discussions between the two parties were the elections for the House of Representatives and Tokyo Metropolitan Assembly, both scheduled for 2021. The fact that there are elections next year must have motivated Komeito to hold down the amount that voters would have to shoulder as much as possible.

    It is expected that the timing of raising medical fees, which had been projected to take effect in April 2022, will also be postponed to October that year or later out of consideration for the House of Councillors election slated for the summer of 2022.

    However, Japan cannot avoid challenges over how to maintain financing its health insurance as the population continues to shrink.

    About 90% of medical expenses in Japan, excluding what patients cover out of pocket, for those aged 75 and older are covered by those including younger generations still in the workforce and the national government. By 2022, Japan's baby boomers born anywhere between 1947 and 1949 will start turning 75, which as a result is expected to add more to the country's medical spending. The seniors will have to shoulder their fair share.

    Raising the out-of-pocket medical payment for older residents was decided a year ago. We must point out that discussions on the matter were difficult likely because the ruling parties did not face the issue sincerely.

    It's true that the main source of income for the elderly population is their pensions and how increasing their burden will affect them needs to be considered. In addition, each person is expected to have different circumstances based on the situation of their assets and whether they have support from their family. That said, no concrete arguments were made during the discussions between the LDP and Komeito.

    Politicians are responsible for confronting the need to place a greater burden on people and gaining their understanding over such matters.

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