Debate inevitable over increased burden on beneficiaries

It is important to review the nursing care insurance system so that older people can live with peace of mind even if they need to receive such services.

Debate on the reform of the nursing care insurance system has gotten in full swing at the Social Security Council of the Health, Labor and Welfare Ministry. How to increase the burden on the elderly is the point of contention, and the council is expected to reach a conclusion on the issue by the end of the year.

Due to the graying of the population, the cost of nursing care services has been increasing every year. The figure in fiscal 2021 was about ¥11 trillion, about 2½ times the cost in fiscal 2001.

The elderly population 65 and over will peak around 2040. Accordingly, the number of people needing nursing care is expected to increase. On the other hand, the working generations that support the nursing care insurance system will rapidly shrink.

This harsh reality cannot be ignored. To ensure the stable operation of the system, there is a need to steadily implement reform even though it will inevitably be painful for beneficiaries.

The nursing care insurance system is covered by out-of-pocket expenses paid by service users, premiums paid by people age 40 and older, and public funds.

Currently, the out-of-pocket cost for users is 10% of their own nursing care services in principle, and users above certain income thresholds are required to pay 20% or 30%. For example, single-person households with an annual pension income of ¥2.8 million or more and less than ¥3.4 million, are required to pay 20%.

However, those who bear 20% or more of the costs are less than 10% of all those certified as requiring nursing care. For this reason, the council is considering reviewing the income thresholds to expand the bracket to encompass more people who will have to pay 20% or more.

The nursing care insurance premiums paid by people 40 to 64 are noticeably on the rise. To ease the burden on the working generations, it is inevitable to demand that those receiving nursing care services pay their fair share.

The government should give consideration to the actual situation surrounding the lives of the elderly when setting income standards that would increase the burden.

Social security system reforms in recent years have increased the burden on the elderly. Just in October this year, the out-of-pocket share of medical expenses was raised from 10% to 20% for people 75 and over with incomes above a certain level.

The government aims for nursing care insurance reform to be in effect from fiscal 2024 after taking steps such as revising related laws next year.

Recent price hikes on food and other items have been dealing a blow to the daily lives of the elderly. With regard to the timing of the reform, it is essential to closely determine the economic situation.

When considering the issue of caregiving, it is also important to keep in mind the need for efforts to minimize the number of people in need of nursing care.

It is important to not only create an environment in which motivated senior citizens can work, but also to actively provide opportunities for them to exercise and extend their healthy life expectancies.

(From The Yomiuri Shimbun, Nov. 10, 2022)