No. 1438 Election Pledges to Reduce Social Insurance Premiums
The general election has ended. During the election campaigns many political parties pledged to decrease payment for social insurances, but these parties focused on diminishing services provided to the elderly. If a reduction is done in the premium payment, healthcare and elderly care will be aggravated; benefit will be less and monetary burden will be bigger.
PUBLIC FUND SHOULD BE SPENT MORE TO SUSTAIN SERVICES
Types and premium ratios of insurance
A company employee has five kinds of social insurances; insurances for pensions, healthcare, elderly care, employment and labor accidents. As for the labor accident insurance, all the financial obligations are levied solely on employers. The rest of four insurance plans are supported by both of employees and employers.
The insurance premium ratio of the employee pension program is set as 18.30% of salary (it has been fixed since September 2017 by the decision made in the Pension Law amendment of 2004). As of 2025, the insurance premium ratios are 10.00% for healthcare, 1.59% for elderly care (during the period from 40 years of age to 65), 1.45% for employment (0.55% for employees and 0.9% for employers).
On the government’s budget basis of the fiscal 2025, public service allowances accounts 140.1 trillion yen. Concerning benefits, 62.5 trillion yen is spent on pensions (44.4%), 43.3 trillion yen on healthcare (30.8%), and 14.0 trillion yen on elderly care (9.9%).
As for financial obligations, premiums count 82.2 trillion yen (59.8%), in which workers pay 43.5 trillion yen (31.6%) while employers do 38.8 trillion yen (28.2%). For public fund, the sum is 55.3 trillion yen (40.2%), out of which the state pays 38.2 trillion yen (27.7%) and the municipalities do 17.2 trillion yen (12.5%).
Political parties focus on healthcare and elderly care
The social insurance premium ratio imposed on the working generation by the National Association on Healthcare Insurance counts 29.9%, which includes the premiums for the pension, healthcare and elderly care insurances. Employees owe 15.0%. The Ministry of Health, Labor and Welfare says the premium ratio imposed on the working generation occupies almost 30% of salary, estimating it will keep surging. Under these conditions, healthcare and elderly care are targeted for aggravation.
The state’s authority has proposed putting a severer limit on medical benefit, including OTC (over-the-counter) drugs, as a reform policy in the Social Services Program (a reduction by 100 billion yen for two years to come in the burden of insurance premiums on the side of government). It has requested to review the benefit program for high-cost medical treatment (a reduction by 160 billion yen for three years to come) and indicated to decrease prices of medicines (during the fiscal 2026 a reduction by 200 billion yen).
Furthermore, from the fiscal 2026, collection of money for a childcare assistance fund will begin. The sum is estimated as 643.6 billion yen and an additional premium rate of 0.23% will be put on the healthcare insurance premium (owed by both employers and employees). And from the fiscal 2027, the government is planned to increase payment on the side of patients for medical treatment cost for the age-group older than 75 years and to expand a sphere of the elderly who are to owe 20% of the care services given. Some of the political parties are to hit senior citizens, following the government.
A progressive collection system should be enhanced
Insurance premiums must be set in accordance with incomes, not by a simple reduction of payment on the side of the working generation. A portion owed by employees should be lessened. Government money should be spent more on alleviating their premium payments. Absence of services and an increased payment on the side of users must be avoided.
今次衆院選では、多くの政党が現役世代の社会保険料引下げを公約した。しかし、高齢者がターゲットにされており、引下げが行われた場合、医療と介護は給付の抑制・負担の強化になる。
保険の種類と料率
会社員の社会保険には、厚生年金保険、健康保険、介護保険、雇用保険、労災保険の５種類がある。保険料は労災保険のみ全額事業主負担で、他はおおむね労使折半となっている。
厚生年金保険の保険料率は18・30％（04年の年金法改正で17年９月以降固定と決定）。また、25年時点での保険料率は、健康保険は10・00％、介護保険（40歳以上65歳まで加入）は１・59％、雇用保険は１・45％（労働者０・55％、事業主０・９％）となっている。
25年度予算ベースの社会保障給付費は１４０・１兆円。給付は、年金が62・５兆円（44・４％）、医療43・４兆円（30・８％）、介護14・０兆円（９・９％）である。
負担は保険料が82・２ 兆円（59・８％）で、うち労働者拠出が43 ・５ 兆円（31・６％）、事業主拠出38・８兆円（28 ・２％）。公費負担が55・３兆円（40・２％）で、うち国費が38・２兆円（27・７％）、地方が17・２兆円（12・５％）だ。
狙いは医療・介護
現役世代の社会保険料率は、協会けんぽの場合、年金・医療・介護を合わせて29・９％で、うち労働者負担は15・０％である。厚労省は現役世代の保険料率は報酬の３割に迫り、今後も継続的に上昇すると見込む。そこで、ターゲットにされているのが、医療と介護である。
国は、保険料負担抑制に向けた社会保障制度改革として、ＯＴＣ類似薬等の薬剤給付の負担増（保険料負担を２年間で１０００億円減）、高額療養費制度の見直し（同３年間で１６００億円減）、薬価引き下げ（同26年度２０００億円減）などを示した。
更に26年度から子ども子育て支援のための支援金の徴収が始まる。６４３６億円と見積もられ、医療保険料に一律０・23％（労使折半）上乗せで調達する。また、27年度から後期高齢者医療の窓口負担増や介護保険の利用者負担２割の対象者拡大などあげる。一部政党も、正に高齢者を狙い撃ちしている。
累進性強化すべき
現役世代の安易な保険料の引下げではなく、保険料の累進性の強化、労使折半の労働者割合の軽減、そして国費の投入などで保険料負担を軽減し、サービス切捨てと利用者負担増を避けるべきだ。
英訳版↓
No. 1438 Election Pledges to Reduce Social Insurance Premiums
The general election has ended. During the election campaigns many political parties pledged to decrease payment for social insurances, but these parties focused on diminishing services provided to the elderly. If a reduction is done in the premium payment, healthcare and elderly care will be aggravated; benefit will be less and monetary burden will be bigger.
PUBLIC FUND SHOULD BE SPENT MORE TO SUSTAIN SERVICES
Types and premium ratios of insurance
A company employee has five kinds of social insurances; insurances for pensions, healthcare, elderly care, employment and labor accidents. As for the labor accident insurance, all the financial obligations are levied solely on employers. The rest of four insurance plans are supported by both of employees and employers.
The insurance premium ratio of the employee pension program is set as 18.30% of salary (it has been fixed since September 2017 by the decision made in the Pension Law amendment of 2004). As of 2025, the insurance premium ratios are 10.00% for healthcare, 1.59% for elderly care (during the period from 40 years of age to 65), 1.45% for employment (0.55% for employees and 0.9% for employers).
On the government’s budget basis of the fiscal 2025, public service allowances accounts 140.1 trillion yen. Concerning benefits, 62.5 trillion yen is spent on pensions (44.4%), 43.3 trillion yen on healthcare (30.8%), and 14.0 trillion yen on elderly care (9.9%).
As for financial obligations, premiums count 82.2 trillion yen (59.8%), in which workers pay 43.5 trillion yen (31.6%) while employers do 38.8 trillion yen (28.2%). For public fund, the sum is 55.3 trillion yen (40.2%), out of which the state pays 38.2 trillion yen (27.7%) and the municipalities do 17.2 trillion yen (12.5%).
Political parties focus on healthcare and elderly care
The social insurance premium ratio imposed on the working generation by the National Association on Healthcare Insurance counts 29.9%, which includes the premiums for the pension, healthcare and elderly care insurances. Employees owe 15.0%. The Ministry of Health, Labor and Welfare says the premium ratio imposed on the working generation occupies almost 30% of salary, estimating it will keep surging. Under these conditions, healthcare and elderly care are targeted for aggravation.
The state’s authority has proposed putting a severer limit on medical benefit, including OTC (over-the-counter) drugs, as a reform policy in the Social Services Program (a reduction by 100 billion yen for two years to come in the burden of insurance premiums on the side of government). It has requested to review the benefit program for high-cost medical treatment (a reduction by 160 billion yen for three years to come) and indicated to decrease prices of medicines (during the fiscal 2026 a reduction by 200 billion yen).
Furthermore, from the fiscal 2026, collection of money for a childcare assistance fund will begin. The sum is estimated as 643.6 billion yen and an additional premium rate of 0.23% will be put on the healthcare insurance premium (owed by both employers and employees). And from the fiscal 2027, the government is planned to increase payment on the side of patients for medical treatment cost for the age-group older than 75 years and to expand a sphere of the elderly who are to owe 20% of the care services given. Some of the political parties are to hit senior citizens, following the government.
A progressive collection system should be enhanced
Insurance premiums must be set in accordance with incomes, not by a simple reduction of payment on the side of the working generation. A portion owed by employees should be lessened. Government money should be spent more on alleviating their premium payments. Absence of services and an increased payment on the side of users must be avoided.
February 11, 2026