道しるべ

のしかかってくる負担増
高齢者医療・介護

2021/06/08
 今国会で、「75歳以上の医療費の窓口負担を原則2割に引き上げる法案」が5月11日に衆議院を通過し、参議院で審議されている。また、21〜23年度の介護保険料が5月14日に公表された。

 廃止すべき制度

 75歳以上の高齢者の医療は、後期高齢者医療制度で運営されている。高齢者のみ被保険者とする独立の医療保険制度は世界に類がなく、廃止すべきだ。

 後期高齢者医療制度の財政は、高齢者の自己負担金と、75歳以上の高齢者の保険料1割、現役世代の各医療保険者からの後期高齢者支援金4割、公費5割で賄われている。

 現在75歳以上の高齢者は、窓口で医療費の1割を負担している(但し、現役並みの所得〈単身世帯の場合、年収383万円以上〉の場合は3割負担)。

 財界や健康保険組合は、以前から後期高齢者支援金の負担が重いと引下げを求めてきた。とりわけ、25年に団塊の世代全員が75歳に達するため、早期の実現を求め、政府も、「全世代対応型の社会保障制度」を掲げ、現役世代の負担の軽減を目指してきた。

 引上げは廃案に

 法案は、単身世帯で年収200万円以上383万円未満の場合、窓口負担の2割への引上げを22年度後半から実施する内容だ。75歳以上の高齢者は約1815万人で、約320万人が対象となる。厚労省は当初、単身で年収170万円以上を対象に検討していたが、自公の与党協議で200万円以上になった。

 年収200万円台で、消費税引上げやコロナ災害で生活苦に陥っている高齢者は多い。自己負担引上げは、受診抑制を招いて重症化し、逆に医療費増につながりかねない。1970年代、70歳以上は医療費無料の時もあった。引上げ法案は廃案にすべきだ。

 6000円台に  

 介護保険制度は、今年度から第8期に入っており、保険料は3年ごとに改定される。第1号被保険者( 65歳以上)の今期の基準額(月額)の全国平均は6014円で、前期比145円(2 ・5%)増で、初めて6000円台に達した。

 基準額とは、本人が住民税非課税で、世帯に住民税課税者がいる人で所得金額が80万以上の場合だ。年金額年200万円でも大半の人は住民税課税となるので、毎月基準額以上の支払いとなる人は多い。しかも、保険料は年金からの強制天引きである。

 多くの高齢者は医療・介護の負担増で生活困難に陥る。反対の声を上げよう。

英訳版↓

No. 1213 Elderly Care and Medical Service

A bill to increase payment for healthcare is put on debates in the House of Councilors. It is applied for those older than 75 years of age, and it was approved June 11 by the House of Representatives. If the bill passes both of the Houses, the elderly will have to pay 20% of the actual cost of medical service at the hospitals. Separately, on May 14 an announcement was made on the elderly care insurance premium payment to be implemented during the period of 2021-2023.

HEAVIER BURDENS WILL BE IMPOSED ON THE ELDERLY

Abolish the plan!

Medical service provided to those elderly over 75 years of age is administered by an independent insurance system, the Medical Program for Those Older than 75 Years of Age. Only these senior citizens are enrolled by the plan as the insured. The system is peculiar and cannot be found anywhere in the world. It should be repealed.

The financial sources are of actual payment by elderly people at the hospitals, the insurance premium payment in the program, which accounts 10%, donations from other medical programs to which younger, working generations belong, accounting 40%. The medical program is managed publicly up to 50%.

Currently senior citizens over 75 years of age pay 10% of the actual treatment cost at the hospitals. (If he/she, in a single household, has an income exceeding 3.83 million Yen per annum, he/she owes 30% of the actual cost.)

For many years the financial circle and the healthcare plan managing organizations have claimed to reduce donations to the healthcare program for elderly people. In particular, the 2025 problem has been focused, as all of the baby-boomers will be over 75 years of age by the year. The government, too, has sought for a way in which burdens of working generations should be made less by creating a comprehensive public service system that may respond properly to all generations.

The bill must be dumped

The bill outlines; an elderly person in a single household whose income is between 2 million and 3.83 million Yen yearly will have to pay 20% of the actual treatment cost at the hospital. The plan will be introduced in the latter half of the fiscal 2022. Today, people older than 75 years of age count 18.15 million and 3.2 million of them will be affected. The Ministry of Health, Labor and Welfare, at first, had demanded to set the annual income level at a 1.7 million Yen line, and later it was fixed at 2 million Yen through talks of the ruling parties.

Many of senior citizens whose income is around 2 million Yen a year live a tough life due to the surged consumption tax and the pandemic. If they are obliged to pay more at the hospital, they will refrain from consulting with doctors. Thus, diseases will be more serious, which will adversely impact on the healthcare plan. During the decade of 1970, free medical service was offered to those who were over 70 years of age. The bill must be withdrawn.

Monthly elderly care insurance payment - on a digit of \6,000

The elderly care plan is ushered now in the 8th Period. Insurance premium payment is revised every three years. Standard Premiums of the First Category Elderly (over 65 years of age) is \6,014 monthly on the average in the country, which is higher by \145, a 2.5% rise, than that of the previous Period. It is for the first time that the monthly payment exceeds \6,000.

A standard premium is imposed on those elderly who are exempt from paying a residence tax and live with a family member who pays that tax, and whose income is over 800 thousand Yen per annum. The majority of the senior citizens who have a pension amounting two million Yen pay a residence tax, and so their monthly payment in the elderly care plan is beyond the standard premium. Furthermore the insurance premiums are automatically deducted in advance from the pension payment.

If the bill is approved, many of the elderly will face harder life. Let’s raise loud voices of opposition!



June 8, 2021