Elderly also need to shoulder fair burden of nursing care cost
To maintain the nursing care insurance system, it is impossible to ask only those people who are under retirement age to bear the heavy burdens. It is necessary for the elderly to bear their fair share of the costs.
The Health, Labor and Welfare Ministry has submitted to the Social Security Council a draft to review the self-pay rate for nursing care services from the current 10 percent to 20 percent for people earning a certain level of income.
The ministry plans to submit a bill to revise the Nursing Care Insurance Law to an ordinary Diet session next year, aiming at enforcing the revised law in fiscal 2015. If realized, it would be the first raise in the self-pay rate since the nursing care insurance system was created in 2000.
Due to the rapid graying of society, the payment of benefits under the system has been snowballing. It is quite understandable that the government is trying to secure revenue.
The people who will become subject to the increase in the self-pay rate are those with an annual pension income of nearly ¥3 million. About 20 percent of people aged 65 or older meet this criteria.
Under the health care insurance system, the self-pay rate of those aged 70 or older and who have a monthly income of ¥280,000 has already been raised to 30 percent. It is inevitable to increase the amount paid for the nursing care insurance system in proportion to income.
The ministry will also review a system to lessen the burden on residents at nursing care facilities for the purpose of spending cuts.
At facilities like special nursing homes for the aged, expenses, such as living and meal costs paid by low-income residents, are currently subsidized through nursing care insurance revenue. Under the ministry’s envisioned review, married couples with savings of ¥20 million or more will be excluded from the system.
Currently, low-income earners are eligible for the subsidies even if they have a huge amount of assets. It is natural to review the system. There are no subsidies for people who receive in-home nursing care services or residents in so-called group homes for the aged, leading some to criticize the system as unfair. This point should be taken into consideration.
However, the increased revenue following these measures is expected to reach only about several tens of billions of yen, which is obviously insufficient. We also doubt to what extent the government will be able to determine individuals’ assets since, in principle, the government will rely on self-reporting. These are major points to be studied.
The ministry is now considering removing services for those users who require only low-level nursing care services from the nursing care insurance system and transferring them to programs run by city, town and village governments utilizing volunteers. The ministry is also thinking about changing the criteria for those eligible to enter special nursing homes for the aged from the current “Nursing care required: Level 1 or higher” to “Nursing care required: Level 3 or higher” under the nursing care requirement authorization system.
We think the direction of the policy, using the limited revenues mainly for people requiring intensive nursing care, is appropriate. The important thing is to make the entire nursing care insurance system efficient.
On the other hand, the welfare ministry will reduce the nursing care insurance premiums of low-income earners, who account for 30 percent of the elderly. It is designed to prevent an increase of the burden on low-income earners if an increase in premiums is unavoidable due to the increase in the number of nursing care service users.
However, public funds will be required to take such a measure for low-income earners. To ensure that revenue can be secured by increasing the burden on high-income earners, we think the rate and the people entitled to reduced premiums must be limited to the minimum necessary.
(From The Yomiuri Shimbun, Oct. 10, 2013)