Health Care Reform Needed for Aging Society

By Honda, Mayumi; Noguchi, Hirofumi | The Daily Yomiuri (Toyko, Japan), April 23, 2013 | Go to article overview

Health Care Reform Needed for Aging Society


Honda, Mayumi, Noguchi, Hirofumi, The Daily Yomiuri (Toyko, Japan)


A government panel on social security reform has called for a shift from the current health care system, which depends heavily on hospitals, to a community-based system, due to the nation's rapidly aging population.

The outline, compiled Monday by the National Council on Social Security Reform, has stressed the need to shift some of the burden of the nation's health and nursing care to communities and away from hospitals.

Public attention is likely to be directed toward the question of the extent to which the government will be able to achieve the envisaged reform plans with funds from consumption tax increases.

"The council has called for a review of the free access system while maintaining its merits, and urges prefectural governments to play a greater role in establishing local health and nursing care systems.

"In this way, we narrowed down contentious points [on social security reform]," panel Chairman Atsushi Seike, president of Keio University, said after intensive panel discussions.

The outline was drawn up to respond to the nation's rapidly aging population and growing demand and costs for social security services.

According to government estimates, people aged 75 and over--the age bracket most likely to need medical and nursing care--would account for 20 percent of the total population in the 2030s, up from the current 10 percent.

The population is aging particularly in rural areas, but Tokyo, Saitama Prefecture and other urban areas are expected to see such social demographic changes in the future, and face significant shortages of facilities and personnel in medical and nursing care.

In fiscal 2025, when baby boomers will begin turning 75, annual government spending on social security benefits is expected to soar to nearly 150 trillion yen.

Panel member Shinichi Oshima, president of the National Center for Geriatrics and Gerontology, said: "Health care is a limited public resource. Both medical service providers and receivers should be aware of this. We need to change the current system to one in which we will receive appropriate medical services at appropriate places at minimum costs."

Effective systems, limited funds

One of the key issues addressed by the government panel is the so-called free access system that allows people to receive services at any medical institution simply by showing their health care insurance cards. The Japanese health care system's main feature is described as the ability for anyone to receive medical services anytime and anywhere.

However, many patients tend to receive services at more than one medical institution, and tend to go directly to big hospitals when they need health care, as they are unsure about where to go. The public's preference for big hospitals has placed high patient loads on doctors working at such hospitals, preventing hospitals and clinics from evenly sharing the burden of providing medical services.

Meanwhile, many other countries have introduced systems to effectively provide health care services with limited funds.

In Britain, people first see registered family doctors and are referred to specialists if necessary. …

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