By Yuki Tsukui

The Diet debate for the new medical insurance system for people aged 75 and older started between the ruling and opposition parties. The system that went into effect from this April was far from perfect and it has been having problems from the beginning of its enforcement and is in need of drastic reforms. The ruling and opposition party should develop countermeasures to meet the complaints of older people.

The Ministry of Health, Labor, and Welfare began investigating complaints from all over the country in early May. It brought to light the problems of the system.

On April 15, when the first deduction after the new system began, many people couldn't understand why there is a new system for those aged 75 and older. Most members of the system complained that they couldn't understand why the deduction for the insurance premium is so high, why they had to go to a different window at the ward office because they couldn't make sense of the system, and why the monthly retirement income is much lower after the deduction. One person said, "I wonder if government officials want us to die soon." Even an officer in charge of the local government complained about the length of time it took the government to decide the insurance premium.

The number of complaints increased after notification of the insurance payment. Some people indicated that they didn't know which figure is for the insurance. Most people are indignant at the poor preparation of the system and are dissatisfied with the fundamentals of the system. It has become clear that the government is out of touch with the actual state of citizen's lives.

The solution of the problem is focused on the cuts in the insurance for low-income earners, the deduction of the insurance from pensions and the readjustment of the medical care policy.

The most serious problem is that there are a number of low-income earners whose insurance payments increased rapidly. The biggest reason is that the government set up new local entities separate from the municipality, which operates the new system in each prefecture. The new local entities specified how to collect the insurance in an ordinance. The municipality cannot use the measures in place before which contributed toward the cost of insurance for low-income earners using tax money.

On June 4, the Ministry of Health, Labor, and Welfare announced the results of a survey of households that switched to the new system from the National Health Insurance system. The survey found that the percentage paid by low-income earners is higher than that of higher income groups. Health Minister Youichi Masuzoe said, "It reduced the burden of 70 percent of households. It isn't wrong in that sense." However, in reality, people who really need help are suffering more than before.

In addition, the new special local public entity system in each prefecture is confusing. The members of the new system don't know what area they should be in or which counter they should go to. It seems that the government didn't think about the users of the system and simply imposed the system on the elderly.

The ruling party proposed an additional resolution to make a new system for the elderly. According to the bill announced on June 3, they would increase the amount for insurance premiums according to income. Meanwhile, the opposition party rode the wave of public criticism of the new system and submitted a bill calling for its repeal to a Lower House plenary session. The opposition party passed the bill with a majority vote. The bill proposes abolishing the new system and returning to the traditional elderly health care system. In addition, they want to stop deductions from pensions by this October, and they will not collect the insurance payments from nonworking dependents who didn't have that burden under the old system.

Those bills will not settle the essential matters but only lessen the burden. The government is procrastinating to avoid criticism. It is also important to remember that if they make broad cuts in the premiums, they will need huge amounts of financial resources. Also, they can't gain the public's understanding if they just put the old system back into place.

The government should try to understand the current living conditions of the elderly and take all possible measures to ensure that people who are in need of help will not be excluded from the system.

The Ministry of Health, Labor, and Welfare pointed out that a major feature of the new system is that low-income earners can get a reduction in payments and that higher income groups will shoulder a bigger burden. However, according to an announcement from the ministry, the results turned out to be just to the opposite. They should consider this a wake-up call. It is important to know the true condition of the elderly and anticipate every possible problem.

It is expected that health care costs for the elderly will increase rapidly because of the declining birthrate and a growing proportion of elderly people. University students who are about to enter the world of work will not be satisfied if these changes pass the burden on to future generations. It will cause a serious problem if nothing is done. The public expects the government to not waver from criticism and reconsider the system thoroughly for future generations no matter how long it takes.