The Yomiuri Shimbun
Tackle and overcome low birthrate through measures across society
社会保障改革 少子化の克服へ総力で挑もう

◆医療・介護の効率化も急ぎたい

The low birthrate is shaking the future foundation of Japan. It will not only jeopardize the stability of the country’s social security system, but also cause a decline in socioeconomic vitality.
少子化が、日本の将来を揺るがしている。社会保障制度の安定を脅かすだけでなく、経済・社会の活力も低下させる。

We should make this year the starting point for our society to do everything in our power to take drastic measures to tackle and overcome the low birthrate.
少子化の克服へ向け、今年を、抜本的対策に総力を挙げて取り組む出発点としたい。

After peaking in 2008, the nation’s total population has declined and now stands at about 127 million. Should the birthrate remain at the current level, the total population is expected to fall to 87 million in 2060. Elderly people aged 65 or older are projected to account for as much as 40 percent of the total population by then.
日本の総人口は、2008年をピークに減少に転じ、現在は約1億2700万人だ。出生率が今の水準のままなら、60年には8700万人に落ち込むと推計される。65歳以上の高齢者は総人口の4割に達する見通しだ。

Expand child care services
◆保育サービスの拡充を

While social security spending, such as medical and nursing care service expenses, is ballooning in line with the super-graying society, the number of those who would support the social security system is on the decline, due to the low birthrate. If the matter is left uncorrected, it is certain that the system will get bogged down sooner or later.
超高齢化に伴って医療や介護などの社会保障費が膨張する一方、少子化で制度の支え手は減り続ける。放置していては、いずれ行き詰まることが確実である。

Late last year, the government set a national target of securing a “total population of 100 million in 2060.”
政府は昨年末、「60年に人口1億人」を確保する目標を掲げた。

The target is based on the assumption that the total fertility rate — the average number of children who will be born to one woman over her lifetime — would be raised from the current 1.43 to 2.07 in 2040. This is the level that would enable the nation to sustain population levels.
1人の女性が生涯に産む子供の平均数を示す合計特殊出生率を今の1・43から、40年には2・07に引き上げることを想定している。これが人口を維持できる水準だ。

The number of children considered ideal for a married couple is said to be 2.4 on average. The unmarried rate is rising but, in fact, nearly 90 percent of unmarried young people want to get married.
夫婦が理想とする子供の数は平均2・4人とされる。未婚率は上昇しているが、実際は独身の若者の9割近くが結婚を望んでいる。

The low birthrate shows that many people are giving up on getting married or have children due to economic and other reasons.
出生率の低迷は、経済的な理由などにより、結婚や子育てをあきらめる人が多いことを物語る。

If young people are provided with an environment in which they can get married and have children as they wish, it will never be impossible for the nation to achieve it’s target.
若い世代が希望通りに結婚・子育てができる環境が整えば、目標達成は決して不可能ではない。

In doing so, it is important for women to be able to have a baby with a sense of reassurance, without being pressed to choose between their career or child-rearing. To lessen their concern or sense of strain over child-rearing, it is also desirable to build a system to offer comprehensive advice and support for women from pregnancy onward.
女性が仕事と子育ての二者択一を迫られずに、安心して出産できるようにすることが重要だ。育児への不安や負担感を減らすため、妊娠期からきめ細かく相談・支援する体制作りも望まれる。

The highest priority should be given to the improvement of child care services.
最優先すべきは、保育サービスの拡充である。

From April, the government will start a new system to support parents and child rearing — the system intended to bring to zero the number of children on waiting lists for admission to child care centers.
今年4月から、待機児童解消などを目指す子ども・子育て支援新制度がスタートする。

Under the system, the government will increase the number of child care facilities. Additional annual expenses totaling more than ¥1 trillion will be needed in fiscal 2017, making it a big challenge to secure a source of revenue.
保育所の増設などを進めるが、17年度には年1兆円超の追加費用が必要とされる。財源確保が大きな課題だ。

Concerns of nonregular staff
◆非正規の処遇改善せよ

Also needed are changes in the mind-set of business corporations and men. While the number of dual-earner households is increasing, it would be difficult to raise the birthrate as long as the tasks of child-rearing and household chores are left entirely on working women.
企業や男性の意識改革も求められる。共働きが増える中、育児や家事を女性任せにしていては、出生率回復は難しい。

There is a report that the percentage of women having their second or further children would rise if their husbands are proactively involved in child-rearing.
夫が育児に積極的だと第2子以降の生まれる割合が高くなるとの報告もある。

It is deemed essential to review the way people work, including correcting long working hours, in tandem with the support for balancing work and family.
仕事と家庭の両立支援と併せ、長時間労働の是正など働き方の見直しが欠かせない。

A major factor behind the low birthrate is an increase in the number of nonregular workers, according to experts. Their status is marked by such unfavorable conditions as low wages, lack of job security and scant opportunities for promotion or pay hikes. Another indicator in this respect is the percentage of married male nonregular workers. Their figure is much lower than that of regular employees of the same sex.
少子化の大きな要因として、非正規労働者の増加が指摘される。低賃金で身分が安定せず、昇進・昇給の機会もほとんどない。男性の場合、既婚率が正社員と比べて著しく低い。

Given this, an improvement in the job security of young people is vital in countering the low birthrate.
若者の雇用安定は、少子化対策の要である。

It is important to ensure nonregular employees are paid wages that are commensurate with their labors, while also providing them with greater opportunities to improve their status as corporate employees. This requires improving the treatment of nonregular workers and giving them more opportunities to acquire job skills while at the same time increasing efforts to aid the corporate sector in upgrading their status to that of regular employees.
非正規労働者の処遇改善と技能習得の機会拡充、正社員への転換支援の強化などで、働きに見合った賃金を確保し、キャリアアップの道を広げることが大切だ。

There is a need to make progress in fighting the spread of poverty in our society and rectifying economic and other disparities among people, a task requiring effort to promote working conditions conducive to making young people better motivated to work.
若者が意欲を持って働ける職場作りを通して、貧困や格差を是正していく必要がある。

Another essential task is to facilitate an environment in which women and elderly persons can bring their abilities into full play. This is important as there are growing concerns about an anticipated labor shortage due to the population decrease.
人口減少で労働力不足が懸念される中、女性や高齢者も十分に能力を発揮できる環境を整えることが肝要である。

We believe doing so will do much to achieve success in transforming our country into “a society in which women can shine,” one of the goals pursued by the administration of Prime Minister Shinzo Abe.
それが、安倍政権が掲げる「女性が輝く社会」の実現にもつながろう。

Progress in the graying of baby boomers will be accompanied by a rapid increase in medical and nursing-care payments in the near future. Efforts must be made to curtail benefits covering a portion of the expenditures incurred while also improving the quality of such services. All this will require converting the medical and nursing-care systems into lean and efficient schemes.
医療・介護費は今後、団塊の世代の高齢化と共に急増する。ムダを省いた効率的な制度に改め、質を高めつつ、給付の抑制を図らねばならない。

The first task in this respect is to draw a clear line between medical services for acute cases and those for recuperating patients at hospitals and other medical institutions.
まずは、病院・病床の役割分担を明確にすることだ。

As circumstances stand today, there is an excess in the number of hospital beds registered for patients who need acute-phase treatments. Medical institutions in this category have advanced equipment and highly skilled staff.
高度な設備やスタッフを備えた急性期向けの病床が過剰となり、

In some cases, however, these registered beds are occupied by elderly people with chronic health needs but whose conditions have already stabilized.
そこに症状の安定した慢性期の高齢者が入院している。

Given the status quo, it is necessary to reduce the number of beds used for the costlier treatment received by these patients to an appropriate level. This calls for improving the quality of medical services in a manner that can meet the needs of a super-aging society, including advice for inpatients regarding when the time is right for their discharge from the hospital as well as an at-home diagnosis and treatment.
退院支援や在宅診療など、超高齢社会のニーズに合った医療を充実させ、コストのかかる急性期病床を適正数に絞り込むべきだ。

‘Pains’ must be tolerated
◆「痛み」伴う政策が要る

Another case in point is the government-run nursing care insurance system. Starting next fiscal year, some services for elderly persons requiring a low degree of nursing care will be transferred to the control of city, town and village governments.
介護保険では、新年度から、介護の必要性が低い軽度者向けサービスの一部を市町村事業に移す。

This will be complemented by a plan to tighten the requirements that must be met by elderly people who want to be housed in homes for persons requiring around-the-clock nursing care.
特別養護老人ホームの入居要件も厳しくする。

It is also inevitable to allot a greater portion of benefits to aged persons who require a high level of nursing services.
重度者に給付を重点化することは、やむを得まい。

There is a pressing need to renovate the system to make it possible for elderly persons to receive the nursing care they truly need, mainly at home, instead of excessively relying on hospitals and other facilities.
病院や施設に過度に依存せず、在宅を中心に必要なケアが受けられる体制作りが急がれる。

An important task in pension system reforms is to expand the scope of subscribers to the corporate employees’ pension plan. There are concerns about a possible surge in the number of people who would only be entitled to low value pension payments in the future. This is because a number of nonregular workers are excluded from the list of subscribers to the current corporate employees’ pension program.
年金制度では、厚生年金の加入対象の拡大が重要課題だ。非正規労働者の多くが除外される現行制度では、将来、低年金者が急増する恐れがある。

With this in mind, it is advisable to study the idea of imposing greater taxes on pension benefits and curtailing the amount of benefits received by high-income pensioners.
年金課税の強化や高所得者の年金減額も検討すべきだろう。

In sustaining the social security systems in our rapidly graying society, it is unavoidable to carry out reforms that entail pains, such as a curb in pension benefits and an increase in the financial burden on affluent elderly persons. All this requires strong political leadership.
超高齢社会において社会保障制度を維持していくには、給付の抑制や、経済力のある高齢者の負担増など、「痛み」を伴う改革が不可避である。政治の強い指導力が求められる。

(From The Yomiuri Shimbun, Jan. 7, 2015)

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