Average monthly fee per subscriber: 350 yen to 600 yen.
The highest estimate for insured persons, excluding dependents such as children, is 950 yen.
As part of its efforts to combat the declining birthrate, the government collects funds through public health insurance under the Child and Childcare Support System.
Estimates of the amount of support for each type of medical insurance have been made public for the first time.
On the other hand, the government explains that the aid money will "actually impose no burden."
Both the ruling and opposition parties have complained that the explanation is difficult to understand, but will it really be a new burden?
(Shino Mitou, Taichi Takahashi, Kohei Kano)
table of contents
What is your “support amount”?
Is it true that there is “no real burden”?
The explanation is not a lie, but...
Open table of contents
table of contents
table of contents
What is your “support amount”?
Is it true that there is “no real burden”?
The explanation is not a lie, but...
The published estimate is
First, I would like to take a look at the details of the estimates released by the government.
The Child and Childcare Support System will begin in 2026, with 600 billion yen to be collected in the first year, 800 billion yen in 2027, and 1 trillion yen from 2028 onwards.
The estimates released today show the average monthly cost per member of the entire medical insurance system over the past three years: 250 yen in 2026, 350 yen in 2027, and 450 yen in 2028.
The "support amount" as of 2028 for each type of medical insurance is as follows.
What is your “support amount”?
(Office employees, etc.)
◆This is a health insurance association for people who work for large companies, and the average amount of support per member, including dependents, is 500 yen per month.
◆The fee is 450 yen for the ``Kyokai Kenpo,'' which is mainly for people working in small and medium-sized companies.
◆The Mutual Aid Association, which civil servants and others join, costs 600 yen, the most expensive of all insurance plans.
In this type of insurance, dependent members such as children do not pay ``support money,'' so the cost per ``insured person'' who pays insurance premiums ranges from 700 yen to 950 yen.
Also, the amount will vary depending on your income.
Under the 50-50 split between labor and management, employers will also pay the same amount.
(National Health Insurance)
The National Health Insurance, which covers self-employed people and non-regular workers, costs an average of 400 yen per person.
The actual amount will be determined for each household based on income and number of people, but children under high school age will not be included in the number of people, and reduction measures will also be taken for low-income households. The average amount per household is 600 yen.
(Medical care system for the elderly aged 75 and over)
Elderly people aged 75 and over are also required to pay 8.3% of the total cost, which is an average of 350 yen per person.
However, the actual amount will vary depending on income and the financial situation of the local government.
What is the government's explanation?
The "Support Subsidy System" is a new mechanism to procure 1 trillion yen of the 3.6 trillion yen annually required for the "Acceleration Plan" to counter the declining birthrate, which will be implemented by fiscal 2028. is.
The establishment of the Children's Future Strategy Policy was first announced in June last year.
June last year
After that, the government decided to utilize the public health insurance system.
The reasons for this are that people from the widest range of generations pay insurance premiums, that if we can put a brake on the declining birthrate and population decline, the sustainability of the entire social security system will increase, and that companies will also have to bear the burden. List.
In other words, it means that society as a whole should support children and child rearing.
However, the government explains that ``the actual burden of support funds is zero.''
The ``Children's Future Strategy Policy'' states that ``we will advance countermeasures against the declining birthrate without requiring the people to bear any 'substantive additional burdens,'' and in the current Diet session, Prime Minister Kishida and Minister in charge of Children's Policy Kato have stated that ``expenditures will be "By creating the effect of suppressing the social security burden rate through reforms and wage increases, and building the system within that range, there will be no real burden overall."
Meanwhile, Minister Kato has stated in the Diet that the ``contribution amount'' per person enrolled in medical insurance will be just under 300 yen in fiscal 2026, under 400 yen in 2027, and under 500 yen in 2028.
Benefits too
In February, it was also announced for the first time that the creation of a ``support subsidy system'' would increase the amount of benefits that children can receive by the time they reach the age of 18 by an average of 1.46 million yen per child.
Combined with the current child allowance, this means an average of approximately 3.52 million yen per child.
By showing not only the burdens but also the benefits, the aim is to emphasize the need to counter the declining birthrate and secure financial resources.
Is it true that there is “no real burden”?
What is the actual burden?
The following exchange occurred at the House of Representatives Budget Committee in February.
Hitoshi Aoyagi of the Japan Restoration Association
: ``Isn't the increase in monthly insurance premiums a ``real burden'' on the people?''
Prime Minister Kishida
: ``There will be differences depending on your income and the type of insurance you take out, but overall (social security) burden rates will not increase.''
If ``support funds'' are paid on top of insurance premiums, the amount each person will have to pay may increase.
However, the government uses the ``social security burden rate'', which is the ratio of the burden of social insurance premiums to the national income (income of individuals and businesses as a whole), as an indicator of the ``real burden'', rather than the burden of insurance premiums for each individual. .
However, the explanation is complicated.
The "social security burden rate" was 10.2% in fiscal 1989, but is expected to rise to 18.4% in the new fiscal year (2024).
Although the burden of insurance premiums is expected to continue to increase due to the declining birthrate and aging of the population, the government is trying to
1) suppress the increase in the burden of insurance premiums, which is the ``numerator'', as much as possible through expenditure reforms for medical and nursing care;
2) increase the national income, which is the ``denominator''. This method
of increasing wages through wage increases
suppresses the increase in the ``social security contribution rate'' as much as possible, and in order to have the ``support funds'' contributed within the suppressed range, the ``contribution rate'' does not increase depending on the ``support funds.'' That's what it means.
Increased counter burden is “not a burden”
In addition, although social security spending reform may increase the burden on medical and nursing care services or reduce services, the government has decided that insurance premiums will not increase and this will not lead to an increase in the social security burden rate. Therefore, it is not included in the ``substantive burden.''
Additionally, insurance premiums are expected to increase by 340 billion yen in FY2023 and FY2024 due to wage increases for people working in the medical and nursing care fields, but it is assumed that this will be covered by the increase in insurance premiums due to wage increases for society as a whole. The government has decided that this will not be included in the increase in insurance premiums when calculating the ``actual burden.''
Why avoid “increased burden”?
Why does the government avoid the phrase ``increased burden'' so much?
A government official explains:
``In June of last year, when the ``Support System'' was launched, the government was concerned about the success of the ``Japan Restoration Association,'' which advocated ``self-defeating reforms,'' in unified local elections. Due to headwinds, we were unable to increase the burden."
However, it was argued that without financial resources, it would be impossible to stop the declining birthrate and population, and the explanation was that the burden would be ``zero in real terms.''
But it's hard to understand
Even members of the ruling party have criticized the government's explanation as ``difficult to understand.''
Komeito Political Affairs Research Chairman Takagi
: ``The explanations are difficult to understand, and this may be one of the reasons why people's understanding is slow to progress.We should explain the significance and necessity of the subsidy system more head-on.''
Opposition parties have criticized the government, saying, ``It is clear that they are trying to collect financial resources by creating complicated explanations and calculation formulas that the public cannot understand.''
The explanation is not a lie, but...
The following voices are also heard from bureaucrats:
"It's a macro and virtual explanation, so if you say it's hard to understand, you're right."
"I'm not lying or cheating, but it's unfortunate that I had to proceed with this explanation. As far as it goes, it's my own fault."
There are even bureaucrats who say things like:
"I have to say that the support money is an added burden. We should have asked them to shoulder the burden squarely for future generations."
Full-scale debate in the Diet
Looking back at the Diet session thus far, the debate has focused on the nature of the ``subsidy system'' and the government's explanation, and it cannot be said that there has been a deep debate on the essential content of countermeasures for the declining birthrate.
Amendments to the Children and Childcare Support Act and other laws are scheduled to be debated in the Diet in April.
As the birthrate and population decline accelerate, what urgent measures should be taken, and what financial resources should be used to support them?
I hope that the information will be presented in an easy-to-understand format and that discussion will be thorough, as the content has a major impact on people's lives.
(Scheduled to be broadcast on News 7 on March 29th)
Political Department reporter
Shino Mito Joined the agency in
2017 After working in Hokkaido for six years at the Sapporo and Obihiro bureaus
, she joined
the Political Department in 2023 in charge of the Children and Families Agency.
She also serves as the Prime Minister
Political Department reporter
Taichi Takahashi
Joined the agency in
2017 After working at the Kagoshima Bureau
and then becoming the Prime Minister of the Political Department, he is currently in charge of reporting on the medical insurance system at the Ministry of Health, Labor and Welfare.
Politics reporter
Kohei Shikano Joined the bureau
in 2014
After working in the Tsu bureau and Nagoya bureau, he was in charge of the Ministry of Health, Labor and Welfare at the political bureau.Social
security and finance are his current biggest reporting topics.