Aging population in Asian countries |Lessons from Japanese experiences |
Aging population in Asian countries |Lessons from Japanese experiences |
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亚洲国家人口老龄化|日本经验教训|
DOI：
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
M. Tsukamoto
中科院分区：
文献类型：
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作者：
Ai Oku;Eri Ichimura;M. Tsukamoto
许多亚洲国家都面临着人口迅速老龄化的问题。人口老龄化将导致国家预算内社会保障支出增加。目前，亚洲国家的财政状况相对稳定，但各国政府将被要求控制社会保障支出，以保持财政稳健。日本于1961年建立了全民健康保险和养老保险制度。1973年，也就是所谓的高水平社会福利第一年，开始为老年人提供免费医疗服务和与指数挂钩的养老金制度。目前，在日本，衡量65岁或以上人口比例的老龄化比率已达到27%，同时该国继续面临财政赤字，政府债务一直在积累。其他亚洲国家已经开始发展本国的社会保障制度，因此，现在是时候回顾一下日本在社会保障支出和国家预算条件方面的经验教训了。本文重点介绍了日本的社会保险制度，特别是医疗保险和养老保险制度，并对亚洲国家的社会保险制度进行了借鉴。医疗保险制度的经验教训是：(1)重要的是不按患者的年龄，而是根据他们的收入和资产来确定医疗费用的公共分担比例；(2)建立全民医疗保险制度，重要的是确保拥有无法向其他保险公司投保的保险公司的稳定财务收入。养老保险制度的经验教训是：(1)政府应以不增加养老金福利的方式管理通货膨胀的急剧加速，从而防止子孙后代的经济负担；(2)养老金制度的设计应基于对人口老龄化速度和总生育率的长期预测，并应相应地调整政策；(3)政府最好采用宏观经济下滑的养老金制度，这是一个固定的缴费时间表，加上一个通过自动调整福利来重新平衡养老金财务的机制。
Many Asian countries are facing a rapidly aging population. An aging population will cause social security expenditures in national budget to rise. Currently, fiscal conditions in Asian countries are relatively stable, but governments will be required to control social security expenditures to maintain fiscal soundness. Japan established universal health insurance and pension insurance systems in 1961. In 1973, the so called gfirst year of high-level social welfare h, free medical services for the elderly and the indexlinked pension system were started. Currently, in Japan, the aging rate, which measures the share of the population aged 65 years old or over, has reached 27%, while the country continues to face fiscal deficits and government debt has been accumulating. Other Asian countries have started to develop their countries f social security systems, so it is time to review the lessons that can be drawn from Japanese experiences relating to social security expenditures and national budget conditions. In this paper, we focused on Japanese social insurance systems, especially health insurance and pension insurance systems, and addressed some lessons to Asian countries. Lessons from health insurance system are: (1) It is important to determine public contributions f share of medical expenses not by patients f age, but based on their income and assets, (2) To establish universal health insurance system, it is important to ensure the stable financial revenues of insurers with subscribers who are unable to enroll with other insurers. Lessons from the pension insurance system are: (1) It is important for the government to manage sharp acceleration of inflation in such a way as to not increase pension benefits, thereby preventing the financial burdening of future generations, (2) The pension system should be designed based on the long-term projections of the population aging rate and total fertility rate, and policies should be adapted accordingly, (3) It would be preferable that the government take a gMacro-economic slide h pension system which is a fixed contribution schedule coupled with a mechanism to rebalance pension finances through automatic adjustment of benefits.