Anew trend ofsocial security - health care and long-term care insurance as a income redistribution system

本研究的主要目的是调查和思考日本老龄化社会下社会保障特别是医疗保健和长期护理保险的新趋势。笔者曾对五个地区(札幌市、仙台市、横滨市、高知市和北九州市)进行了关于这些主题的调查和思考。1990年代下半年以来，由于地方分配税和公用事业的限制，许多地区的地方政府经济和公共财政状况恶化。另一方面，医疗保健和长期护理保险成为贫困地区或社区取代通常的地方分配税和公用事业的最重要的收入再分配制度之一。这些新的收入再分配制度是不可或缺的。尤其是高知市和北九州市，与其他地区或社区相比，地区经济和公共财政一直在下滑。原因之一是医疗保健和长期护理的供应条件安排良好，平均住院天数较长，机构长期护理的使用率高于仙台市和横滨市。因此，高知市和北九州市的大量收入来源得到了重新分配

The main purpose of this study is to investigate and consider about a new trend of social security, especially health care and long-term care insurance under aging society in Japan. I have been investigated and considered five regions (Sapporo city, Sendai city, Yokohama city, Kochi city and Kitakyushu city) about these themes.The conditions of economy and public finances of local government in many regions have been getting worse by the restraining of local allocation taxes and public utilities after the latter half of 1990's. On the other hand, health care and long-term care insurance become one of the most important income redistribution systems instead of usual local allocation taxes and public utilities for the declining areas or communities.These new income redistribution system are indispensable, especially for the Kochi city and Kitakyushu city in where have been declining regional economies and public finances compared with other areas or communities.One of the reasons is that supply conditions of health care and long-term care are well arranged, average hospital days are longer and utilization rates of institutional long-term care are higher than the Sendai city and Yokohama city. As a result, a large amount of revenue sources have been redistributed for Kochi city and Kitakyushu city