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Adap%ng to New Challenges - Japanese Case - 34 th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor, College of Policy StudiesTsuda University Itaru Sato Senior Researcher, National Institute of Population and Social Security Research JAPAN

Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

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Page 1: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Adap%ngtoNewChallenges-JapaneseCase-

34th ASSA Board Meeting August 23, 2017

Udonthani, Thailand

Akira Morita Professor, College of Policy StudiesTsuda University

Itaru Sato

Senior Researcher, National Institute of Population and Social Security Research JAPAN

Page 2: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

0

20

40

60

80

100

120

140

1880 1900 1920 1940 1960 1980 2000 2020 2040 2060 2080 2100

1938

National Health Insurance Law

1961 Universal pension health insurance

2000Nursing care insurance law

2015127 million

Trends of Japan's population and age structure: 1880 - 2110

12.5%

60.8%

26.6%

Elderly

Working age

51.4%

10.2%

38.4%

Child 25.6%

68.1%

5.7%

2065 88.1 mil.

211550.6 m.

210059.7 m.

190043.9 m.

187234.8 m.

Source: Ministry of Internal Affairs and Communications, Statistics Bureau, “Population Census,” “Population Estimates”, National Institute of Population and Social Security Research(2017), Population Projection for Japan:2016-2065.

2008Medical care systemfor elderly in the latter stage of life

2

Page 3: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

3

Population “Pyramids”    Depopulation and aging

Page 4: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Increased burden on working generation’s shoulders  

1965 Celebrating

longevity with “victorious toss”

2050 Piggyback ride

by a senior on the shoulder of one young

9.1 people age 20-64 per one senior (65+)

2.4 people age 20-64 per one senior (65+)

1.2 people age 20-64 per one senior (65+) (estimate)

Number of birth (in ten thousands)

1965 2012 (estimate)

2050 (estimate)

2010 “Senior-Lifting”

gymnastic exercise

Declining number of birth

Concern for the burden of tax and social security by the younger generation raised the public support for “Comprehensive Reform of Tax and Social Security”, initiated by the government in late 2000’s.

As for the public pension, however, the major “overhaul” from actuarial point of view, including the introduction of the “macroeconomic indexation”, has already been introduced in 2004 reform. Today’s topic, “raise of the eligibility age” has already been introduced in a gradual manner before the 2004 reform.

4

 Progress of aging

Page 5: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

中国の年齢層別人口の推移:1950-2100年

Japan

From: Joseph A. McFalls, Jr. Population: A Lively Introduction. Third edition. Population Reference Bureau 53(3); 1998: 38

Sources: United Nations (2015), World Population Prospects: The 2014 Revision. Statistics Bureau, Census, National Institute of Population and Social Security Research(2012), Population Projection for Japan:2011-2060.

将来推計

Elderly population

Working age population

Child

China

Population trends by age group in China:1950-2100

Projection

5

Page 6: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Japan

From: Joseph A. McFalls, Jr. Population: A Lively Introduction. Third edition. Population Reference Bureau 53(3); 1998: 38

Sources: United Nations (2015), World Population Prospects: The 2014 Revision. Statistics Bureau, Census, National Institute of Population and Social Security Research(2012), Population Projection for Japan:2011-2060.

将来推計India

Population trends by age group in India:1950-2100

Elderly population

Working age population

Child

将来推計Projection

6

Page 7: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

7Akira Morita © Copyright

0 375 750187.5 km4

Population(thousand persons)

2010589 - 14511452 - 37653766 - 74117412 - 13159

2010

Tokyo

Osaka

Fukuoka

Okinawa

Hokkaido

Fukushima

(source) Ministry of Internal Affairs and Communications(2010)Census 2010.

Page 8: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

8Akira Morita © Copyright

0 375 750187.5 km4

Elderly Population Rate (%)2010

17.4 - 21.021.1 - 28.028.1 - 35.035.1 - 29.6

*The Cartogram (based on Total Population 2010) is created using the Gastner-Newman method in ArcGIS

2010

Tokyo

Osaka

Fukuoka

Okinawa

Hokkaido

Fukushima

(source) Ministry of Internal Affairs and Communications(2010)Census 2010.

Page 9: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

9Akira Morita © Copyright

0 375 750187.5 km4

Elderly Population Rate (%)2020

22.9 - 21.021.1 - 28.028.1 - 35.035.1 - 37.2

*The Cartogram (based on Total Population 2020) is created using the Gastner-Newman method in ArcGIS

2020

Tokyo

Osaka

Fukuoka

Okinawa

Hokkaido

Fukushima

(source) NIPSS(2013) Regional Population Projections for Japan: 2010-2040

Page 10: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

10Akira Morita © Copyright

0 375 750187.5 km4

Elderly Population Rate (%)2040

30.3 - 21.021.1 - 28.028.1 - 35.035.1 - 43.8

*The Cartogram (based on Total Population 2040) is created using the Gastner-Newman method in ArcGIS

2040

Tokyo

Osaka

Fukuoka

Okinawa

Hokkaido

Fukushima

(source) NIPSS(2013) Regional Population Projections for Japan: 2010-2040

Page 11: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

11Akira Morita © Copyright

0 375 750187.5 km4

Elderly Population Rate (%)2040

30.3 - 33.533.6 - 37.037.1 - 39.940.0 - 43.8

*The Cartogram (based on Total Population 2040) is created using the Gastner-Newman method in ArcGIS

2040 Jenk Classification

Tokyo

Osaka

Fukuoka

Okinawa

Hokkaido

Fukushima

(source) NIPSS(2013) Regional Population Projections for Japan: 2010-2040

Page 12: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

12Akira Morita © Copyright

Gangwon-do

Gyeongsangbuk-do

Jeollanam-do

Jeollabuk-do

Jeju

Gyeonggi-do

Gyeongsangnam-do

Chungcheongnam-do

Chungcheongbuk-do

Ulsan

Daegu

Seoul

Busan

Daejeon

Incheon

Sejong

Gwangju

IncheonIncheon

IncheonIncheon

0 90 18045 km4

Population (thousand persons)

2013120 - 570571 - 20602061 - 34263427 - 12137

2013

(source)Kostat(2014)장래인구추계 시도편:2013-2040

Page 13: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

13Akira Morita © Copyright

0 90 18045 km4

Elderly Population Rate (%)2020

10.7 - 14.014.1 - 21.021.1 - 28.028.1 - 23.8

*TheCartogram(basedonTotalPopula%on2020)iscreatedusingtheGastner-NewmanmethodinArcGIS

2020

Seoul

Daejeon

Gwangju

Daegu

Busan

Ulsan

Sejong

Incheon

(source)Kostat(2014)장래인구추계 시도편:2013-2040

Page 14: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

14Akira Morita © Copyright

0 90 18045 km4

Elderly Population Rate (%)2040

25.7 - 28.528.6 - 30.430.5 - 36.336.4 - 41.1

JenkClassifica%on

*TheCartogram(basedonTotalPopula%on2040)iscreatedusingtheGastner-NewmanmethodinArcGIS

2040

Seoul

Daejeon

Gwangju

Daegu

Busan

Ulsan

Sejong

Incheon

(source)Kostat(2014)장래인구추계 시도편:2013-2040

Page 15: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

東京大阪神奈川

愛知埼玉北海道

千葉兵庫福岡静岡広島茨城新潟京都長野宮城福島岐阜岡山群馬熊本鹿児島

三重

栃木

山口

愛媛

長崎

岩手

青森

奈良

山形

秋田

大分

宮崎

滋賀

富山

石川

和歌山

香川

沖縄

高知

山梨

徳島

佐賀

島根

福井

鳥取

0

50

100

150

200

250

300

350

400

450

1950

1960

1970

1980

1990

2000

2010

2020

2030

2040

東京大

阪神奈川

愛知埼

玉北海道

千葉兵

庫福岡静

12

34

56

78

9

1 0

2015年

高齢者人口

万人

都 道 府 県

Source: Population Census of Japan, Statistics Bureau of Japan, Ministry of Internal Affairs and Communications, Future Population Projections By Prefecture (Mar. 2013) National Institute of Population and Social Security Research Japan

Change in distribution of elderly by prefecture: 1950 → 2040

Over 65 population

Comparison of elderly population of Japan prefecture of residence by year

Elderly population (ten thousand persons)

Prefecture (2010 % Elderly population)

1 Tokyo 2 Osaka 3 Kanagawa 4 Aichi 5 Saitama 6 Hokkaido 7 Chiba 8 Hyogo 9 Fukuoka 10 Shizuoka

15

Page 16: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

•  Universal pension coverage –  All registered residents of Japan aged 20 to

59 years must be covered by the National Pension system

•  Role of public pension in Japan –  account for about 70% of the income of

senior households –  60% of senior households live on pension

income only. –  70% of persons rely on pensions for life

design of their senior years. –  It is fixed as a pillar of senior life, and plays

an indispensable role in the life of the people

•  Multi-tiered pension system –  National Pension –  Employees’ Pension Insurance

•  Pension system financing –  Premium

•  The contribution amount / rate –  National Pension : \16,490/month (for the

fiscal year 2017) –  Employees’ Pension Insurance : 18.182%

(for the fiscal year 2017)

–  Government subsidy •  Subsidy for basic pension

–  Reserve •  Finite balance formula⇒pension reforms in

2004 16

Pension system in Japan  

Page 17: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

•  Macro-Economic Slide Formula –  Adjust benefit according to future social

and economic conditions

•  Finite balance formula –  Alleviate the burden of premium in the

future by holding accumulated fund and utilizing its investment return

–  Reserve for about one year in about 100 years.

•  Step-by-step raising of premium rate with fixed ceiling

–  National Pension •  The premium would be raised by ¥280 (price in FY2004) each

year from ¥13,300 in FY2004 and reach a ceiling of ¥16,900 (price in FY2004) in FY2017, and to maintain this level subsequently.

–  Employees’ Pension Insurance •  Raise the premium rate for employees' pension by 0.354% each

year from 13.58% in 2004, to reach a ceiling of 18.3% in 2017, and to maintain said rate thereafter.

Pension reforms in 2004  

Page 18: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

•  Raise of the pensionable age for the “Basic Pension” (1st tier) –  Introduced gradually from age 60 to

65 –  Started on April, 2001 for men,

2006 for women. –  Completed in 2013.

•  Raise of the pensionable age for the “Employees’ Pension Insurance” (2nd tier) –  Introduced gradually from age 60

until 2025. –  Started on April, 2013 for men,

2018 for women. •  The rule for the retirement age

has been amended following the changes of the public pension system. –  Secure elderly employment for

everyone who desires employment until the age of 65.

Raising Pensionable Age

Page 19: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Characteristics of the universal health insurance system in Japan 1.  Universal coverage with

compulsory public health insurance

2.  Free access to medical facilities 3.  High-quality health care

services with low costs 4.  Based on the social insurance

system subsidized by public expenditure

Breakdown of National Medical Expenditure by source of funding in Japan

(FY2014)

�  Japan has achieved one of the world's highest level of life expectancy and health care standards through a universal health insurance system.

�  It is necessary to continue to ensure a safe and secure lives of citizens by firmly maintaining the universal health insurance under the current social insurance system.

Universal Health Insurance System

Premium from insured (28.3%)

Premium from employer (20.4%)

National gov’t expenditure (25.8%)

Local gov’t expenditure (13.0%)

Copayment (11.7%)

Page 20: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Medical Care System for the Elderly Aged 75 and Over •  Covers the elderly aged 75+ years (16.1 million people) •  47 insurers (one in each prefecture) •  Medical benefit: 16 trillion yen

*1 Of these, 13.1 million are covered by NHI, 2.1 million by JHIA, 0.9 million by Health Insurance Societies, and 0.1 million by Mutual Aid Associations. *2 Figures are as at FY2015. In addition to the systems above, an interim scheme, System for Medical Services for Retired Persons (with about 2 million people covered), is in place.

Fiscal adjustments: Each insurer pays medical benefit for the elderly aged 65–74 years (6.7 trillion yen, 16.3 million people*1)

according to its number of insured people aged 0–74 years

75

Health Insurance Societies

•  Cover employees of large corporations (28.9 million people)

•  Approx. 1,400 insurers

Japan Health Insurance Association (JHIA)

•  Covers employees of small and medium-size enterprises (35 million people)

•  Single insurer across the country

•  Medical benefit: 5 trillion yen

National Health Insurance (NHI)

•  Covers self-employed, pensioner, precarious worker, etc. (37 million people)

•  1,800+ insurers (municipal-controlled NHI and NHI societies)

•  Medical benefit: 10 trillion yen

•  Cover civil servants (8.8 million people

•  85 insurers

Mutual Aid Associations

20

Outline of Healthcare Insurance System

Age

65

•  Medical benefit: 4 trillion yen

Page 21: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

•  Summary of system –  Medical insurance system

for the elderly aged 75 and over was enacted in April 2008.

•  from the viewpoint to clarify the burden between aged and young generations.

–  System to adjust the finance of insurers was introduced.

•  in order to adjust the imbalance among the insurers due to the uneven distribution of the elderly aged between 65 and 74.

•  Structure of Medical Care System for the Elderly aged 75 and Over

Current Medical Service System for the Elderly

Page 22: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Trends in Medical Expenditure

Page 23: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

•  Introduction of the Long-Term Care Insurance System in 2000

•  Basic Concepts –  Support for independence –  User oriented –  Social insurance system

•  Primary Insured Persons(aged 65 or over) and Secondary Insured Persons(aged 40-64)

•  Long-term care benefits and Preventive long-term care benefits

•  Varieties of Long-term Care Insurance Services

•  State of Affairs Regarding Long-Term Care Insurance in the Future

•  Major Contents of Revision of Long-term Care Insurance (2014 revision)

Long-Term Care Insurance System of Japan

Page 24: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Pay 90% (80%) of the costs

Primary Insured Persons - aged 65 or over

Secondary Insured Persons - aged 40-64

Premiums

 Withheld from pensions,

in principle

National pool of money

National Health Insurance, Health Insurance Society, etc.

Use of the services

Insured persons

Municipalities (Insurer)

22% 28%

Tax

Premiums

Municipalities Prefectures State 12.5% 12.5%(*) 25%(*)

Fiscal Stability Funds

(JFY2015-2017)

Service providers ¡ In-home services - Home-visit care - Outpatient Day Long-Term Care, etc. ¡ Community-based services -  Home-Visits at Night for Long-Term Care -  Communal Daily Long-Term Care for Dementia Patients, etc. ¡  Facility Services - Welfare facilities for the elderly - Health facilities for the elderly, etc.

(32.02 million people) (42.47 million people)

Individual municipality

Certification of Needed Long-Term Care

Application

* As for benefits for facilities, the state bears 20% and prefectures bear 17.5%.

50%

50% Determined based on the population ratio

Note: The figure for Primary Insured Persons is from the Report on Long-Term Care Insurance Operation (provisional) (April, 2009), Ministry of Health, Labour and Welfare and that for Secondary Insured Person is the monthly average for JFY2008, calculated from medical insurers’ reports used by the Social Insurance Medical Fee Payment Fund in order to determine the amount of long-term care expenses.   Burden ratio for persons with income above certain level is 20:80, after Aug 2015.

Users pay 10%(20%) of long-term care services in principle, but must pay the actual costs for residence and meals additionally.

24

Structure of the Long-Term Care Insurance System

Page 25: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Varieties of Long-term Care Insurance Services

Long-term Care Facility

Private Home Home-visit Services

Home-visit Care, Home-visit Nursing, Home-Visit Bathing Long-Term Care, In-Home Long-Term

Care Support, etc. 

Day Services Outpatient Day Long-Term Care, Outpatient

Rehabilitation, etc.

Short-stay Services

Short-Term Admission for Daily Life Long-Term Care, etc.

Residential Services Daily Life Long-Term Care Admitted to a

Specified Facility and People with Dementia etc.

In-facility Services Facility Covered by Public Aid Providing Long-

Term Care to the Elderly, Long-Term Care Health Facility, etc.

25

Page 26: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

•  Increase in number of insured persons aged 65 and older

•  Increase in number of persons with care needs & support needs certification

•  Increase in number of service users

End of April,2000

End of April,2015

21.65 million 1.53 times 33.08 million

End of April,2000

End of April,2015

2.18 million 2.79 times 6.08 million

End of April,2000

End of April,2015

Number of users of in-home care

0.97million3.94 times

3.82million

Number of users of facility care

0.52million1.73 times

0.90million

Number of users of community-based care

39million

Total 1.49million3.43 times

5.11million

Increase in number of persons who are eligible for LTC insurance and users

Page 27: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

•  The no. of seniors over age 65

•  Among seniors over age 65, seniors with dementia will increase –  4.62million in 2012, approx. 7million

in 2025.

•  Changes in the Population Over Age 75

(Age group with high percentage of persons requiring care)

–  Increased rapidly and such increase will continue for 2025.

–  From around 2030, the rapid growth of the population over age 75 will level off

–  the population over age 85 will continue to increase for another 10 years.

•  Changes in the Population Over Age 40

(Age group paying for long-term care insurance system)

–  The population over age 40, who pay for the long-term care insurance, will start to decrease after 2021.

2010 2015 2025 2055

No. of seniors 65 & older

29.48 million

33.95 million

36.57 million

36.26 million

No. of seniors 75 & older

14.19 million

16.46million

21.79 million

24.01 million

State of Affairs Regarding Long-Term Care Insurance in the Future

Page 28: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

•  Establishing the Community-based Integrated Care System –  Enriching Services

•  Enhancing coordination between In-home Medical Care and In-home Long-term Care

•  Promoting measures against dementia •  Enhancing Community Care Meetings •  Improving the Livelihood Support

Services –  Making Services More Focused and

Efficient •  Transferring nationally-unified

Preventive benefits (Homevisit Care and Out-patient Long-tem Care) to Community Support Projects of municipalities, and diversifying them.

•  Restricting users of in-facility services of Special Long-term Care Health Facilities to people whose care level is 3 or higher in principle.

•  Making Contribution Equitable–  Expanding Reduction of Premiums

of People with Low-income •  Expanding the reduction rate of

premiums of people with low income –  Review of Co-payments etc.

•  Increasing co-payments of users with income more than a certain level.

•  Adding assets to the check list of requirement for "Supplementary Benefits," which provides money for food and residence to in-facility users with low income.

Major Contents of Revision of Long-Term Care Insurance in 2014

Page 29: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

0

100

200

300

400

500

600

700

800

900

1000

0

10

20

30

40

50

60

70

80

90

100

110

120

FY1950

47.4

24.8

3.5 0.1 0.7

105.2

Pension

Medical care

Per capita (thousand yen)

(Trillion yen)

1960 1970 1980 1990 2000 2010 2016

118.3

  1970 1980 1990 2000 2010 2016 GNI (trillion

yen) 61.0 203.9 346.9 375.2 352.7 385.9

Total benefit 3.5 24.8 47.4 78.3 105.2 118.3

Pension 0.9 (24.3%)

10.5 (42.2%)

24.0 (50.7%)

41.2 (52.6%)

53.0 (50.4%)

56.7 (47.9%)

Medical care

2.1 (58.9%)

10.7 (43.3%)

18.4 (38.8%)

26.0 (33.2%)

32.9 (31.3%)

37.9 (32.0%)

LTC, welfare, etc.

0.6 (16.8%)

3.6 (14.5%)

5.0 (10.5%)

11.1 (14.2%)

19.3 (18.4%)

23.7 (20.0%)

% Total Benefit/GNI 5.77% 12.15% 13.66% 20.88% 29.83% 30.65%

78.3

Trends in social security benefits expenditure

Long-term care, welfare, etc.

Sources: “The Financial Statistics of Social Security in Japan for FY2014,” National Institute of Population and Social Security Research. The figures for FY2015 and 2016 are estimated by MHLW. GNI for FY2016 is based on “Fiscal 2016 Economic Outlook and Basic Stance for Economic and Fiscal Management,” Cabinet Decision of Jan22, 2016. Note: Figures in the graph are social security benefit expenditures for FY1950, 1960, 1970, 1980, 1990, 2000, 2010, and 2016.

Social security benefit expenditure per capita

Right scale

29

Pension

Medical care

LTC, welfare, etc.

Left scale

Page 30: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

•  FY2017 Budget: Expenditure and Revenue

•  Social security plays an important role, but reform is required

•  Comprehensive Reform of Social Security and Tax –  Increasing the consumption

tax rate –  Expand the range of

purposes: Four costs for social security

•  Pension •  Medical care •  Long-Term care •  Children and Child-Rearing

30

Comprehensive Reform of Social Security and Tax

Page 31: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

0

10

20

30

40

50

60

70

80

90

100

110

1880 1900 1920 1940 1960 1980 2000 2020 2040 2060 2080 2100

Before the WWII

Pop. Bonus

2015 64.5 %

201520.6 %

2065 94.5 %

201619.8 %

198013.5 %

198034.9 %

Long term trend of the dependency ratio

Pop. Onus

After the WWII

Projection

Dependency ratio

Child dependency ratio

Dep

ende

ncy 

ratio

(%)

Year

1980 48.4 %

201543.8 %

201674.6 %

Source: Ministry of Internal Affairs and Communications, Statistics Bureau, “Census,” “Population Estimates”, National Institute of Population and Social Security Research(2017), Population Projection for Japan:2016-2065.

31

Page 32: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Comparison of population bonus - Japan vs. South Korea, China, Indonesia and Indonesia

Source: United Nations (2011) World Population Prospects: The 2010 Revision. NIPSSR (2012), Population Projection for Japan:2010-2060

96.3

75.7

91.2

51.7

61.5

0

10

20

30

40

50

60

70

80

90

100

1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 2060

Year

Future projectionsActual

China

Japan IndiaSouth Korea

Ratio of dependent population

( Non-w

orking dependents / Working age population (%

))

Indonesia

32

Page 33: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

33Akira Morita © Copyright

The%merequiredfromagingrate7%to14%

2000

2000

2017

2011

2002

2008

2002

2000

1998

2004

1970

1966

1930

1947

1941

1944

1944

1938

1890

1865

18

19

19

21

22

24

24

26

27

33

26

45

45

45

53

65

69

73

85

115

2018

2019

2036

2032

2024

2032

2026

2026

2025

2037

1996

2011

1975

1992

1994

2009

2013

2011

1975

1980

1850 1870 1890 1910 1930 1950 1970 1990 2010 2030 2050

South Korea

Singapore

Colombia

Brazil

Thailand

Tunisia

Sri Lanka

China

Chile

Azerbaijan

Japan

Poland

United Kingdom

Spain

Hungary

Canada

United States

Australia

Sweden

France

Year

By

proj

ectio

n

Note:ThenumberoftheleOofthebardesignatedtheyearwhentheagingrateaQained7%;thenumberontherightofthebardesignatedtheyearwhentheagingrateaQained14%.Thenumberinthemiddleofthebardesignatestheyearsrequiredthattheagingratechangedfrom7%to14%.

Source:KinsellaandWanHe(2009)

Page 34: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

34

Re-define Elderlies: Life Expectancy Equivalent Age

Male Female

Remainingexpectancy

Remainingexpectancy

50 65 75 90 50 65 75 901960 22.4 11.6 6.5 2.6 1960 28.0 14.1 7.9 2.91990 28.4 16.2 9.5 3.5 1990 33.4 20.0 12.0 4.12010 31.4 18.7 11.4 4.2 2010 37.5 23.8 15.3 5.52030 33.5 20.6 13.1 5.1 2030 39.7 25.8 17.1 6.72060 35.5 22.3 14.6 5.9 2060 41.7 27.7 18.9 7.9

Male Female

Equivalentageadjusted1960remainingexpectancy

Equivalentageadjusted1960remainingexpectancy

50 65 75 90 50 65 75 901960 50.0 65.0 75.0 90.0 1960 50.0 65.0 75.0 90.01990 57.0 71.6 80.8 94.5 1990 58.1 72.2 81.2 94.42010 60.4 74.8 83.7 96.7 2010 62.5 76.5 85.4 97.92030 62.8 77.2 86.4 99.5 2030 64.8 78.8 87.8 100.62060 64.9 79.3 88.5 101.7 2060 66.9 81.0 89.9 102.7

Page 35: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

⽼年⼈⼝割合 後期⽼年⼈⼝割合

従属⼈⼝指数 ⽼年従属⼈⼝指数 (⽼年)潜在扶養指数

5.7

12.1

23.0

31.6

39.9

5.7 6.610.4

15.9

19.8

0

10

20

30

40

1960 1990 2010 2030 2060

暦年齢定義

余命等価年齢定義

高齢化率

1.74.8

11.1

19.5

26.9

1.7 2.0 3.15.4

7.4

0

10

20

30

40

1960 1990 2010 2030 2060

暦年齢定義

余命等価年齢定義後期老年人口割合

55.7

43.5

56.7

72.2

96.3

55.7

33.1 30.735.5

40.7

0

20

40

60

80

100

1960 1990 2010 2030 2060

暦年齢定義

余命等価年齢定義

従属人口指数

8.9

17.3

36.1

54.4

78.4

8.9 8.813.5

21.527.9

0

20

40

60

80

100

1960 1990 2010 2030 2060

暦年齢定義

余命等価年齢定義老年従属人口指数

11.2

5.8

2.81.8

1.3

11.2 11.3

7.4

4.63.6

0

2

4

6

8

10

12

14

1960 1990 2010 2030 2060

暦年齢定義

余命等価年齢定義

(

老年)

潜在扶養指数

資料: 2010年以前は「完全生命表」、2030年、2060年は「将来推計人口(平成24年1月推計・死亡中位仮定)」を用いて算出。

35

1960年基準 平均余命等価年齢による 高齢化指標

・ある年(基準年)のある年齢と平均余命が同じ別年の年齢を、平均余命等価年齢と呼ぶ。

 ・・・健康度がほぼ同じと考えられる

・ 1960年を基準年として、この年の65歳と平均余命等価な年齢

を求め、これを「高齢」の区分

年齢とした各種の高齢化指標を

計算した。→

 ・・・高齢化の将来像が違って

見える。通常の暦年齢定義の場合

Statistical indicators change due to re-defining elderlies Through Life Expectancy Equivalent Age

Page 36: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

図表 27労働力人口と労働力供給逼迫への対処

資料:国立社会保障・人口問題研究所「日本の将来推計人口(平成 18 年

12月[推計出生中位・死亡中位推計])」、 2005年国勢調査(労働力率)

1,000 500 0

男男男

労働⼒⼈⼝

⾮労働⼒⼈⼝

0 500 1,0000

10

20

30

40

50

60

70

80

90

100

労働⼒⼈⼝

⾮労働⼒⼈⼝

※ 本図表は、平成18年1⽉推計による

女性人口(単位:千人)男性人口(単位:千人)

36

Working age population – approach to the shortage of labor supply

Working population

Working population

Dependents Dependents

M F

Page 37: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Aging of decision-making structure(1960~2060)

(Note)% Voters:Ratio of Japanese population over legal age to total population and distribution ratio by age group % Young Voters:Ratio of voters under 35 years old to total voting population, % Middle Aged Voters: Ratio of voters 35 -64 years old to total voting population; % Elderly Voters: Ratio of voters over 65 years old to total voting population, % Old elderly voters: Ratio of voters over 75 years old to total voting population; Old system:Calculates Japanese voters over 20 years old as of October 1 each year, New system : Calculates Japanese voters over 18 years old as of October 1 each year (Source)1955~2010: Population Census of Japan, Statistics Bureau of Japan, Ministry of Internal Affairs and Communications, 2016~2060: Future Population Projections By Prefecture (estimated Jan. 2012) Estimated based on [Projection of Medium Fertility and Medium Mortality]

Year

Ratio of voting

population to total

population

Actu

al re

su

lts

% YoungVoters

(~35 yrs old)

% MiddleAged Voters

(35~64 yrs old)

% Elderly Voters

(65~yrs old)

% Old elderly Voters

(75~ yrs old)

 

1960

1990

2010

2030

2060

2016

 Old s

yste

mN

ew

sys

tem

Fu

ture

pro

jectio

ns

59.7

73.1

81.0

85.1

85.0

42.9

27.0

20.9

18.5

15.7

47.5

56.5

50.8

44.7

38.4

9.6

16.5

28.3

36.8

45.9

2.9

6.6

13.6

22.8

31.1

81.7 18.5 48.0 33.5 16.5

83.5 20.3 47.0 32.7 16.1

% % % % %

Age Composition of Voting Population (Japanese over voting age)

Page 38: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

Aging of decision-making structure: Voting rate

(Note)Number of voters by age group in 45th Lower House general election (Aug. 2009)

46.7 52.1

61.2 66.3

70.4 75.0

78.9 80.4 83.4 85.0 83.3

77.7

56.1

0

10

20

30

40

50

60

70

80

90

100

男性

女性

Voting rate by age65〜69 yrs old

85.0 %

20〜24 yrs old46.7 %

Total Male Female

Page 39: Adap%ng to New Challenges - Japanese Case - sso · Adap%ng to New Challenges - Japanese Case - 34th ASSA Board Meeting August 23, 2017 Udonthani, Thailand Akira Morita Professor,

終The End

Thank you for your attention.