社会保障改革:预算后共同支付额上调和药品覆盖限制详情

在2026财年预算为社会保障拨款创纪录的39.06万亿日元后,日本政府敲定了两项关键改革措施,以遏制医疗费用飙升,包括提高患者共同支付额和对某些药品实施保险限制。官员们强调需要清晰解释以获得公众理解。

日本政府已敲定社会保障改革两大核心要素的具体方案,此前于12月27日批准的2026财年预算在老龄化人口导致医疗和护理费用上升的背景下,将社会保障支出定为创纪录的39.06万亿日元。

在高额医疗费用负担减轻制度下,该制度对昂贵治疗的自付费用设上限,根据年收入将共同支付比例提高4%至38%,将于2027年8月前分阶段实施。对于年收入在650万至770万日元之间的人群,每月上限将从约8万日元提高至11万日元,并新增年度上限53万日元,以避免过度负担。

此举继去年前任政府提议上限提高高达73%引发反对党及患者团体批评,认为会阻碍就医之后,总理大臣高市早苗内阁旨在更有效地与利益相关者沟通。

第二项措施是将类似于非处方药的处方药部分排除在公共保险之外。在约7000种此类药品中,约1100种继续纳入保险覆盖,患者自付25%。日本维新会曾要求全部除名,但通过妥协解决了日本医师会关于就医减少和漏服药物问题的担忧。

这些改革预计通过药品调整节省900亿日元,通过高额医疗制度节省1600亿日元,尽管相对于每年50万亿日元的医疗支出而言规模不大,但实现可持续变革仍需更广泛的审查。

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日本政府于周五通过了2026财年预算案,为社会保障相关支出拨款创纪录的39.06万亿日元,比2025财年增加7600亿日元。这一增长反映了由于人口老龄化导致的医疗和护理成本上升。然而,减轻劳动世代健康保险保费负担的努力仍有限。

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高市早苗首相领导下的2026财年预算获得国民民主党支持,提高了原案通过的前景。然而,作为首次债务偿还费用超过30万亿日元的预算,社会保障支出控制不足未能缓解市场担忧。利率上升构成风险。

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随着日本2026年众议院选举竞选活动展开,高市早苗首相倾向于暂时将食品消费税降至零。自由民主党内部对财政影响持谨慎态度,实施取决于选举后讨论。此举旨在回应选民关切,同时应对反对派推动的减税要求。

 

 

 

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