Influence that the integrated tax and social security reform on persons with disabilities(IMAMURA Noboru,STEP Edogawa)
The article "A Voice of our own" published in our periodical #27-2 is as following;
The Headquarters of the Government and Ruling Parties for Social Security Reform reported July 1, 2011 the definite plan for the comprehensive reform of social security and tax (hereinafter referred to as “the definite plan”) to the Cabinet, which has not been decided in the Cabinet yet. It is likely that Democratic Party of Japan is planning to discuss with the opposition party and make arrangement based on the definite plan in order to make a draft law within 2011. Mr. Noda, the present Minister of Finance, is elected to be the next prime minister while I am writing this article. When this is published, the Noda administration will have started. Great attention is paid on how the new Cabinet handles this issue as well as the framework proposal for the Comprehensive Welfare Law which is supposed to be finalized on August 30, 2011.
For the disability issues, the definite plan only mentions “fulfillment of comprehensive disability policy (which supports every person with disability with no exclusion, and community lives), measures for persons with intractable diseases and secured community model in disaster recovery”. At temporary schedule, discussions at the Panel for Comprehensive Welfare Service will be done until December, 2011 and the Comprehensive Welfare Law will be submitted to the Diet in January-March, 2012. That’s all mentioned in the definite plan. If we only see the definite plan, it seems that the Comprehensive Welfare Law will be made based on the framework proposal, but there is no guarantee. It would be possible that the definite plan will be used as a reason why the law cannot be made based on the framework proposal during the process of discussion.
So what makes us worry? Firstly, the purpose of the definite plan is to secure the fund of social security policy and assurance of sound financial status. To attain this purpose, there are three measures suggested; 1) gradually increase Consumption Tax up to 10% until the middle of 2010s, 2) expand social security expenditures including measure for declining birthrate, not only for the elderly (medical, pension and care), 3) introduce social security number system for taxation as well.
Even though Personal Income Tax to reduce inequality and promote income distribution and tax on estate are mentioned in the Clause “Comprehensive Tax Reform”, what we need to focus is that only Consumption Tax is mentioned in detail. If tax are increased, there’s no guarantee that it will be used for social security. It is regarded that tax increase is to enforce social security system and maintain sustainability. 1% increase of Consumption Tax makes approximately 2.5trillion yen. So if Consumption Tax is increased up to 10%, 12.5trillion yen will additionally become revenue for social security. But it won’t be fully used. 1% will be used for system sustainability, another 1% will be used for enforce the system with policy reform and rest of it (7.5trillion yen) will be compensated with general revenue, the source said.
I am sure that there would be opinions say “Even 1% of Consumption Tax should be used for social security” or “Financial reform also is important. There is no choice but tax increase”. What I am concerning is if the revenue is used for disability policy. The plan for the elderly aims the following up to 2025; 1) to increase users of group home and multi-functional small facility from 210,000 to 770,000 per day, 2) to increase users of home care service from 3.35million to 5.1million per day. It is appreciated that in-home care system for the elderly also is being promoted. Standard of hospitalization, however, was shortened from 20 days to 9 days. Even for persons at highly acute phases, the standard was shortened the length only for 15 days. It aims to decrease 5% of number of outpatients and 3% of number of persons who need nursery care and plans to make recipients of public assistance pay their medical expenses. To shorten the length of hospitalization and return to the community, it is necessary to fulfill and enforce social support for social work and empowerment rather than medical treatment. The government has not taken care of these things. Promotion of care management and service centralization which are mentioned in the definite plan seem to be the countermeasures of hospitalization issue, but the current care management is nothing but combination of services of the nursing care insurance system. Moreover, what worries us most is that the definite plan emphasizes on complete efficiency of the payment system. We have to remember the Reform Grand Design, which was the base of the Services and Supports for Persons with Disabilities Act, was supposed to make “efficient payment system”. Expanding social security expenditures for the elderly (medical, pension and care) has to be regardless of age. Therefore, however the government may explain that “the nursing care” in the definite plan means the nursing care insurance for the elderly, we cannot trust that persons with disabilities is the exception of the system. For instance, “Social security number system”, which is supposed to combine social security and tax, includes disability field because it introduces limit of amount to be borne in every field such as health care, elderly care and child care. It seems to be acceptable to set limit of amount to be borne, but there is possibility that the services may be based on its amount to be borne because tax payments and services are managed together. And there could be limit of public services shown by the government saying that persons who need more than given services pay for services. Thus the definite plan has a lot of points to be worried while it suggests important concepts like “guarantee of participation”.
The conclusion is, as I see it, it is outstanding in the integrated tax and social security reform that it emphasizes on complete efficiency of the payment system. The government is trying to decide on the overall reform in accordance with the definite plan while they say the disability policy will be prepared with the discussion of the Committee for disability policy reform and the Panel for Comprehensive Welfare Service. And they divide public opinion by spreading the worn-out phrase “It cannot be supported by citizen” through press room of Ministry of Health, Labour and Welfare. Otherwise disability issues and our voices are ignored because this field is basically not popular. To avoid it, now is time we need to do our best to make our voice.