• Kyodo, Jiji

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The government on Monday finalized its plan to raise out-of-pocket medical fees for some people age 75 or older, as part of efforts to avoid a further hike in the burden on younger generations due to a rapidly graying population and low birthrate.

The plan, which is expected to be approved by the Cabinet on Tuesday, will require people over 75 living alone with an annual income of ¥2 million or more to shoulder 20% of the fees from fiscal 2022, officials said.

The government will also provide public health insurance coverage for fertility treatment from April 2022.

“We will curb the growing burden on working generations” and create a social security system that is fair to all, Prime Minister Yoshihide Suga said at a related meeting.

Since 2001, many people age 75 or older have been paying 10% of their medical expenses, compared with the usual 30%.

The plan to double the charge for those who can afford it comes as postwar baby boomers start turning 75, fueling concerns over a further ballooning of social security spending.

The income threshold of ¥2 million will be set on a single-member family basis. For two-member households in which both are 75 or older, the income threshold will be ¥3.2 million. About 3.7 million people are expected to be subject to the increase in costs.

For the first three years, the government will implement a measure to ease the transition to the higher burden.

Regarding the proposed insurance coverage for fertility treatment, the Central Social Insurance Medical Council, which advises the health minister, plans to start discussions on the measure.

Treatment such as in vitro fertilization, microinsemination and male fertility treatment will be covered by public health insurance under the government plan.

Until the insurance coverage takes effect, the government will substantially boost its existing subsidies for such treatment.

To address the issue of children on nursery waiting lists, the government plans to create additional nursery capacity for roughly 140,000 children between fiscal 2021 and fiscal 2024. To secure funding for the measure, it will abolish special child benefits to households with an annual income of ¥12 million or more.

The government will submit a bill for the social security reforms to a 150-day ordinary Diet session set to convene in January.

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