People’s trust in the Health, Labor and Welfare Ministry has fallen due to various problems such as a shortage of doctors, especially obstetricians, pediatrics and emergency specialists, irregularities related to pension premium payments records and confusion linked to the health insurance system for people age 65 or over. After months of discussion, a government panel has issued its final report on desirable health, labor and welfare administration. Unfortunately, its review and proposals are mainly written in general terms and are too shallow.

The discussions of the panel, established in August 2008 by then Prime Minister Yasuo Fukuda, focused on what changes have to be made to the ministry’s structure. Health, Labor and Welfare Minister Yoichi Masuzoe, aware of the problem, said that his ministry, established in 2001 through a merger of the Health and Welfare Ministry and the Labor Ministry, is too big to carry out efficient administration.

The panel’s final paper proposed the establishment of a policy promotion conference to assist the minister and the creation of a headquarters to carry out unified policies to cope with the declining birthrate. The rapid graying of the population and the declining birthrate have spawned a large number of problems that must be tackled by the ministry. The panel did not sufficiently delve into the question of what kinds of new organizations are needed and what kinds of concrete roles they should fulfill.

To solve the problems related to pension premium payment records, the report called for hiring more personnel and increasing expenditures. But more drastic measures may be necessary, such as integrating the ministry’s pension bureau and a new entity, which would replace the Social Insurance Agency.

The report did not investigate whether stronger measures were necessary to increase the collection rate — only about 64 percent in fiscal 2007 — for premiums in the pension system that mainly covers self-employed and unemployed people. The government may need to restructure or divide the ministry to improve medical and nursing-care services and welfare measures for the poor and the unemployed.

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