Minister of Health and Welfare Shoichi Ide submitted the 1995 white paper on welfare to a May 23 Cabinet meeting for approval. The annual paper for the first time deals with "medical care" in a comprehensive manner and concludes that we are now in an age in which the quality of medical care must be viewed from the consumers' standpoint of being an essential service. In view of the changed structure of maladies and an increase in the number of the elderly over 75, medical care which also stresses "cure," but without exclusive emphasis on "cure" alone is also necessary. In this context, the paper calls for expediting introduction of a "new publicly-funded care system" targetted for the elderly. This is currently being studied by the Council on Health and Welfare for the Elderly. In addition, the paper urges a drastic review of the framework of the current Older Persons Health System and Medical Insurance System.
Subtitled "Medical Care-Quality, Information, Choice and Mutual Understanding," the paper for the first time reviews medical service as the central subject. It points out the gradual decline in fatality rates from such maladies as cancer, coronaries and strokes which are called the "three major adult maladies." The report also points to the rising number of bedridden older persons who die from pneumonia and bronchitis, thus recognizing the 1990s as an era when the "adult maladies" cause a smaller share of deaths.
Predicting that more elderly people will be inflicted with maladies for longer periods in the years to come, the paper analyzes that the nation is now entering an age calling for better care as well as cures. The paper also refers to ever-increasing medical expenses, saying that growth in total medical costs has since 1991 continued to grow faster than national income. The paper thus stresses the need to review the nation's medical insurance system. In this respect, the tasks the country must tackle are the following. First, in view of the graying population and the changing employment structure, reviewing employees' insurance, local insurance and the older persons' insurance systems. Second, dealing with the problem of increasing medical costs from both aspects of benefits and contributions. Third, instituting a fairer allocation of contributions and benefits which are presently differentiated among the insured, the paper says.
The Cabinet of Prime Minister Tomiichi Murayama approved the 1995 white paper on international trade and the 1995 small business white paper, submitted by Ryutaro Hashimoto, Minister of International Trade and Industry, on May 12.
The annual report on trade characteristically focuses on the internal-external price gap, which is responsible for domestic companies' rising costs and weakening of international competitiveness, citing as one illustration the cost of doing business in Japan is the highest among the advanced industrial nations. Touching also on the "hollowing out" of Japanese industry, the report points out that Japanese companies are shifting their operations offshore due to the strong yen. Furthermore, it analyzes that governmental regulations, high costs and business practices constitute obstacle to foreign direct investment. Thus, in 1994 the number of domestic plants starting operations dropped to one-third of the number in 1989 and direct investments into Japan from abroad is not increasing, the report maintains.
On trade issues, a MITI official expressed concern over possible U.S. unilateral action such as the use of the "Super 301" sanctions on unfair trade practices. Curbing exports to slash the current account surplus "goes against the ideals of free trade," the official said. Partly because a meeting of the Asia-Pacific Economic Cooperation Forum will be held in Osaka in November, the white paper states that Japan should play a leading role in liberalizing trade and investment restrictions in the region. Domestic demand-led economic growth through deregulation will help reduce the trade surplus, the white paper concludes.
The small and medium-sized Enterprise white paper concludes that the sluggish business performance of smaller firms was brought on by structural changes-such as the rocketing yen and price busting. These firms will soon be in difficulty if they stick to the conventional way of coping with such problems, the paper warns, thus asking them to actively take measures to diversify into new business fields and push ahead with technological development in order to pull out of their difficulties.
Women in their late 20s to early 30s, finally deciding to have babies, contributed most to the increase. By age group, women in all age brackets, excluding those in their late teens, contributed to the increase. In particular, women in the 30-to-34 age bracket had 20,300 more babies than the year before, while those in the 25-to-29 age bracket had 15,000 more and those in the 35-39 age bracket had 8,300 more births.
The average number of children born to a Japanese woman during her lifetime increased to 1.50 last year from the all-time low of 1.46 in 1993, representing the first increase in 10 years. The factors behind this are as follows. First, the "trend toward waiting until later in life to marry and have a family" still persists. Second, people belonging to the second baby boom-generation are now reaching marriageable age.
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