Title: Act to Promote the Reform to Establish Sustainable Social Security System
Promulgation Date: December 13, 2013
Act No.: 112	Responsible Division: Counsellor's Office for Social Security, Director-General for Policy Planning and Evaluation
1. PurposeThe Act aims to clarify the overview image and direction of social security system reform and to promote reform to establish sustainable social security systems with benefits and burdens being balanced as “legislative measures” based on the provisions of Article 4 of the Act on Promotion of Social Security Reform in consideration of the results of deliberations made at the National Commission on Social Security System Reform.
2. Outline(1) Social security reform measures, etc. to be takenMeasures to clarify discussion items of the reform, implementation period of the reform, and the target submission period of relevant bills to the Diet with regard to the reforms of the medical care system and long-term care insurance system, etc.[1] Measures for declining birthratea. Steady implementation of necessary measures (new support system for children and child-rearing, urgent day-care services security projects, securing operation expenses of day-care centers, and enhancement of social child care) for the provision of early childhood education/day-care and community-based child and childcare support in an integrated manner and implementation of the Acceleration Plan for Reducing the Number of Wait-listed Children, etc.b. Discussion of the extension of the Act on Advancement of Measures to Support Raising Next-Generation Children (temporary legislation until FY2014)[2] Medical care systema. Medical services, etc. provision systemNecessary measures shall be taken by FY2017. Aiming toward submission of necessary bills to the 2014 regular Diet session.[Major discussion items](a) Creation of a hospital bed function reporting system, formulation of concepts of regional medical service provision systems and measures necessary for realizing them (establishment of appropriate classification of necessary hospital beds, strengthening of roles of prefectures, etc.), creation of a new financial support system, and appropriate responses in relation to medical fees(b) Security of doctors and nurses, etc. in regions, and improvement of their work environments, etc.b. Medical insuranceNecessary measures shall be taken from FY2014 and until around FY2017. Aiming toward submission of necessary bills to the 2015 regular Diet session.[Major discussion items](a) Reform concerning enhancement of financial support for National Health Insurance and appropriate insurer/operation of the National Health Insurance(b) Necessary measures as provided for in Article 2 of the Supplementary Provisions of the 2013 Act for Partial Revision of the Health Insurance Act (appropriate national subsidy rate of the Japan Health Insurance Association-managed Health Insurance and sharing the costs of medical services for the elderly)c. Intractable disease measures, etc.Necessary measures shall be taken until around FY2014. Aiming toward submission of necessary bills to the 2014 regular Diet session.[Major discussion items](a) Elimination of excessive burden on prefectures of intractable disease measures(b) Establishment of a fair and stable medical expenses subsidy system, etc.[3] Services of long-term care insuranceNecessary measures shall be taken until around FY2015. Aiming toward submission of necessary bills to the 2014 regular Diet session.[Major discussion items]a. Promotion of comprehensive community care (stronger cooperation between in-home medical/long-term care, establishment of bases of daily life support and long-term care prevention for the elderly, dementia measures)b. Review of community support programs and support for people requiring support according to the actual situations of the regions, etc.[4] Public pension systema. Steady implementation of measures based on four pension reform-related laws.b. Discussion on appropriate macro-economic slide, expansion of application of Employees' Health Insurance to part-time workers, appropriate pension benefits with consideration given to the individual situations according to the diversity of vocational life at an advanced age, and appropriate pension benefits and pension taxation of persons with high-income, etc. to take necessary measures(2) Establishment of a system for promoting social security system reformIn order to promote smooth implementation of (1) above and to continue to discuss sustainable social security systems with benefits and burdens being balanced for medium- to long-term, etc., Headquarters for the Promotion of Social Security System Reform, comprised of relevant Ministers and Council for the Promotion of Social Security System Reform comprised of experts, shall be established.