Premiums and wages at heart of social security debate ahead of Upper House vote

Japan Times

09-07-2025

Political parties have pledged to reduce social security premiums and raise salaries for medical and nursing care workers in their campaigning for the July 20 election for the House of Councilors, the upper chamber of parliament.
The pledges come as premiums have been rising because of an aging population and higher prices. Since benefits and burdens come as a set, it is essential for the parties to identify a concrete path to realize the reform.
Social security benefits swelled from ¥78.4 trillion in fiscal 2000 to ¥137.8 trillion in fiscal 2022, while social security premiums grew from ¥26.7 trillion to ¥40.7 trillion, according to the welfare ministry's National Institute of Population and Social Security Research.
For this reason, the government aims to increase social security burdens on certain people, but such reform faces strong opposition. For example, the government had to freeze a plan to raise out-of-pocket payments for high-cost medical care due to a backlash from opposition parties and patient groups.
Campaign pledges by Nippon Ishin no Kai put priority on reducing social security burdens on households.
The opposition party promised to raise net income by ¥60,000 per person per year by reducing the country's medical expenses by ¥4 trillion annually. The reduction can be achieved including by cutting the number of excess hospital beds by around 110,000, Nippon Ishin said.
The Democratic Party for the People, another opposition party, calls for raising out-of-pocket medical expenses for people who are 75 or older from the current 10%, in principle, to 20% to reduce the premiums for the working generation.
The main opposition Constitutional Democratic Party of Japan seeks to set an upper limit on the total amount of out-of-pocket expenses for medical, nursing care and welfare services in accordance with the user's income.
The ruling Liberal Democratic Party pledged to raise the official prices of medical and nursing care services to raise the wages of workers in the sectors. Komeito, the LDP's coalition partner, called for raising the wages of nursing care and welfare workers to the average of all industries, at ¥386,000 per month.
The proposal by the ruling coalition to raise the official prices of medical and other social security services would lead to an increase in premiums and tax burdens. Opposition parties' pledges to reduce premiums are also challenging in terms of how to secure financial resources.
Prime Minister Shigeru Ishiba, who leads the LDP, said the government will consider establishing a suprapartisan panel on social security reform, stressing the need to discuss the issue without prioritizing the interests of parties.
Through such discussion, both ruling and opposition parties need to foster a common understanding that social security reform requires painful measures, experts said.