Senior citizens' financial circumstances should not be assumed to be uniform when discussing social security policy for the nation's rapidly graying society. 

Discussion of plans to reform the medical insurance system among the government and ruling coalition parties are focusing on how much of their own medical expenses senior citizens should be asked to shoulder. 

Currently, people aged 3 to 69 pay 30 percent of their medical expenses at clinics and hospitals. Citizens aged 70 or older pay 10 percent, with the exception of those earning "the same level as those of working age," who pay 20 percent. 

The government and the ruling coalition of the Liberal Democratic Party and New Komeito are planning to raise the burden for elderly people earning "the same level as those of working age" to 30 percent of total medical bills. 

"The same level as those of working age" means about 1.45 million yen or more in taxable income per household. In terms of annual income, it means about 6.2 million yen or more for a couple of senior citizens and 4.8 million yen or more for a single senior person. 

Such earnings may be insufficient for a retirement of leisure, but are sufficient to live in moderate fashion. Among senior citizens, about 6 percent or 1.2 million people, have incomes in excess of this level. The government would be able to win the public's support if it insists on increasing the burden to 30 percent for those people. 

Tax reform means change:

Since the tax system reforms abolish some tax breaks next fiscal year, the taxable income for a senior couple earning 5.2 million yen a year will exceed 1.45 million yen. As a result, the number of senior citizens considered to be earning "the same level as those of working age" will increase to 11 percent or 2 million people. 

They are also people with enough financial strength to maintain good earnings even after retirement. There may be little opposition to increasing their burden as long as some measures are taken to alleviate drastic changes. 

However, careful discussion is needed on increasing the burden for the other nearly 90 percent of senior citizens. 

Financial circumstances differ widely among senior citizens. According to the results of a survey by the Health, Labor and Welfare Ministry, 2.2 percent of senior citizens' households earn 10 million yen or more a year, while nearly a half of the households earn less than 2 million yen a year. 

Consider income disparity:

The government and the ruling coalition are discussing a plan to charge medical burden of 20 percent for those aged 65 to 74 among senior citizens not earning an income at "the same level as those of working age." However, they have to pay more careful consideration to income disparity among the elderly population. 

Of the total medical costs of 32 trillion yen a year, senior citizens account for one third. This portion keeps expanding as the population ages. To maintain the public medical insurance system, the government cannot avoid demanding that senior citizens shoulder greater burdens according to their means, though careful consideration must be paid to those with low incomes. 

However, this reform of the medical insurance system has not been discussed as part of the social security system. Pension, nursing care and medical insurance reform plans have been discussed every year in this order, but, they have been discussed separately and every reform increases the burden borne by the public. This only increases people's concerns about their lives after retirement. 

The government and the ruling coalition should start a comprehensive review of the social security system as soon as possible.