4 四つの論点から見る障害年金改革 : アメリカ,スウェーデンとの比較を手がかりに(III 投稿論文)

抄録

This paper examines and compares the structure of disability pensions in the United States and Sweden. Based on this analysis, the paper then analyzes the current status of disability pensions in Japan. The following four viewpoints are adopted throughout the paper: (1) disability evaluation, (2) employment support, (3) the relationship between disability pensions and old-age pensions, and (4) methods for procuring financial resources. The following are the conclusions and suggestions based on an analysis of disability pensions in the United States, Sweden and Japan. Regarding disability evaluation, in the United States and Sweden disability is assessed mainly based on the decline in income-earning ability, whereas in Japan the assessment is made primarily according to the levels of functional deficit. Several problems arise out of Japan's system of assessment. This may suggest that Japan's current system of disability evaluation needs to be reexamined. Regarding employment support, the United States adopts the Ticket to Work program mainly in order to control costs, and urges disability pension recipients to utilize vocational rehabilitation services. Sweden values job assistance for disability pension recipients, and provides assistance for recipients to be engaged in social activities, especially from the viewpoint of social inclusion. Japan, following the latter viewpoint, needs to build a framework that encourages disability pension recipients to participate in social activities and the labor market. This framework also needs to be combined with income security. Regarding the relationship between disability pensions and old-age pensions, disability pensions have been separated from old-age pensions in Sweden due to pension reforms in recent years. Japan will also face greater difficulties in dealing with these two types of pensions under a single system if it attempts to strengthen the corresponding relations between contributions and benefits of public pensions. Furthermore, the increasing expansion of the differences between aging and the risks of becoming disabled undermines the rationale of having these two pensions under a single system. In addition, as is discussed in the United States, if the standard of disability pension benefits is reduced at the same rate as that of old-age pension benefits, disability pension recipients will be more adversely affected. Therefore, the management of two different pensions under a single system may require reconsideration. Finally, although Japan's disability pensions system is managed under a social insurance method, most of the recipients receive noncontributory pensions. Moreover, social insurance premiums are used as part of the financial resources of the noncontributory pension, and this makes disability pension system extremely obscure. In the United States and Sweden, however, when social insurance systems cannot in principle deal with persons who have no or insufficient contribution records, a tax-funded scheme such as public assistance (United States) or minimum guaranteed benefit (Sweden) is uniformly utilized. There is also scope to consider this type of clear division of financial resources in Japan.