高額医療費制度は、高額な医療費支払いに対して所得に応じて支払額がキャップされることで多くの方に恩恵があります。
その中で、更なる改善点が「中低所得者への取組み」と言えましょう。
その取組みを公明党の「コメすけ」が分かりやすく説明いたします。どうぞご覧ください。
病気やけがで高額な医療費が掛かっても、医療機関の窓口で支払う1カ月の自己負担額を所得に応じた限度額に抑える「高額療養費制度」。誰もが安心して医療を受けられるように、公明党は一貫して制度の改善を進めてきた。これまでの主な取り組みを紹介します。
「入院時の負担が前回より減額され、とても助かりました」―。
今年1月からの制度見直しでは、公明党が長年訴えてきた中低所得者の限度額引き下げが実現。
高額療養費の計算例今回の見直しでは、70歳未満の所得区分のうち、住民税非課税者と上位所得者(年収約770万円以上)の間にある「一般」の区分を分割。年収約370万円までの限度額を従来の8万円程度から5万7600円に引き下げた。自己負担3割で医療費が100万円なら、負担は約3万円減る計算だ。負担軽減の対象は約4060万人。
これまで、一般の区分は年収の幅が広いため、より所得が低い患者ほど負担割合が大きくなっていた。そこで公明党は、2010年1月の衆院予算委員会で井上義久幹事長が「一般」の分割を提案するなど、粘り強く改善を推進。その結果、社会保障と税の一体改革の中で見直しが決まった。
このほか、同制度に関連して公明党が実現させたのが、医療費窓口支払いの負担軽減だ。
同制度では、70歳未満で窓口負担が自己負担限度額を超えた場合、いったん患者が窓口負担額を支払い、申請を経て後日、加入する公的医療保険から窓口負担と限度額の差額が支給される。しかし、これでは患者が一時的とはいえ多額の費用を用意しなければならない。その上、差額の払い戻しが受診月から3カ月程度かかるのも難点だ。
このため公明党は、入院については07年から、事前に公的医療保険が発行した認定証を提示すれば、窓口での支払いを限度額までとする改善を実現。12年からは外来診療も同じ仕組みとなり、長期にわたって高額な抗がん剤を使用する通院患者などの負担が軽減されている。
なお70歳以上は、低所得(住民税非課税)の区分は認定証が必要だが、それ以外は手続きをしなくても限度額までの支払いとなる。
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