Bioethics Across the Globe by Akira Akabayashi
Author:Akira Akabayashi
Language: eng
Format: epub
ISBN: 9789811535727
Publisher: Springer Singapore
7.1.2 Social Welfare: Public Livelihood Assistance and Pensions
In 2017, roughly 2.14 million persons (1.8% of the total population) were eligible for and received welfare benefits. Of these, 45.5% were 65 years or older. In Japan, those eligible for welfare receive a monthly amount of JPY 137,400 in addition to free medical care and medicines. Thus the living costs alone add up to roughly JPY 3.84 trillion, and such costs are increased if the health benefits for welfare recipients are added.
If a Japanese citizen is employed at a private company between the ages of 20 and 60, a portion of his or her salary is withheld from each paycheck as a pension. As of 2019, a couple who are 65 years and older receive a pension of average JPY 220,000. This is close to an average starting salary of a university graduate. This is another example of outcome egalitarianism. While some discrepancy remains in the amount set aside for each individual, all citizens receive nearly the same amount in their pensions. However, the pension alone is insufficient to cover the cost of living, so those who are able to do so will also prepare by saving for retirement. As regards health care, 10–30% of medical fees for those receiving a pension are covered out-of-pocket.
One may argue that investing heavily in welfare is one form of outcome egalitarianism, in that a nation chooses to assist others so that the outcomes (living standards) are “equal” (with as few disparities as possible). In Japan, this is demonstrated by a general intent “by all citizens to help those in need so that they can all live at roughly the same level as everyone else.” The philosophy of outcome egalitarianism—represented in this case by equal burden and mutual aid—plays a major role in this system. This outcome egalitarianism guaranteeing access to medical care and social welfare is rooted not only in medical care, but also in many other policies in Japanese society.
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