日本健保、長照費用齊漲逾2%，高齡化浪潮下的艱難抉擇
日本政府決議自2026年度起調漲醫療與長照給付，漲幅分別為2.22%與2.03%。此舉雖為改善照護人員待遇，卻也加重民眾負擔，凸顯高齡化社會的嚴峻財政挑戰。
漲價的警鐘已經響起。當日本政府拍板調漲醫療與長期照護費用，這不只是一串冰冷的數字，而是對每個國民未來生活的直接衝擊。根據12月24日的最新決策，攸關醫療院所收入的「診療報酬」與長照機構營運的「介護報酬」將從下一年度起同步調升。這是在人口結構懸崖邊緣，一場無可避免的痛苦平衡。
雙重調漲：為待遇加薪，還是為財政續命？
具體而言，日本政府決定，醫療部分的「診療報酬」整體將調升2.22%；而「介護報酬」也將以改善照護人員薪資為名，臨時調漲2.03%。此舉的背後，是醫療與長照前線日益嚴峻的人力缺口。政府希望透過提高給付，直接反映在薪資單上，藉此留住人才，避免體系崩潰。
使用者首當其衝：自付額悄然增加
然而，羊毛終究出在羊身上。在提高給付的同時，民眾的荷包也將面臨更大壓力。就在今日（12月25日），官方傳出將依據所得，調高「高額療養費制度」的每月自付費用上限。不僅如此，厚生勞動省已於12月22日大致同意，將過去原則上免費的「照護管理」（Care Management）服務部分轉為收費制。這意味著，服務的使用者，也就是高齡者與其家屬的負擔加重，已成定局。
122兆日圓預算下的社福壓力
這一系列的政策調整，反映了日本國家財政的殘酷現實。預計明日公布的下一年度總預算，一般會計總額將高達122兆3100億日圓左右，其中社會福利支出是最大宗，且隨著人口老化持續膨脹。此次的同步調漲，凸顯了政府在這巨大財政壓力下，維持社福體系運作的左支右絀。
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