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介護支援専門員のための介護保険NEWS

 「契約にのれない高齢者を支える仕組みが必要」

「契約に乗れない高齢者」を支える仕組みが不十分で、救貧的なサービスが必要な高齢者を社会が見捨てることになりかねない―。日本医学協会が6月14日、「医療と介護と高齢者」をテーマに開いたシンポジウムで、ケアマネジャーでもある結城康博・淑徳大准教授はこう指摘した。介護保険制度がスタートしてから、介護サービスは「措置」から「契約」に変わったが、低所得や独居の高齢者など「契約主義に乗れない人」もいる。社会保険だけでなく、福祉の枠組みで高齢者を支えることが必要だという。

 結城准教授は冒頭、「今、国では要介護認定の問題が出ているが、わたしはより本質的な医療、介護の現場の問題があると考えている」と述べた。特に2006年の医療制度改革と介護保険の改正を挙げ、「小泉政権時代のこの改革をきちんと見ないと、本質的な医療と介護の問題は語れないと思う」と語った。
 その上で、医療費や介護費の抑制策は、「失策というほかない」と指摘。群馬県渋川市の無届け施設で起こった火災なども、「失策によって増えてきた問題」とし、「わたしが現場にいた時も、独居高齢者はたくさんいたが、何とか法にのっとった社会資源を使うことができた。それが、(今では)ほとんどそのカードがなくなってきている」と述べた。

 また結城准教授は、社会保険の枠組みだけで高齢者へのサービスを行うことには限界があると指摘。「高齢者へのサービスが、あまりにも社会保険にシフトし過ぎたのでは。本来、医療と介護と老人福祉という分野がなければならないのではないか。しかし実際には、医療保険と介護保険しかない」と述べた。
 特に介護保険制度がスタートしてから、高齢者向けのサービスは「契約が前提」となったため、「『契約に乗れない人』の行き場が、だんだんなくなっている」と指摘。中でも独居高齢者には、お金があっても、「そのお金を使うサポートをする身内」がおらず、現場では問題になっているとした。
 さらに結城准教授は、こうした独居高齢者は今後、増えていくことが予想されるが、日本の社会ではまだ、他人によるサポートがしづらいことが問題だと指摘。成年後見制度も、低所得者が利用するのは「かなり難しい」のが実情で、後見人も善意でやっている面があるとし、「政策的になっていないのではないか」と述べた。
 その上で、「独居高齢者が増える中で、制度はどんどん契約主義にシフトしているにもかかわらず、『契約主義に乗れない人』のサポート的な社会資源がない」「福祉サービスを制度に残しておかないと、低所得者や救貧的なサービスを必要としている高齢者を、社会が見捨てることになりかねない」と強調した。
 
 社会保障の財源については、年金、医療、介護のうち、「基本的に医療と介護は消費税で賄うべきだと思う」と述べ、50年度までに消費税率を徐々に引き上げていくべきとの考えを示した。また、財源の問題では政治の責任が大きいが、「厚生労働省はもう少し、(概算要求で)『これだけ必要だから』と財務省に伝えて、(予算の確保に)頑張ってほしい」と述べた。(医療介護CB)


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NEWS】病院の病床数、1年間で8600床減-10月末概数【介護支援専門員】アルツハイマー治療薬は2,900億市場に――民間調査【介護支援専門員】アルツハイマー治療薬は2,900億市場に――民間調査【介護支援専門員 NEWS】「潜在ヘルパー」有資格者の79%【介護支援専門員 NEWS】サービス提供責任者の責務に介護報酬を―ホームヘルパー協会が要望書【介護支援専門員 NEWS】「高齢者向け食品・飲料購入のきっかけはケアマネジャー」電通調査結果【介護支援専門員 NEWS】厚生労働省、介護給付費実態調査月10月分を公表【介護支援専門員 NEWS】介護業界売上トップ10!2000億超の企業は?――帝国データバンク【介護支援専門員 NEWS】健康状態の悪化や、退職の割合に介護が影響【介護支援専門員 NEWS】厚労省の社会保障検討本部が発足【介護支援専門員 NEWS】「どこでもMY病院」など情報化促進に15億円-経産省11年度予算案【介護支援専門員 NEWS】世界80カ国で承認の2型糖尿病治療剤「パイエッタ」発売【介護支援専門員 NEWS】29兆円のうち、介護2兆2,037億円――平成23年度予算案【介護支援専門員 NEWS】「地域医療支援センター」に意見が集中―社保審医療部会【介護支援専門員 NEWS】サービス付き高齢者住宅、24時間介護との組み合わせで【介護支援専門員 NEWS】サービス付き高齢者住宅の促進に325億円―国交省11年度予算案【介護支援専門員 NEWS】一部ユニット型施設、省令改正で廃止へ【介護支援専門員 NEWS】来年度の平均保険料率9.5%に引き上げへ-補助率の据え置き受け入れ【介護支援専門員 NEWS】認知症の要介護認定について【介護支援専門員 NEWS】「ケアプラン有料化」見送り!厚労相が改正6要点を表明!【介護支援専門員 NEWS】新規アルツハイマー病治療薬などの承認を了承―薬事分科会【介護支援専門員 NEWS】来年度予算案を閣議決定、厚労省分は約29兆円【介護支援専門員 NEWS】横浜の市民団体、配食サービス時の認知症見守りハンドブック発行【介護支援専門員 NEWS】「福祉士研修の大幅削減はバナナの叩き売り」――検討会レポ2【介護支援専門員 NEWS】民主政調、介護保険改革の提言を決定―細川厚労相に提出【介護支援専門員 NEWS】ケアマネ対象の医療研修など「10年後の東京」を策定――東京都【介護支援専門員 NEWS】交付金の影響でケアマネも1.1万円昇給【介護支援専門員 NEWS】新高齢者医療制度、国保のあり方など地方と協議へ―厚労省方針【介護支援専門員 NEWS】他国に比べて高コスト体質の日本の介護保険【介護支援専門員 NEWS】「重症」の医療区分1の患者が急増―医療療養病床【介護支援専門員 NEWS】「利用者負担導入反対決議文」を厚労省に提出――日本介護支援員協会【介護支援専門員 NEWS】マクドナルドが高齢者宅へ宅配開始、創業40年で初!【介護支援専門員 NEWS】介護職の医行為、2012年実施へ【介護支援専門員 NEWS】ケアマネ試験、合格率は過去最低の20.51%【介護支援専門員 NEWS】「介護保険制度改正ができないなら、政権担当能力はない」【介護支援専門員 NEWS】障がい者改革会議、現状認識に関係省庁と隔たり【介護支援専門員 NEWS】介護職員の医行為の範囲など示した中間まとめを了承―厚労省検討会【介護支援専門員 NEWS】介護療養廃止「3年延期」などの提言を大筋了承―民主・厚労部門会議【介護支援専門員 NEWS】成年後見制度の改善求め厚労相らに提言―日本社会福祉士会【介護支援専門員 NEWS】600万人の高齢「買い物弱者」支援マニュアル―経産省が公表 【介護支援専門員 NEWS】「介護なんでも110番」電話殺到で対応は約3%【介護支援専門員 NEWS】シルバーマークは「時代的役割終えた」?―省内仕分けで議論【介護支援専門員 NEWS】「男女雑魚寝」「2年連泊」、お泊まりデイの実態調査を―共産都議団【介護支援専門員 NEWS】平成22年 介護保険部会の取りまとめ【介護支援専門員 NEWS】精神障害者への訪問支援で大幅なコストダウンも―民主PTがヒアリング【介護支援専門員 NEWS】首都圏の介護事業者団体「地域係数見直しを」―細川厚労相に要望書【介護支援専門員 NEWS】24時間巡回型に1.5億、医行為研修2.8億円計上――第2次補正予算案【介護支援専門員 NEWS】介護療養型医療施設は「医療・介護の連携にベストな施設」【介護支援専門員 NEWS】高いレベルの介護福祉士、職能団体が認定―厚労省案【介護支援専門員 NEWS】都が介護事業所の指定取り消しへ、1億5千万円超の返還求める【介護支援専門員 NEWS】特養も有料老人ホームも高専賃も「高齢者住宅」―類型簡素化を ケアプラン有料化は未決着、賛否両論併記で国会提出!――社保審レポ【介護福祉士 NEWS】24時間訪問介護やお泊まりデイは区市町村が指定を―都が提言【介護支援専門員 NEWS】介護職員交付金、報酬への組み入れに疑問も―民主・介護WT【介護支援専門員 NEWS】介護保険、4割強が税負担を容認―内閣府調査【介護支援専門員 NEWS】新規アルツハイマー治療薬2品目の承認を了承―医薬品第一部会【介護支援専門員 NEWS】高専賃での居宅介護支援、集中減算に批判―高齢者集合住宅研究大会【介護支援専門員 NEWS】認知症患者の見守りネット、稼働の自治体は1割未満【介護支援専門員 NEWS】定額訪問介護、「報酬28万―30万円必要」―ジャパンケア・対馬会長【介護支援専門員 NEWS】介護保険制度の見直しに向けた素案を提出―厚労省【介護支援専門員 NEWS】第5期の介護保険料、1000円超アップの5200円―厚労省が試算【介護支援専門員 NEWS】障害者自立支援法改正案を可決―衆院厚労委【介護支援専門員 NEWS】「国保の都道府県単位化」に異論なし―民主・高齢者医療WT【介護支援専門員 NEWS】介護予防事業の再仕分け、前回同様「予算要求の縮減」【介護支援専門員 NEWS】「ケアプランの利用者負担は断固反対」――JCMA提言【介護支援専門員 NEWS】「介護職員の医行為は、医療・介護の新たな線引きを考える糸口」【介護支援専門員 NEWS】仕事に関する相談窓口、職場に「なし」が9割――ヘルパー満足度調査【介護支援専門員 NEWS】「介護政策、財源足りない」―小宮山厚労副大臣【介護支援専門員 NEWS】「地域医療支援センター」に意見が集中―社保審医療部会【介護支援専門員 NEWS】『VIPSですすめるパーソン・センタード・ケア』発行【介護支援専門員 NEWS】静岡で過去最大級の報酬不正受給―介護療養型医療施設の指定取り消しへ【介護支援専門員 NEWS】特養の運営「社福に限定を」約5割―施設長有志団体【介護支援専門員 NEWS】75歳以上の医療費負担、「税金の割合増で」が4割超【介護支援専門員 NEWS】全老健、老健の医療に関する意見書を発表【介護支援専門員 NEWS】【11月13日】ケアマネ独立開業セミナー 【介護支援専門員 NEWS】全老健、介護保険制度に対する意見書を発表【介護支援専門員 NEWS】通所サービスの見直しも―厚労省老人保健課長【介護支援専門員 NEWS】日本介護福祉士会が人員配置、処遇改善などの提言書を提出【介護支援専門員 NEWS】末期がんで福祉用具貸与、軽度者でも保険適用可能―厚労省が事務連絡【介護支援専門員 NEWS】区分支給限度基準額の運用見直しなどを提言―ホームヘルパー協議会【介護支援専門員 NEWS】ケアプラン作成「利用者負担」導入を提示――社会保障審議会【介護支援専門員 NEWS】介護福祉士資格の600時間研修案「現実的ではない」【介護支援専門員 NEWS】1万人超の障害関係者が「自立支援法の廃止を」【介護支援専門員 NEWS】介護職員養成13万円、救急搬送7,600円――埼玉県「行政の値札」【介護支援専門員 NEWS】 夜間訪問介護で16億円ムダ、端末機は倉庫保管でホコリかぶる【介護支援専門員 NEWS】ユニット型特養の約1割が赤字【介護支援専門員 NEWS】介護サービス費用額、6000億円超える―給付費実態調査・8月分【介護支援専門員 NEWS】 来年アリセプト以外の新薬認可【介護支援専門員 NEWS】介護福祉士の医行為追加研修と上級資格創設――厚労省会議 【介護支援専門員 NEWS】特養入所申し込み者、実際の待機は22.5%―厚労省 【介護支援専門員 NEWS】1万円増えた!ケアマネ月給26万3,754円――日本介護クラフトユニオン調査介護支援専門員のための介護保険NEWS介護支援専門員の介護保険NEWS介護支援専門員の介護保険NEWS介護支援専門員の介護保険NEWS介護支援専門員の介護保険NEWS介護支援専門員の介護保険NEWS介護支援専門員の介護保険NEWS介護支援専門員の介護保険NEWS平成21年介護支援専門員実務研修受講試験 合格率介護支援専門員の介護保険NEWS介護支援専門員の介護保険NEWS介護支援専門員の介護保険NEWS介護支援専門員の介護保険NEWS平成21年介護支援専門員実務研修受講試験 都道府県別 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