Top > ご連絡など > ケアマネジャーの介護保険NEWS > 【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】民主政調、介護保険改革の提言を決定―細川厚労相に提出
提言では、総論として、第4期介護保険事業計画期間(2009-11年度)で4160円となっている介護保険料の全国平均について、第5期(12-14年度)は、5000円以内に抑える必要があると明記。今回の制度改正は必要最低限にとどめ、今後の税と社会保障をめぐる改革の議論と歩調を合わせながら、党の介護ビジョン策定や診療報酬・介護報酬の同時改定に向けた検討を進めるとした。
各論では、介護療養病床の取り扱いについて、「2011年度末の廃止を3年間延期する法改正を行う」とした上で、「施設サービス全体で、機能や評価の見直しを進める」と明記した。延期期間終了後の在り方ついては、「どういう方向性を取っていくかは、実態をよく精査して政府が判断すべき」(石毛座長)との立場だ。
11年度で終了する介護職員処遇改善交付金については、介護報酬の外に位置付ける現在の仕組みを12年度以降も継続するよう要望。一方、交付金を介護報酬に組み入れる場合は、「ガイドラインの提示などで実効性を担保するとともに、財源は義務的経費として確保に努める」ことを提案している。
また、社会保障審議会介護保険部会がまとめた意見書の中で、賛成と反対の両論併記が目立った利用者負担を引き上げるメニューについては、「(負担額を)上げたからといってそれほど大きなプラス効果を生むものではない」(石毛座長)として、導入に慎重な姿勢を示した。生活援助の2割負担導入や居宅介護支援(ケアプラン作成)への自己負担導入を「行わない」と明記したほか、高所得者の負担引き上げや多床室の室料負担についても、実態を踏まえた慎重な検討を求めている。
国庫負担の軽減策として検討されている第2号被保険者の介護保険料への総報酬割導入をめぐっては、「高齢者医療制度との兼ね合いもあり、拙速な導入は避ける」とした。一方で、財政安定化基金の取り崩しについては、「保険料の軽減に活用できるよう法的整備をする」とした。
提言ではこのほか、▽介護職員によるたんの吸引などの医療行為については、法整備を行って実施体制を確立する▽介護福祉士の資格取得方法の見直しを3年間延期するとともに受講者の負担軽減などを図る▽24時間対応の定期巡回・随時対応サービスや複合サービスを整備する▽生活援助サービスを継続する▽低所得者対策は介護保険の中での対応ではなく公費福祉施策として拡充を図る―などの項目を盛り込んでいる。
民主党はこれまで、厚労部門会議の下に設置された介護保険制度改革ワーキングチーム(主査=藤田一枝衆院議員)で、介護保険制度の見直しに向けた提言を議論してきた。その提言案は 8日の厚労部門会議、15日の政調役員会で大筋了承されたものの、文言の一部に修正を求める意見が上がった。続く17日の拡大政調役員会でも議題となったが、政調役員と厚労部門会議の間で情報共有が不十分だったとして、最終決定は持ち越しとなっていた。
■介護従事者の4万円賃上げ「実現したい」―石毛座長
細川厚労相への提言提出後に記者団の取材に応じた石毛座長は、民主党が昨年の衆院選で掲げた介護従事者の月額4万円程度の賃金引き上げについて、「実現していきたい」との考えを改めて示した。その上で、税と社会保障をめぐる改革の議論を踏まえながら、ワーキングチームや厚労部門会議で議論する課題だと述べた。
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【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
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