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Health Policy Summit 2019 Hosted by Health and Global Policy Institute (HGPI) 2019年2月23日（土） Saturday, February 23, 2019 医療政策サミット2019

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Health Policy Summit 2019 Hosted by Health and Global Policy Institute (HGPI) 2019年2月23日（土） Saturday, February 23, 2019 医療政策サミット2019 医療政策サミット2019 特定非営利活動法人 日本医療政策機構（HGPI） 主催 Health Policy Summit 2019 Hosted by Health and Global Policy Institute (HGPI) 2019年2月23日（土） Saturday, February 23, 2019 医療政策サミット2019 ■日時： 2019年2月23日（土）10:30-15:30 ■会場： 六本木アカデミーヒルズ タワーホール 10:30 開会 開会の辞 10:35-10:40 上野 宏史（厚生労働大臣政務官） 趣旨説明・HGPIの15年を振り返る 10:40-10:50 乗竹 亮治（日本医療政策機構 理事・事務局長） 10:50-11:50 セッション 1「次世代を担うキーパーソンと考える日本の医療」 11:50-13:00 ランチネットワーキング 13:00-14:00 セッション 2「リデザイニング人類社会 ～デジタル化する医療・国・個人の関係のなかで」 14:20-15:20 セッション 3「いま考える2040年の社会保障」 閉会の辞 15:20-15:30 黒川 清（日本医療政策機構 代表理事） *同時通訳あり・敬称略 Health Policy Summit 2019 ■ Date & Time: 10:30-15:30, Saturday, February 23, 2019 ■ Venue: Tower Hall, Roppongi Academy Hills 10:30 Opening Welcoming Remarks 10:35-10:40 Hiroshi Ueno (Parliamentary Vice-Minister of Health, Labour and Welfare (MHLW)) Explanatory Introduction / Reviewing HGPI’s 15 Years 10:40-10:50 Ryoji Noritake (CEO, HGPI) 10:50-11:50 Session 1: A Conversation on Healthcare in Japan with Key Leaders of the Next Generation 11:50-13:00 Lunch Networking Session 2: : Redesigning Society – Digitization of the Healthcare-Government-Individual 13:00-14:00 Dynamic 14:20-15:20 Session 3: Setting a Vision for Social Security Towards 2040 Closing Remarks 15:20-15:30 Kiyoshi Kurokawa (Chairman, HGPI) *Simultaneous translation will be available **Titles omitted 2 | Health Policy Summit 2019 セッション1「次世代を担うキーパーソンと考える日本の医療」 10:50-11:50 Session 1: A Conversation on Healthcare in Japan with Key Leaders of the Next Generation 多くの政策領域と同じくして、医療政策を含む社会保障政策では、国民への給付や富の再分配のみならず、国 民に負担の分配を求める状況が発生します。特に、超高齢社会を迎えた我が国においては、社会保障領域での 今後の国民負担は、多くの国民にとって関心事になっています。国立社会保障・人口問題研究所が2017年に公 表した推計によると、2025年には、75歳以上の後期高齢者の全人口に対する割合が17.8パーセントに達し、2040 年代には高齢化社会がピークに至り、人口の35パーセント以上が65歳以上の高齢者になると予測されています。 このような状況にあって、「日本のあるべき医療・社会保障」について国民にビジョンを示し、説得していく 政治的リーダーシップは不可欠です。立法府で今後も活躍が期待される次世代のキーパーソンが思い描くビ ジョンは何か。与野党のリーダーの知見を共有します。 As is common in many other fields of policy, social security policy including healthcare policy can cause the redistribution of public benefits and wealth and may increase the burden borne by the public. This is particularly true in Japan, where the population is rapidly aging and the future public burden in the in the field of social security is a point of concern for many citizens. According to a projection published in 2017 by the National Institute of Population and Social Security Research, the percentage of Japan’s population in the late elderly stage of life aged 75 and over will reach 17.8% in 2025. They predict that this rate will peak in the 2040, when over 35% of the population will be 65 and older. In light of this situation, the public must be presented with a vision of the ideal form of health and social security for Japan and, to this end, convincing political leadership is crucial. What is the vision of the next generation of key persons who will be active in creating the legislation of the future? We will share knowledge from members of both the ruling and opposition parties. セッション2 「リデザイニング人類社会 ～デジタル化する医療・国・個人の関係のなかで」 13:00-14:00 Session 2: Redesigning Society – Digitization of the Healthcare-Government-Individual Dynamic 国民皆保険など保健医療システムを含む社会保障の給付や負担などのメカニズムは、国民国家にとって、そし て市民にとって、国家と国民の関係性を形作る人類の「発明」でもありました。一方で、世界はグローバル化 し、デジタル化し、病原菌の伝播も、イノベーションの伝播も、医療データの収集も、全地球的なスピードで 進みつつあります。このように、人類社会にとっての保健医療システムが大きく変わろうとするなかで、国と 個人の関係はどのように変化していくのでしょうか。医療の概念は、どのように変遷するのでしょうか。デジ タルヘルスやデータヘルス、そしてデザイン領域の有識者とともに、医療のグローバル化とデジタル化が、人 類社会にもたらす意味合いを検討します。 To the nation-state and the public, the mechanisms governing benefits and burdens in social security systems – including healthcare systems like universal health coverage (UHC) – were a human invention for linking the nation and its citizens. However, the world has globalized and digitized. The transmission of both pathogenic bacteria and innovation as well as the collection of healthcare data is accelerating around the entire world. In light of such progress, how will the major changes to healthcare systems we are trying to make alter the relationship between the state and the individual from a societal viewpoint? How will the concept of healthcare change? Together with experts in digital health, data health, and the field of design, we will examine the implications of the globalization and digitization of healthcare for society. セッション3「いま考える2040年の社会保障」 14:20-15:20 Session 3: Setting a Vision for Social Security Towards 2040 世界でも類をみないスピードで少子高齢化と人口減少が進む日本。65歳以上人口が約4,000万人とピークに達す る2040年には、社会保障給付費が、2018年度121.3兆円から、190兆円にのぼるという推計が2018年5月に経済財 政諮問会議で示されました。こうした状況を踏まえ、2018年10月には、「2040年を展望した社会保障・働き方 改革本部」が厚生労働省に設置されるなど、具体的な議論が始まろうとしています。今後、日本が限られた資 源をいかに効率的に活用し、また、生産性を向上させていけるのか。具体的な政策の打ち手は何か。2040年の あるべき姿を見据えたうえで、必要な施策について議論を深めます。 With a decreasing birthrate and aging public, Japan’s population is decreasing at a rate seen nowhere else in the world. According to a May 2018 finding by the Council on Economic and Fiscal Policy (CEFP), the cost of social security is projected to increase from 121.3 trillion yen in 2018 to 190 trillion yen in 2040, when the number of people aged 65 and older will peak at approximately 40 million people. In response, the Ministry of Health, Labour and Welfare has begun concrete discussions on this subject, starting with the first headquarter meeting for social security and work style reforms for the year 2040 that was held in October 2018. In the future, how can Japan optimize the use of its limited resources and how can it increase productivity? What specific policies should be enacted? With a focus on the ideal situation for 2040, we will deepen discussions on what policies must be created. Health Policy Summit 2019 | 3 日本医療政策機構 代表理事 挨拶 「医療政策サミット2019」にご出席いただき、誠にありがとうございます。日本医療政策機構は、2004年に非営利・独立・ 超党派のシンクタンクとして活動をスタート、今年で15年目を迎えました。国民が真に必要とする医療を実現するには、幅 広いステークホルダーを結集し、政策の選択肢をオープンに議論し、責任ある決定を求めるプロセスの確立が不可欠である との考えのもとに、「Healthy Debate」というキーワードを掲げ、活動を行ってまいりました。 2018年は、診療報酬・介護報酬の同時改定をはじめとし、医療計画や介護保険事業（支援）計画の新たな期がスタートする など医療・介護一体改革を進めるにあたって変革の年となりました。また当機構では、世界認知症審議会（WDC: World Dementia Council）と連携し、3月にはWDC会議を東京で開催致しました。WDCは昨年12月には5周年を迎え、記念誌には安 倍総理の巻頭辞が掲載されるなど、世界の認知症対策における日本の引き続きのコミットメントを示す機会となりました。 さらに当機構は、AMR アライアンス・ジャパン（薬剤耐性: Antimicrobial Resistance）の設立、NCDアライアンス（Non- Communicable Diseases：非感染性疾患）の日本事務局としての正式登録など、感染症・非感染性疾患の両分野においてもマ ルチステークホルダーが連携し、グローバルで対策を進めていくプラットフォーム構築を主導してまいりました。 2019年は、大阪でG20サミット、横浜でTICAD7（第7回アフリカ開発会議）が開催されます。ユニバーサル・ヘルス・カバ レッジ（UHC: Universal Health Coverage）はもちろんのこと、AMRやNCDsをはじめとしたボーダレスな医療政策課題について 日本が主導して議論を進める重要な年となります。そして、今年は「平成」から新たな元号に移る節目の年でもあります。 2040年に向けて真に持続可能な社会保障制度が構築できるよう、中長期的な視点からの取り組みをスタートさせるのはもち ろんのこと、短期的な視点では給付と負担の見直しに関する議論も避けて通ることはできません。そして高齢化最先進国と して、その取り組みを世界へ発信していくことが引き続き求められています。 当機構においても、国際的課題である認知症については、引き続き世界認知症審議会（WDC: World Dementia Council）と連 携し、認知症にやさしい社会の構築に向けた各国との連携・共同研究などを深めていく予定です。さらにはNCDsの視点から、 疾患横断的に患者・当事者の声を政策立案に活かすための試みを進めてまいります。また、日本を含む世界各国において、 国際的脅威ともなっているAMR対策については、AMRアライアンス・ジャパンを通じて多様なステークホルダーとの連携を 深め、さらなる政策の進展に寄与していきます。 昨今の医療政策課題は国内課題でありながらもグローバル課題でもあるという状況が生まれています。だからこそ、グロー バルな視座からマルチステークホルダーがオープンに議論し、論点を整理する場が必要なのです。「医療政策サミット 2019」では、産官学民のマルチステークホルダーが集い、これまでの成果そして課題を整理しつつ、「平成」の次の時代を 見据え、これらに向き合う将来像やビジョンを、そして喫緊の解決策について、議論を深めてまいります。オープンな議論 が行われ、参加者ひとりひとりが立場を越えて行動する、そのきっかけとなる場にして頂きたいと願っています。 日本医療政策機構 代表理事 黒川 清 4 | Health Policy Summit 2019 Greeting from HGPI Chairman Thank you for joining Health Policy Summit 2019. Fifteen years have passed since HGPI began its activities as a non-profit, independent, nonpartisan think-tank in 2004. In order to implement the healthcare the public truly needs, we have brought together a wide variety of stakeholders to openly debate policy options operating under the banner of “Healthy Debate.” It is our firm belief that this is absolutely necessary for us to create a process by which responsible decisions can be reached. 2018 was a year of change. There was a simultaneous revision of medical service and nursing fees and our plans concerning the Future Vision for Health Care and nursing insurance support system reforms entered a new phase. This brought us closer to welcoming a total reformation of healthcare and nursing. Working together with the World Dementia Council (WDC), we held the WDC meeting last March in Tokyo. Last December marked the fifth anniversary of the founding of the WDC. Prime Minister Abe contributed the opening address to the publication commemorating that event, giving us in Japan an opportunity to exhibit our continued commitment to building countermeasures for dementia around the world. Additionally, HGPI formed the Antimicrobial Resistance Alliance Japan and was formally registered as secretary for Japan in the Non-Communicable Diseases Alliance. We gathered multi-stakeholders from the fields of both communicable and non-communicable diseases (NCDs) and provided leadership in the construction of a platform to pursue measures on a global level. In 2019, the G20 Summit will be held in Osaka and the Seventh Tokyo International Conference on African Development (TICAD7) will be held in Yokohama. It will be an important year to advance discussions on challenges facing borderless healthcare policy to address antimicrobial resistance (AMR), NCDs, and, of course, Universal Healthcare Coverage (UHC). Japan must provide guidance in these discussions. This year, the Heisei Era will draw to a close and a new period will dawn for Japan. To facilitate the construction of a truly sustainable social security system by 2040, we must not only begin medium- and long-term efforts, but we must also recognize the fact that debates about revising benefits and costs are unavoidable in the short term. And, as the world leader in societal
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