健康診断を受診しないと保険料引き上げも 政府が検討

政府は成長戦略の中に、健康づくりや予防に熱心に取り組んだ人の保険料を軽減できる制度を導入することを検討する。一方、健康診断を受診しないなど、予防に無関心な加入者の保険料は、引き上げる方向で検討する。
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Mark Bowden via Getty Images

政府は6月に策定する成長戦略の中に、健康づくりや予防に熱心に取り組んだ公的医療保険の加入者に対し、保険料を軽減できる制度を導入することを検討する。医療費の伸びを抑えることが目的だという。一方、対象であるにもかかわらず特定の健康診断を受診しないなど、予防に無関心な人の保険料は、引き上げる方向で検討する。6月5日、毎日新聞などが報じた。

個人の保険料増減の目安となる指標としては、メタボリックシンドローム(腹部肥満)検診などの特定健診を受けているか▽健保や自治体が手がける健康づくり(運動プログラム)に参加したか−−などを想定している。今の保険料は所得に応じて決めており、新たな基準で徴収額を決めるには法改正が必要となる。

また、積極的に特定健診を受ける加入者に対し、各健保が健康グッズと交換できる「ヘルスケアポイント」や現金を支給できる仕組みを推進する。保健指導などの取り組み状況に応じ、各健保の高齢者医療費への拠出金を増減する現行制度についても、加算・減算率を拡大するなど強化する。

(毎日新聞「成長戦略:健康予防で保険料を増減 政府検討」より 2014/06/05 06:30)

東京大学大学院の増田寛也客員教授は3月28日、政府の産業競争力会議の医療・介護等分科会で、保険料増減の標案として特定健診受診の有無や運動プログラムに参加したかどうかのほか、「喫煙の有無」「本人や家族の医療費」「健康診断における有所見率」「生活習慣病の罹患率」などをあげている。

既にヘルスケアポイントを付与するなど、個人に対してインセンティブを付与する仕組みを導入している健康保険組合は存在する。東京都職員共済組合では、組合員の健診結果データに基づいてポイントを付与する仕組みを導入しており、「肥満度」「血糖」「血圧」「脂質」の分類で、ポイント付与を行っているという。

一方、特定の対象者の保険料を上げるなどのディスインセンティブを付与している健康保険組合の例としては、ローソン健康保険組合が、健康診断を受診しなかった社員と直属の上司には、翌年度支給される賞与から本人15%、直属の上司10%を減額するなどの取り組みを行っているほか、過去の議論では、乳がん検診を受診していない人をディスインセンティブ対象とすべきではないかなどの意見も出ている。

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