Ageing in Japan 老齡化在日本

Home help?居家協(xié)助

The government is struggling to curb the rising cost of health care 政府正努力控制日益上漲的醫(yī)保費(fèi)用

curb: 控制；限制赎瑰，約束；抑制

struggle:奮斗; 搏斗; 努力; 爭(zhēng)取;

In a sunny room in a small apartment in the Tokyo satellite town of Kunitachi lies Yasuyuki Ibaraki, eyes closed and breathing laboured. Yukio Miyazaki, his doctor, who visits fortnightly from a local clinic, suspects that he does not have much time left: he has brain damage from a cerebral infarction, a tumour in his digestive system and is unable to swallow or talk. Reiko, his wife, feeds him through a tube to his stomach and clears phlegm from his throat. “He is from a close-knit family and is a quiet man, so I think it is better for him to be here rather than in a hospital,” she says, over green tea and grapes.

Kunitachi: 日本地名攘乒，國(guó)立市

labour: （因?yàn)閯诶郏┏粤Φ钠瓴剩毁M(fèi)力的

fortnightly：兩周地

infarction: （組織）梗塞

phlegm: 痰

close-knit: 關(guān)系緊密的；緊密團(tuán)結(jié)的犁河；組織嚴(yán)密的

在東京的衛(wèi)星鎮(zhèn)國(guó)立市一個(gè)小公寓里鳖枕，茨木保之（Yasuyuki Ibaraki音譯）躺在陽(yáng)光燦爛的房里魄梯，合著眼，費(fèi)力地呼吸著宾符。每?jī)芍軙?huì)從當(dāng)?shù)卦\所上門(mén)訪(fǎng)問(wèn)的醫(yī)生宮崎之夫（Yukio Miyazaki音譯）懷疑他所剩時(shí)間不多了：腦部因腦梗受損酿秸，消化系統(tǒng)長(zhǎng)有腫瘤，并且無(wú)法吞咽或說(shuō)話(huà)魏烫。他的妻子麗子通過(guò)一條通向胃部的軟管為他喂食辣苏，并為他清除喉嚨的痰『灏“他來(lái)自一個(gè)關(guān)系融洽的家庭稀蟋，也是個(gè)安靜的人，所以我認(rèn)為他待在這里比待在醫(yī)院更好呐赡⊥丝停”她說(shuō)道，一邊啜著綠茶链嘀，吃著葡萄萌狂。

長(zhǎng)句：he has brain damage from a cerebral infarction, a tumour in his digestive system and is unable to swallow or talk. 注意這里并列的關(guān)系：he has and is， has的賓語(yǔ)是brain damage, a tumour

背景：satellite town: A satellite town or satellite city is a concept in urban planning that refers essentially to smaller metropolitan areas which are located somewhat near to, but are mostly independent of larger metropolitan areas. 衛(wèi)星鎮(zhèn)怀泊，在大城市周?chē)貐^(qū)粥脚，為分散中心城市(母城)的人口和工業(yè)而新建或擴(kuò)建的具有相對(duì)獨(dú)立性的城鎮(zhèn)。

日本名字使用以下網(wǎng)址翻譯：http://www.hipenpal.com/tool/japanese-names-search-and-converter-in-traditional-chinese.php?vp=&sp=&lang=&od=e&startchk=OK&keyword=reiko&to=%E6%AA%A2%E7%B4%A2&lastname=checked&malename=checked&femalename=checked

Life expectancy in Japan is the highest in the world, at 84. This is good news for its people, but means that an ever-higher share of the population is elderly. Fully 28% of Japanese are older than 65, compared with 15% of Americans and 21% of Germans. More old people, in turn, means higher health-care costs. Last year the government budgeted ￥15trn ($138bn, or 15% of its total expenditure) for health care and nursing, excluding the charges it levies for the public health-insurance scheme. With public debt at 250% of gdp, and debt service consuming a further 24% of spending, the government is looking desperately for ways to cut costs. It reckons caring for people at home is one of its best options.

in turn: 依次; 轉(zhuǎn)而; 輪流地; 相應(yīng)地;

budget: [vt/vt]制訂預(yù)算包个，計(jì)劃（開(kāi)支）

levy: 征稅; 征（兵）; 索取; 發(fā)動(dòng)（戰(zhàn)爭(zhēng)）;

debt service: 還本付息，在既定時(shí)期內(nèi)還本付息所需的現(xiàn)金

日本的預(yù)期壽命是全球最長(zhǎng)冤留，高達(dá)84歲碧囊。對(duì)民眾這是個(gè)好消息，但這也意味著在人口結(jié)構(gòu)纤怒，老年人占比前所未有的高糯而。整整28%的日本人年齡大于65歲，而在美國(guó)泊窘，這一數(shù)字是15%熄驼，德國(guó)是21%。更多的老年人烘豹，相應(yīng)地瓜贾，意味著高更的醫(yī)療費(fèi)用。去年携悯，政府為醫(yī)療衛(wèi)生和護(hù)理制定的預(yù)算是15兆日元（1380億美元祭芦，或者說(shuō)總支出的15%），這還排除了政府從醫(yī)療保險(xiǎn)計(jì)劃中征收的費(fèi)用憔鬼。由于公共債務(wù)是GDP的250%龟劲，還本付息又進(jìn)一步消耗了24%的支出胃夏，政府正在拼命尋找降低支出的方法。它認(rèn)為在家照護(hù)老人是最好的選項(xiàng)之一昌跌。

All Japanese pay a monthly premium to the public insurance scheme, either through their employer or the local municipality. In return they are entitled to treatment and drugs from public and private doctors and hospitals, although they must also pay a portion of the cost of treatment (a co-payment, in American parlance), subject to a cap. In 2000 Japan introduced an additional public insurance scheme for long-term care for those over 65, into which people must pay from the age of 40. It works the same way. The premiums and co-payments cover around 60% of the cost of the services provided; the government pays for the rest. And it is the old who cost the most. The government reckons that the average annual cost of health care for someone over 75 is ￥942,000, compared with just ￥221,000 for everyone else.

premium: 獎(jiǎng)金仰禀，津貼；加價(jià)蚕愤；附加費(fèi)

municipality: 市答恶，自治市；市政府审胸，市政當(dāng)局

parlance: 說(shuō)法亥宿，用語(yǔ)

所有的日本人每月都得額外補(bǔ)貼公共保險(xiǎn)計(jì)劃，或是通過(guò)雇主砂沛、或是通過(guò)市政當(dāng)局烫扼。作為回報(bào)，他們被賦予權(quán)利碍庵，可以獲得公立和私立醫(yī)院醫(yī)生的治療和藥物映企，盡管他們還必須支付這筆治療費(fèi)用的一部分（用美國(guó)的說(shuō)法“共同支付”），這筆費(fèi)用有上限静浴。2000年堰氓，日本引入一項(xiàng)新的公共保險(xiǎn)計(jì)劃，針對(duì)65歲以上人士的長(zhǎng)期護(hù)理苹享，參加的人必須從40歲起開(kāi)始交費(fèi)双絮。工作原理是一樣的。額外補(bǔ)貼和共同支付的費(fèi)用覆蓋了服務(wù)費(fèi)用的約60%得问；政府則支付了其余費(fèi)用囤攀。老年人占了支出的最大部分。政府認(rèn)為75歲以上人士在醫(yī)療健康的平均年支出是942,000日元宫纬，其他人僅需要221,000日元焚挠。

By the standards of ageing nations, Japan has managed to curb medical costs fairly well, says Naoki Ikegami of St Luke’s International University in Tokyo. The government sets fees for services to keep costs down (although that encourages providers to perform unnecessary procedures to make more money: Japan has more ct scanners relative to its population than any other country). It has also promoted the use of generic drugs, which are cheaper.

relative to: 關(guān)于…的，和…比較起來(lái);

按老齡化國(guó)家的標(biāo)準(zhǔn)漓骚，日本在醫(yī)療費(fèi)用方面控制得相當(dāng)好——東京圣路加國(guó)際大學(xué)的池上直樹(shù)（Naoki Ikegami）表示蝌衔。政府設(shè)置了服務(wù)費(fèi)用來(lái)降低成本（盡管這鼓勵(lì)了服務(wù)提供商去執(zhí)行些并非必要的步驟，來(lái)賺取更多的錢(qián)：相對(duì)于人口來(lái)說(shuō)蝌蹂，日本CT掃描儀的數(shù)量比全球其他國(guó)家都要多）噩斟。這還促進(jìn)了更廉價(jià)的基因藥物的使用。

背景：圣路加國(guó)際大學(xué)（英文：St. Luke's International University孤个，日文平假名：せいるかこくさいだいがく）簡(jiǎn)稱(chēng)圣路加亩冬、圣路加大，是一所位于東京都中央?yún)^(qū)的日本私立大學(xué)。其前身為1920年創(chuàng)立的圣路加國(guó)際醫(yī)院附屬高等護(hù)士學(xué)校硅急，1964年更名為圣路加看護(hù)大學(xué)覆享，2014年更名為圣路加國(guó)際大學(xué)。目前設(shè)有看護(hù)學(xué)部（本科）营袜，看護(hù)學(xué)研究科（碩士撒顿、博士）。

Life-giving, budget-busting

給予生命荚板，打破預(yù)算

bust: 擊碎凤壁；打破；弄壞

Nonetheless, the country has crept up to sixth place in the OECD’s ranking of the share of gdp spent on health care, behind France and America, but ahead of Italy and South Korea—two other ageing countries (see chart on next page). It is not just that the number of old people is increasing; spending per person is rising, too, as people live longer with diseases like Alzheimer’s and diabetes.

creep up: （價(jià)值或數(shù)量）慢慢增加跪另，逐漸上升

無(wú)論如何拧抖，在經(jīng)合組織內(nèi)，日本的醫(yī)療衛(wèi)生占GDP比例已經(jīng)逐漸上升到第六位免绿，僅次于法國(guó)和美國(guó)唧席，但領(lǐng)先于意大利和韓國(guó)——另外兩個(gè)老齡化國(guó)家。問(wèn)題不僅在于老年人數(shù)量在增加嘲驾，人均支出也在上升淌哟，因?yàn)殡S著壽命延長(zhǎng)，許多人患有阿爾茨海默癥和糖尿病等疾病辽故。

Japan has promoted home care for many years, but it is pushing it harder now. The policy is especially beneficial given that the average hospital stay in Japan is three times longer than in the Netherlands, for instance. The health ministry reckons that 1m people will receive care at home in 2025—one-and-a-half times the current total. The number of special nursing units exclusively for home visits has risen from 7,473 in 2014 to 10,418 in 2018.

日本多年來(lái)都在推廣居家照護(hù)模式徒仓，但現(xiàn)在力度更大√芄福考慮到日本的平均住院時(shí)間是例如荷蘭這樣國(guó)家的三倍掉弛，這個(gè)政策會(huì)尤其有益。衛(wèi)生部認(rèn)為一百萬(wàn)人將在2025年接受居家照護(hù)——現(xiàn)在總數(shù)的1.5倍喂走。專(zhuān)為家庭服務(wù)的特殊護(hù)理單位數(shù)量由2014年的7473上升到2018年的10418狰晚。

Last year a government panel suggested raising the amount doctors are paid for home visits and making consultations conducted via video-conferencing services eligible, too. It also proposed new rules to encourage care at home. Hospitals should be obliged to talk to social services when they discharge a patient, for example.

panel：（選定的）專(zhuān)家小組；嵌板缴啡，鑲板；儀表板瓷们；操縱臺(tái)

oblige: 責(zé)成业栅；強(qiáng)迫，迫使谬晕；be obliged to: 必須; 不得不; 只得;

discharge: 允許…離開(kāi)碘裕；（尤指）允許…出院；（根據(jù)法庭決議）釋放

去年攒钳，一個(gè)政府的專(zhuān)家小組提出建議帮孔，提高醫(yī)生上門(mén)訪(fǎng)問(wèn)的收費(fèi)，并將通過(guò)視頻會(huì)議服務(wù)進(jìn)行的咨詢(xún)?cè)O(shè)為合法。它同時(shí)還提議了一些新措施來(lái)促進(jìn)居家照護(hù)文兢。例如說(shuō)晤斩，醫(yī)院在讓病人出院時(shí)，應(yīng)該被強(qiáng)制和社會(huì)服務(wù)機(jī)構(gòu)交談姆坚。

長(zhǎng)句：Last year a government panel suggested (raising the amount doctors are paid for home visits) and (making consultations conducted via video-conferencing services eligible, too. )

主干：suggested A and B

A: raising the amount. Doctors are paid amount for home visits. amount指金錢(qián)數(shù)量

B: making consultations conducted via video-conferencing services eligible, too. 主干：make sth eligible. sth: consultations (conducted via video-conferencing services)

Some municipalities are already offering good care in the community. Onomichi, a small provincial city that is even older than the country as a whole, is one. Its medical facilities have 15-minute “care conferences” with doctors, nurses, family members and even dentists, to discuss how they will go about looking after people. “It used to be hard for hospitals to tell a patient to return home as there was no system for that; that has changed,” says Hisashi Katayama, a doctor.

Onomichi: [地名] [日本] 尾道;

medical facilities：醫(yī)療設(shè)施

go about: 處理; 到處走動(dòng); 流傳; 改變方向;

某些市政當(dāng)局已經(jīng)在社區(qū)提供了優(yōu)秀的照護(hù)服務(wù)澳泵。尾道是個(gè)小鎮(zhèn)，歷史悠久到甚至比國(guó)家的建立時(shí)間都要早兼呵，它就是其中之一兔辅。尾道市的醫(yī)療設(shè)施能進(jìn)行15分鐘的“護(hù)理會(huì)議”，與醫(yī)生击喂、護(hù)士维苔、家庭成員甚至牙醫(yī)討論他們將如何照顧病人《海“以前醫(yī)院要告訴病人回家是非常困難的介时，因?yàn)闆](méi)有居家照護(hù)系統(tǒng)∪谭ǎ”醫(yī)生片山尚（Hisashi Katayama）表示潮尝。

Community care for specific diseases is improving, too. Take dementia, which currently affects 5m Japanese (4% of the population), and will afflict 6-7% by 2030. Rather than provide only institutional care and medicine, some towns, such as Matsudo, north-east of Tokyo, have set up cafés to offer advice and companionship to patients and their carers. Day centres that give respite to families tending to elderly relatives are common. Much more could be done: only 13% of Japanese die at home, although most say they want to.

dementia: （尤指老年性）癡呆

Matsudo: 松戶(hù)

respite: 暫停；暫時(shí)中止饿序；暫時(shí)緩解

tend to sb/sth: 照料勉失，照顧；關(guān)心

針對(duì)特定疾病的社區(qū)照護(hù)能力也在提高原探。以老年癡呆為例乱凿，老年癡呆現(xiàn)在影響了5百萬(wàn)日本人（人口的4%），這個(gè)數(shù)字在2030年底將達(dá)到6%到7%咽弦。不同于僅僅提供機(jī)構(gòu)式照護(hù)和醫(yī)藥服務(wù)徒蟆，某些鎮(zhèn)，例如東京東北部的松戶(hù)型型，就建造了咖啡廳段审，在此為病人和護(hù)理者們提供建議和陪伴。日間護(hù)理中心為照顧老年家屬的家庭提供了喘息休息的場(chǎng)所闹蒜，它們也很常見(jiàn)寺枉。人們還能做很多其他事情：僅僅13%的日本人在家中逝世，盡管大部分日本人都說(shuō)他們想要如此绷落。

長(zhǎng)句：

(Rather than provide only institutional care and medicine, some towns, such as Matsudo, north-east of Tokyo, have set up cafés to offer advice and companionship to patients and their carers.

Day centres (that give respite to families tending to elderly relatives) are common.

背景：幾種常見(jiàn)的護(hù)理方式：

institutional care: 機(jī)構(gòu)照護(hù)主要是透過(guò)興建集合式照顧設(shè)施姥闪，由行政、護(hù)理砌烁、照顧及社會(huì)工作者等人員進(jìn)駐筐喳，集中照顧老人。

Community care: 社區(qū)照護(hù)

home care: 居家照護(hù)

Day centres: 日間護(hù)理中心

But more widespread home care will not be enough to make Japan’s health care affordable. The government of Shinzo Abe wants to revamp the social-security system, which it reckons will help reduce health-care costs. Raising the retirement age, for example, will keep people active, healthier and paying tax for longer. The government also wants to try to reduce the incidence of diseases that affect older people, but have their origins in behaviour at a younger age. “We have tended to focus on the old, but we need to look at the younger to prevent disease,” says Kazumi Nishikawa of the economy ministry. He is particularly focused on giving people more information on what causes diabetes, which is on the rise in Japan, or exercises that can stem the progression of dementia.

revamp: 修改；改進(jìn)

incidence: 事件避归；（事件的）發(fā)生率

但更廣泛的居家護(hù)理尚不足以使日本能負(fù)擔(dān)起療健康費(fèi)用荣月。安倍晉三（Shinzo Abe）政府想要修改社會(huì)保障系，它認(rèn)為這樣可以幫助降低醫(yī)療費(fèi)用槐脏。舉例來(lái)說(shuō)喉童，提高退休年齡可以讓人們保持積極性，身體更健康顿天，交稅時(shí)間更多堂氯。政府還希望，能夠降低對(duì)老年人產(chǎn)生影響的疾病的發(fā)生率牌废，但這些疾病的根源在于他們?cè)谀贻p時(shí)的行為咽白。“我們傾向于將關(guān)注放在老年人身上鸟缕，但我們需要關(guān)注年輕來(lái)防止疾病晶框。”財(cái)政部的西川和美表示懂从。他尤其關(guān)注于向人們提供更多關(guān)于糖尿病病因的信息（日本的糖尿病發(fā)病率正在上升）授段，或是哪些鍛煉可以阻止老年癡呆癥進(jìn)一步發(fā)展。

People are likely to have to pay more for health care, too. Co-payments for many of those over 75 are only 10%, compared with 30% for everyone else. The government should start by doubling that to 20%, says Shigefumi Kawamoto, managing director of Kenporen, the national federation of health-insurance societies. “Some elderly people don’t have resources, but many do,” he avers. The government could exclude some items from coverage, he says, such as over-the-counter drugs. Meanwhile, back in Kunitachi, Dr Miyazaki talks to Reiko about her husband’s condition. She is worried that her husband is getting worse, she says, and is anxious between visits. The doctor promises to come weekly from now on.

人們也極有可能要為醫(yī)療健康付出更多費(fèi)用番甩。在75年以上老人中侵贵，許多人的共同支付占比僅為10%，相比之下缘薛，其他人都需要30%窍育。“政府應(yīng)該將這筆費(fèi)用翻倍至20%宴胧，以此開(kāi)始漱抓。” 國(guó)家健康保險(xiǎn)組合連合會(huì)（健保連）的董事總經(jīng)理川本重文表示恕齐∑蚵Γ“有些老年人沒(méi)有收入來(lái)源，但許多人有” 他斷言显歧。政府應(yīng)該將一些項(xiàng)目移除出覆蓋范圍仪或，他表示，例如非處方藥追迟。同時(shí)，視線(xiàn)回到國(guó)立市骚腥，之夫醫(yī)生與麗子談?wù)撍煞虻那闆r敦间。她擔(dān)心丈夫的情況有所惡化，她說(shuō)，并且在醫(yī)生上門(mén)訪(fǎng)問(wèn)間隙非常焦距廓块。之夫醫(yī)生承諾厢绝，從現(xiàn)在起，他每周都會(huì)上門(mén)探訪(fǎng)带猴。

Kenporen：けんぽれん 健康保険組合連合會(huì)