Issue Weakening foundations of medical and welfare services

Summary

Ageing and population decline keep raising demand for medical and welfare services, yet shortages of care workers and growing fiscal burdens are expected to limit supply. Rural and fishing areas where depopulation and ageing are fastest face expanding service deserts, which push residents to move away and make it hard to maintain even minimum infrastructure. In cities, competition for services is set to intensify as population concentrates, while fewer children mean shortages of paediatric and obstetric staff that already leave some rural areas without care. Long-term care recipients are increasing very rapidly, raising public spending on health and long-term care insurance and private burdens such as carer costs, while age-tech is being tried to substitute for direct care. The survey calls for guaranteeing a minimum level of social infrastructure so that everyone can reach basic medical and welfare services wherever they live, amid political disputes over welfare spending between generations.