As mentioned in the article, Japan’s public health insurance has provided a one-time allowance for childbirth for many years. The amount has been raised several times;
When I gave birth about 30 years ago, it was around $1,500, but now it’s nearly doubled. I don’t know how the government has seen the current system, but a common criticism among citizens is that every time the allowance goes up, gynecologists(ｶﾞｲﾈｺﾛｼﾞｽﾂ) have also raised their fees accordingly—almost as if they are capitalizing on the subsidy. And of course, as written in the article, standard delivery fees aren't currently regulated by the insurance system, clinics can set their own prices. The amount is different depending on where you live. Gynecologists in urban areas are likely to set higher prices for childbirth. It feels like a vicious cycle.
If the government raised the allowance to $10,000, clinics would likely just hike their prices again.
Many people feel the current system only benefits gynecologists more than parents. Therefore, I believe making childbirth completely free through a universal fee, and parents don’t have to pay at all is a very good idea, especially to prevent opportunistic price hikes by clinics.
I’ve heard that medical costs in the U.S. can be very high, and how much you pay depends on your insurance.
One thing I often notice in American movies or medical dramas is a scene, where a hospital staff tells a patient, “Your insurance doesn’t cover this test or treatment.” That’s actually really surprising from a Japanese perspective—the idea that the type of insurance you have can change what treatment you’re able to receive.
In Japan, we basically have one public health insurance system, so everyone can receive the same treatments.
And when it comes to childbirth, I read that giving birth in the US can cost $15,000 to over $30,000 without insurance, and even with insurance, people still have to pay several thousand dollars.
So from an American perspective, does around $3,000 sound affordable for childbirth?
Japan is not the only country facing a serious declining birth rate. A lot of developed countries have the same problem. On the other hand, some European countries like France, Sweden, and Hungary have reportedly increased their birth rates through government policies.
These countries have focused on improving social systems to better support families.
For example, they have created work environments where male workers can take paternity leave more easily, and the government offers tax incentives that reduce the financial burden depending on the number of children.
Interestingly, in Hungary, I’ve read that parents with more than three children can be exempt from income tax permanently. In Japan, such drastic measures haven’t really been adopted yet. In my opinion, the government needs to consider policies similar to those in Sweden or Hungary if they truly want to reverse the situation.
Under the current system, many couples are anxious about having more children because raising a child in Japan is incredibly expensive. For example, there is a lot of pressure to ensure children graduate from university, and attending cram school is seen as a necessity to get there. Many parents believe these education costs will place a heavy strain on their overall finances. These factors combined are discouraging young people from starting families.
Interestingly, if we look at this issue on a global scale, the population is still growing year by year, mainly in developing countries. People in wealthier countries tend to have fewer children, while those in developing countries tend to have more.
Personally, I feel like the bigger factor isn’t the financial burden of having children, but rather the change in people’s values. In the past, getting married and having children was just the norm.
It was a life goal for most young people. But nowadays, there's a growing sense that it’s perfectly okay to choose not to have kids, or even to stay single.
I think this mindset has become even stronger now that it’s completely normal for women to build their own careers in society. At the same time, even for couples who do want a child, many prefer to have just one because they want to maintain a comfortable standard of living.
Unless there are really strong incentives—like major tax benefits for families with children—I don’t think the birth rate will increase very much.
