Japan has feared its low birth rate and population decline for 50 years, but the new Prime Minister Yoshihide Suga has come up with another solution: fertility treatment.
In his leadership campaign, Mr. Suga requested that in vitro fertilization be covered by state health insurance. The prime minister wants to make it affordable in a country where the median age of first-time mothers is now over 30 and nearly one in five couples have had tests or treatments for infertility.
Mr Suga is hoping the policy will increase Japan's birth rate, which stood at 1.36 children per woman in 2019. The fertility rate has been below the replacement level of 2.1 since the 1970s and includes decades of future population decline with profound consequences for Japanese society. Economy and national security.
While fertility treatment subsidies reflect a slow shift in Japan towards helping parents rather than criticizing the childless, experts said they still have done little to address the economic insecurity and gender inequality that affect marriage and child-rearing disabled.
"In order to lower the hurdle for every family who would like to have a child, we should work quickly to include fertility treatment in health insurance," Suga said last week, expressly formulating the policy as a "countermeasure against the falling birth rate ". .
Infertile couples are fighting in Japan, said Akiko Matsumoto, who is fighting on their behalf as the head of a charity called Fine. "There are four burdens: body, mind, money and time."
The treatment is not only physically and mentally demanding, there is also little financial support and employers allow themselves the free time for medical appointments.
"If someone tries three or four rounds of treatment it can easily lead to 4 million yen ($ 38,000)," she said. Ms. Matsumoto has campaigned with the government to provide insurance coverage for fertility treatment, but said the details are critical. A cost cap that limits the treatments available "would harm patients," she said.
Even if coverage is generous, analysts are wary of how much this affects birth rates. "It's very difficult to estimate, but in 2018 there were around 57,000 births from IVF. That could increase to 100,000 (if they are insured)," said Isao Takumi, lead researcher at the Meiji Yasuda Research Institute.
Every 16th child born in Japan today is the result of IVF and has increased fivefold in the last 20 years. "I think fertility treatment is a great idea, but it depends a lot on the specifics of the policy," Takumi said.
Another 43,000 children a year would make a difference, but Japan was shocked last year when the number of births in the country fell to 865,234, compared to 918,400 in 2018 and more than 2 million in the early 1970s.
After hitting a low of 1.26 in 2005, Japan bounced back to 1.45 by 2015, but has since declined for four consecutive years. Current fertility is well under the assumption that the Japanese population will decline from 127 million in 2015 to 88 million in 2065.
Sumio Saruyama of the Japan Center for Economic Research, who co-wrote a proposal to stabilize the population by adjusting French levels of childcare and family expenses, said that combining work and family is a necessary requirement for Japanese women to have more children.
"The main cause of the falling birth rate is the rise in women's economic power," he said. Nations around the world have seen the same phenomenon as the opportunity cost of having children for well-educated, high-income women.
However, Japan's long-hour culture makes it difficult to work and care for children, and childcare is expensive and difficult to find, while surveys show that Japanese men work less at home than their counterparts in Europe or the US.
Mr. Saruyama said he had not studied the effects of fertility treatment on birth rates. However, his analysis suggests that the cost of childbirth is less relevant than the opportunity cost of lost earnings.
While Mr. Suga does not hide his ambition to increase the birth rate, he is also careful to avoid any suggestion of government interference in private decisions about the birth of children. The subject is taboo in Japan as the militarist government of the 1930s suppressed birth control and turned population growth into an ideology.
Ms. Matsumoto welcomes the public attention given to fertility treatment. But her mission is to help those in desperate need of a child, and she doesn't like to link that to birth rates.
"The people don't have children for the country," she said. "You don't want to be asked to undergo fertility treatment just because it's available. You have the right not to have children."