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The Yomiuri Shimbun
U.S. weapons sale to Taiwan crucial contribution to regional security
米の武器台湾へ　地域の安定へ関与が不可欠だ

Active U.S. engagement is essential for preserving peace and stability across the Taiwan Strait, and by extension the whole of East Asia.
　台湾海峡、ひいては東アジアの平和と安定の維持には、米国の積極的な関与が欠かせない。

The administration of U.S. President Barack Obama has decided to sell weapons worth $1.83 billion (about ¥220 billion) to Taiwan. Two decommissioned frigates, amphibious assault vehicles and small surface-to-air missiles are among the weapons the United States will provide to Taiwan.
　オバマ政権が台湾に対し、総額１８億３０００万ドル（約２２００億円）の武器売却を決めた。退役フリゲート艦２隻や水陸両用車、小型の地対空ミサイルなどを供与する。

A domestic U.S. law stipulates that the United States can provide weapons intended to enable Taiwan to maintain sufficient self-defense capabilities. This stipulation was made with China in mind.
　米国は国内法で、中国を念頭に、台湾の自衛力維持を目的とする武器の提供を定めている。

This latest arms sale is not only a political message in defense of Taiwan. It also appears aimed at keeping Beijing in check as it pushes ahead with the creation of artificial islands in the South China Sea and the establishment of military strongholds on those islands.
　今回の売却決定には、「台湾防衛」の政治的メッセージだけでなく、南シナ海で人工島を造成し、軍事拠点化を進める中国をけん制する狙いもあるのだろう。

A candidate of Taiwan’s largest opposition party, which strongly favors Taiwan independence, will likely win January’s presidential election and usher in a new administration. This may lead to deterioration in the ties between Beijing and Taipei. It seems the United States announced the weapons sale this month due to concern that doing so after the election could cause regional tensions to soar.
　来年１月の台湾総統選では、「台湾独立」志向の強い最大野党の候補が勝利し、政権交代する可能性が大きい。中台関係の悪化も予想される。その局面で決定すれば、地域の緊張が高まると懸念し、今回、決めたのではないか。

The United States and China earlier this month confirmed they would cooperate with regard to the Paris agreement, a framework that spells out steps to counter global warming from 2020. Both sides also want to avoid any decisive confrontations.
　米中両国は、２０２０年以降の地球温暖化対策の枠組み「パリ協定」合意を巡って協調を確認したばかりだ。双方とも決定的な対立は避けたい思惑で一致する。

When the U.S. government announced weapons sales worth about $12 billion in total to Taiwan in 2010 and 2011, China responded angrily and temporarily suspended military exchanges with the United States. Compared with such instances, the latest sale does not include any cutting-edge weapons and could be described as “restrained.”
　米国が１０年と１１年に計約１２０億ドルの武器売却を決めた際には、中国がいずれも猛反発し、米中軍事交流を一時停止した。それに比べると、今回の売却には最新兵器も含まれず、抑制的と言える。

China has upper hand

China has deployed a huge number of missiles along its coast facing the Taiwan Strait, and is mass-producing sophisticated fighter aircraft and frigates. The military balance is overwhelmingly tilted in China’s favor.
　中国は台湾海峡を挟んだ沿岸部に大量のミサイルを配備し、新型戦闘機とフリゲート艦などを量産している。軍事バランスは圧倒的に中国優位に傾いている。

Strengthening Taiwan’s air defense readiness and its ability to repel a landing force will be essential to the island’s defense. Taiwan had urged the United States to provide new-model fighter jets and submarines, as well as Aegis-equipped destroyers, but this did not eventuate. The Obama administration apparently did not authorize the sale of such weapons because they were deemed not to be necessary.
　台湾防衛には、防空態勢や上陸阻止能力の強化が不可欠だが、台湾の求める新型戦闘機や潜水艦、イージス駆逐艦の売却は実現しなかった。オバマ政権は「必要ない」として認めなかったという。

China’s Foreign Ministry has demanded that the United States scrap the weapons deal, and announced sanctions would be imposed on U.S. companies involved in the arms sale. However, Beijing did not go as far as halting military exchanges or taking other steps, so this protest was at a lower level than in previous cases. It appears China has judged that this arms package will not be a substantial threat to its security.
　中国外務省は米国に武器売却の撤回を求め、売却に関与する米企業に制裁を科すと表明した。軍事交流停止などには踏み込まず、控えめの抗議だ。実質的に、中国の脅威になる売却ではないと判断しているのだろう。

The administration of Chinese President Xi Jinping is mistaken if it thinks it can continue military exchanges with the United States and avoid a cooling of bilateral relations even without halting its self-righteous maritime advances.
　習近平政権が、独善的な海洋進出をやめなくても、米国との軍事交流を継続し、関係冷却化を回避できると計算しているのなら、筋違いである。

It is also important that Washington continues its strategy of sending U.S. military vessels through waters within 12 nautical miles of the artificial islands China has built in the South China Sea. Such an operation was conducted in late October, and we think the United States needs to stick to its plan to conduct these patrols about twice every three months.
　米国が、南シナ海の人工島の１２カイリ内に米艦艇を航行させる作戦を継続することも重要だ。１０月下旬に実施したが、３か月に２回程度の頻度で巡視を行う方針を維持する必要がある。

The United States must continue to take concrete steps to urge China to exercise self-control and show that it will not tolerate Beijing’s provocations.
　挑発を容認していると受け取られないよう、具体的な行動で自制を促し続けねばならない。

(From The Yomiuri Shimbun, Dec. 24, 2015)

December 20, 2015 (Mainichi Japan)
Kaleidoscope of the Heart: Christmas is the season for everyone to feel their worth
香山リカのココロの万華鏡: Ｘマスは「あなたの日」　／東京

It's almost Christmas -- a fact that is greeted by most visitors to my office not with joyful anticipation, but rather as a reminder of how lonely they feel. Many of my patients tell me with dark expressions on their faces, "When the streets are bustling and lively, it just makes me feel all the more miserable."
　クリスマスが近づいてきた。診察室では「楽しみです」と言う人より「孤独だと思い知らされる」「街がにぎやかだとよけいに自分がみじめ」と顔を暗くする人のほうが多い。

While I was wondering what I could say to these people, I received a handmade pamphlet from a minister by the name of Yoshikazu Okado, who has been turning out the publication for many years.
　どんな言葉をかけてあげればよいのか、と思っているところに、大門義和氏という牧師から小冊子が送られてきた。大門牧師が手づくりで長年、発行しているものだ。

"Christmas is a declaration that all people are important," he writes in the introduction.
　冒頭に「すべての人が貴い人であるとの宣言がクリスマス」という言葉が記されていた。

As I read this I thought, "Isn't Christmas for Jesus Christ, and romantic partners and families?" Further along, however, came a passage about how the Bible says that the light of Jesus shines on everyone without exception or discrimination.
「クリスマスはイエス・キリストと、あとはハッピーな恋人や家族のものじゃないの？」と思いながら読むと、こんなことが書かれていた。聖書にはイエスは「例外なくすべての人を照らす光」とあり、その光は人を区別したり分類したりはしない。

In other words, Christmas -- the day Jesus was born -- is a joyous moment about happiness for all. It is a holiday in which each person is celebrated.
だから、イエスが生まれたクリスマスは、分け隔てなくすべての人にとっての喜びであり、どんな人をも尊び祝う日なのだ……。

When a person arrives in our offices, doctors like me apply the science of psychiatry to determine what illness they may have, and how severe it may be.
　私のような医者は、診察室に来た人の問診をして「何の病気か」「重症度はどれくらいか」とその人を精神医学の体系にあてはめていく。

People leave the office having been treated entirely as "patients," and I send them off with the words, "Don't push yourself too hard, and I'll see you next week."
そして、診察室を出る頃にはその人をすっかり「患者さん」として扱い、「無理しないでくださいね。ではまた来週」と送り出す。

You could say that classifying people is my job.
そうやって区別、分類するのが私の仕事と言ってもよい。

Within that context, I eventually start to wonder about which more personalized categories patients may fall into. Are they happy, or lonely, or feeling pitiable?
　しかし、その医者としての「区別や分類」は、いつの間にか、その人が幸福なのか、孤独なのか、かわいそうなのか、といった人間的な部分にまで及んでいたかもしれない。

And I don't think it's just me.
そして私だけではなくて、

The patient, too, may begin to classify themselves with labels like "worthless," or "loser."
患者さん側も、自分で自分を「私には価値がない」「負け組です」などと分類しているのではないか。

Okado's little pamphlet points out that in Christianity, Christmas is not a holiday to make lonely people feel even more so.
　先の小冊子で私は、キリスト教では、クリスマスは孤独な人がより孤独を感じる行事ではなく、

Rather, it is a day for everyone -- even those feeling lonely -- to have someone tell them, "It's wonderful that you're alive."
孤独だと思っている人も「あなたが生きているのはすばらしいことです」とたたえられるための日なのだ、と知った。

This was something of an epiphany for me.
なるほど、と私は膝を打った。

For the rest of December, I will tell my patients, "I've heard that Christmas is a day when no-one is singled out or discriminated against."
これから１２月の診察室では、「クリスマスは誰も区別されない日なんですって」と話すことにしよう。

Actually, I don't think I'll limit this to just the Christmas season.
　いや、クリスマスだけではない。

I'll do the same for New Year's, for all of the various winter festivals around the country, and for all kinds of holidays throughout the year.
お正月、各地で行われる冬のイベント、いろいろな祝日。

If someone says to me with a sad expression on their face, "When everyone around me looks like they're having fun, it just makes me feel all the more miserable," I want to tell them, "This day is for you."
「まわりが楽しそうだとよけいにみじめになる」と暗い顔をする人には、そのたびに「これはあなたのための日ですよ」と声をかけてみることにしたい。

This Christmas season, why don't you try telling yourself, "I'm a precious person, too"?
まずはこのクリスマスシーズンをひとりですごしている人も、「私も貴い人間なんだよね」と笑顔になってみてはどうだろう。

(By Rika Kayama, psychiatrist)
（精神科医）

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The Yomiuri Shimbun
Protecting community medical care crucial in revision of fee schedules
診療報酬改定　地域医療を守る視点が重要だ

Reining in medical care expenses, which have been swelling with the aging of society, is indispensable in order to maintain the social welfare system. To this end, reducing overall medical treatment fees paid to medical institutions under the public health insurance system is unavoidable.
　高齢化で膨らむ医療費の抑制は、社会保障制度を維持する上で欠かせない。診療報酬のマイナス改定はやむを得まい。

In the revision of such fees for fiscal 2016, the government has decided on a 0.84 percent reduction in total. The previous revision of fiscal 2014 called for an increase of 0.1 percent, but it represented a decrease of 1.26 percent if the hike in the consumption tax is excluded. Therefore, the latest revision means medical treatment fees will have been virtually cut for the second time in a row.
　２０１６年度の診療報酬改定で、政府は全体として０・８４％引き下げることを決めた。前回１４年度改定はプラス０・１％だったが、消費増税の対応分を除けばマイナス１・２６％だった。実質的に２回連続の引き下げだ。

The latest revision calls for raising technical fees for doctors and other health professionals by 0.49 percent and lowering the fees paid for pharmaceuticals by 1.33 percent in accordance with market prices.
　今回、医師らの技術料である「本体部分」を０・４９％引き上げる一方、医薬品の価格である「薬価部分」は、実勢価格に合わせて１・３３％引き下げる。

After deciding early on to reduce all medical treatment fees with a view to putting fiscal conditions on a sound footing, the government had looked into the possibility of also cutting the technical fees, the main portion of the fees. However, the Japan Medical Association and other organizations strongly asked for an upward revision arguing that a reduction might cause the medical care system to collapse.
　政府は、財政健全化に向けて全体のマイナス改定を早々に決め、本体部分への切り込みも検討してきた。日本医師会などは、医療崩壊を招きかねないとして、プラス改定を強く求めてきた。

Some people point out that the revision was decided in consideration of medical institutions ahead of the House of Councillors election set for next summer.
　来年夏の参院選を前に、政府・与党が医療機関側に配慮する形で決着したとの見方もある。

Since the previous virtual reduction of medical treatment fees, hospital management has been on the trend of deterioration. At the same time, the doctor shortage in local areas remains serious. Raising the main portion of fees, which covers personnel expenses for those engaged in medical practice, can be regarded as a necessary measure to protect community medical service and alleviate the people’s anxiety.
　前回の実質マイナス改定以降、病院経営は悪化傾向にある。地方の医師不足も依然として深刻だ。医療従事者の人件費となる本体部分の引き上げは、地域医療を守り、国民の不安を和らげるためには、必要な措置と言えよう。

Drug expenses to be curbed

Simultaneously with the revision of medical treatment fees, the government will carry out institutional reform to curb pharmaceutical expenses. The reform calls for, among other things, lowering the prices of newly developed popular drugs that exceeded ¥100 billion in annual sales and limiting the amount of compresses prescribed by doctors.
　報酬改定と同時に、薬剤費抑制のための制度改革を実施する。国内での売り上げが年１０００億円を超えたヒット新薬の値下げや、医師が処方する湿布の枚数制限などが見込まれている。

Use of less costly generic medicines must also be accelerated.
　安価なジェネリック医薬品（後発薬）の利用促進も急ぎたい。

Fees to be paid to drugstores will also be reexamined. To help promote the spread of “regular pharmacies” that use unified management of patient’s drug information, the fees paid to pharmacies located near major hospitals will be reduced. This measure was taken in response to strong criticism that they are making too much profit.
　薬局に支払われる報酬も大幅に見直す。患者の服薬情報を一元管理する「かかりつけ薬局」の普及を促すため、大病院周辺に立ち並ぶ「門前薬局」の報酬は減額する。もうけ過ぎとの批判が強いことを受けたものだ。

Allocation of fees for each medical treatment will be discussed early next year. A medical care system must be built to meet the needs of a super-aging society. It is imperative to allocate fees in the order of priority to promote the quality of medical treatment while reining in expenses.
　診療行為ごとの報酬の具体的な配分は、年明けに議論される。超高齢社会に適した医療提供体制を構築する。費用を抑えつつ、医療の質を向上させる。こうした方向性に沿ったメリハリのある配分にすることが重要である。

Prefectural governments are drawing up community medical service plans that incorporate future needs for medical treatment and the number of beds needed. The plans are aimed at decreasing the number of costly beds for patients requiring acute treatment and improving support for discharge from hospitals and treatment at home.
　都道府県では、将来の医療ニーズと必要な病床数を盛り込んだ地域医療構想の策定を進めている。高コストの急性期向け病床を減らし、退院支援や在宅診療などを充実させるのが狙いだ。

It is necessary to correct the situation in which elderly patients whose conditions are stable are being hospitalized in great numbers because the number of beds for acute patients has increased excessively.
　急性期病床が増えすぎ、症状の安定した高齢患者が多数入院している現状は改める必要がある。

Strengthening the collaboration between medical treatment and nursing care is also important to make it possible for senior citizens to live at peace in the community. This should be treated as a priority in the allocation of the medical treatment fees.
　高齢者が地域で安心して暮らせるよう、医療と介護の連携強化も大切だ。報酬配分で重点課題とすべきである。

(From The Yomiuri Shimbun, Dec. 22, 2015)

The Yomiuri Shimbun
Japan, Australia must build ‘special relationship’ on economy, security
日豪首脳会談　経済と安保で「特別な関係」に

Japan and Australia have an important role in promoting peace and prosperity in the Asia-Pacific region. We should build a comprehensive relationship of cooperation.
　日本と豪州は、アジア太平洋地域の平和と繁栄を牽引けんいんする重要な役割を担う。包括的な協力関係を構築すべきだ。

Australian Prime Minister Malcolm Turnbull, who took office in September, made his first visit to Japan and held talks with Prime Minister Shinzo Abe. The two leaders issued a joint statement that said Japan and Australia would cooperate in the economic and security fields and deepen the “special relationship” of the two countries that share strategic interests.
　９月に就任したターンブル豪首相が初来日し、安倍首相と会談した。経済や安全保障分野で連携し、戦略的利益を共有する日豪の「特別な関係」を深化させるとの共同声明を発表した。

Abe emphasized that both leaders affirmed the “unshakable strategic relationship” between the two countries. “Both countries share the same values,” Turnbull said.
　安倍首相は「揺るぎない戦略的関係を確認した」と強調した。ターンブル首相は「両国は共通の価値観を持っている」と語った。

Turnbull, who is known to be acceptive of China, chose Japan for his first visit to East Asia as prime minister. We welcome Turnbull’s posture of attaching weight to bilateral ties with Japan, continuing the policy pursued by his predecessor, Tony Abbott — like Turnbull a member of the Liberal Party — who was close to Abe.
　中国通で知られるターンブル首相は、東アジアでの最初の訪問国に日本を選んだ。安倍首相と親密だった同じ自由党のアボット前首相の路線を継承し、対日重視の姿勢を示したことを歓迎したい。

Both leaders agreed on expanding bilateral trade and investment, on the basis of the bilateral Economic Partnership Agreement, which entered into force in January.
　両首脳は、今年１月に発効した経済連携協定（ＥＰＡ）に基づき、貿易・投資を拡大させることで一致した。

Abe and Turnbull also confirmed the importance of technological innovation and agreed on bilateral cooperation in such fields as regenerative medicine.
技術革新の重要性を確認し、再生医療などの分野で協力することでも合意した。

Japan and Australia have a mutually complementary relationship, with Japan importing mainly natural resources and foods from Australia, and exporting automobiles and other products to the country. It is important to promote economic cooperation between the two countries, using the EPA as a tailwind.
　日本は、豪州から主に天然資源や食料を輸入し、自動車などを輸出しており、相互補完の関係にある。ＥＰＡを追い風に、日豪の経済協力を進めることが大切だ。

The Trans-Pacific Partnership negotiations, with 12 countries including Japan and Australia participating, reached a broad agreement in October. Japan and Australia should further cooperate in putting the accord into force at an early stage.
　日豪など１２か国が参加する環太平洋経済連携協定（ＴＰＰ）交渉も１０月に大筋合意した。早期発効に向けて連携を強めたい。

Freedom of navigation

With regard to the South China Sea, the joint statement called on “all claimants to halt large-scale land reclamation or construction, and to refrain from using any land features for military purposes.” Needless to say, both have China in mind, as it is building artificial islands and promoting the establishment of military bases there.
　共同声明は、南シナ海情勢に関し、「大規模な埋め立てや建設の停止」と「軍事目的での使用の自制」を明記した。無論、南シナ海で人工島造成と軍事拠点化を進める中国が念頭にある。

The U.S. Navy carried out patrols within 12 nautical miles of the artificial islands in October, while an Australian military surveillance plane recently flew near the artificial islands. It is important to take all possible steps to ensure freedom of navigation and flight under international law.
　米海軍は１０月、人工島の１２カイリ内で巡視活動を行った。豪州軍の哨戒機も最近、人工島付近で監視活動を行ったという。国際法に基づく「航行と飛行の自由」の確保へ、手段を尽くすことが重要だ。

Ensuring the safety of sea lanes will serve as a basis for free economic activities. By cooperating closely with other countries, including the United States, Japan and Australia must urge China to abide by international rules.
　海上交通路（シーレーン）の安全確保は、自由な経済活動の基盤となる。日豪は米国などと緊密に協調し、中国に国際ルールの順守を働きかけねばならない。

During their talks, Abe and Turnbull agreed to strengthen bilateral cooperation in defense on the basis of the security-related legislation. Japan and Australia intend to expedite concluding a “visiting forces agreement,” which would facilitate joint exercises between the Self-Defense Forces and Australian forces.
　首脳会談では、安全保障関連法に基づき、防衛協力を強めることで合意した。自衛隊と豪州軍の共同訓練を円滑にする「訪問部隊地位協定」の締結も急ぐ方針だ。

Japan and Australia should pursue multitiered cooperation, with the United States — an ally of both Japan and Australia — joining in.
日豪両国と同盟関係にある米国を交え、重層的協力を追求したい。

Turnbull expressed Australia’s “deep disappointment” with Japan’s resumption of its research whaling in the Antarctic Ocean. Abe explained the necessity of conducting whaling for research purposes on scientific grounds.
　ターンブル首相は、日本が南極海で調査捕鯨を再開したことについて「深い失望」を表明した。安倍首相は、科学的根拠に基づく調査の必要性などを説明した。

The assertions of the two leaders remain far apart on this issue. But it is necessary for this issue not to damage the overall bilateral relationship.
　双方の主張の開きは大きいが、この問題が日豪関係全体を損なわないようにする必要がある。

(From The Yomiuri Shimbun, Dec. 21, 2015)