Kenporen Official Urges Stakeholder Talks on Japan's Medical Insurance Reform

Takashi Yonekawa, deputy head of the National Federation of Health Insurance Societies, or Kenporen, called for discussions involving all stakeholders on whether and how to reform Japan's public medical insurance system. The interview took place in Tokyo on June 24.

A Kenporen survey conducted online in January received 3,000 responses and found that 37.1 percent of respondents view higher medical expenditures for older people as inevitable.

The share rose to 40 percent among respondents aged 75 or older. The survey occurred amid government and ruling party discussions on possibly increasing out-of-pocket payment rates for older people. Under the current system, the out-of-pocket medical payment rate stands at 30 percent for people under 70, 20 percent for those aged 70 to 74, and 10 percent for those aged 75 or older.

People aged 70 or older with high incomes pay more than the baseline rates. “The working generation feels the heavy burden (of payments) but is not seeking to place an excessive burden on older people,” Yonekawa said. ” He added that both sides are viewing the current situation calmly.

Yonekawa noted that some people aged 75 can work while some in their 60s cannot, arguing it is unreasonable to set burden shares solely on the basis of age. 4 percent of respondents did not know that local government subsidies for children’s medical expenses only cover out-of-pocket payments, with the remaining expenses financed by insurance premiums.

“It is only natural to take your children to see a doctor when they have a fever,” Yonekawa said. He advocated for self-medication and said that if all generations practice it, the approach will help optimize health care spending. “The good thing about the universal health insurance system is that people can go to medical institutions whenever they get sick,” Yonekawa said.