Removing the Instability and Inequity in the Japanese Health Insurance System

Seiritsu Ogura, Tamotsu Kadoda and Makoto Kawamura

in Health Care Issues in the United States and Japan

Published by University of Chicago Press

Published in print November 2006 | ISBN: 9780226902920
Published online February 2013 | e-ISBN: 9780226903248 | DOI:
Removing the Instability and Inequity in the Japanese Health Insurance System

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This chapter compares Japan's current public medical insurance to an unstable two-story building, whose second floor (health insurance for the elderly) is becoming heavier each day, while its first floor is losing strength. It evaluates the weaknesses in the current health insurance system: the insurance of the elderly, or the second floor of our insurance system; and the National Health Insurance (NHI) system. It is observed that a switch to a consumption tax is a reform that brings the burdens of households who are raising families more or less in line with their medical costs. The rich are paying more than they consume under the present system and under any reform plan. In the 1996 health insurance system, it is shown that an imbalance of the benefits and burden of medical services was created across generations and that the imbalance was growing rapidly due to the aging of the population.

Keywords: health insurance system; Japan; elderly; National Health Insurance; consumption tax; medical costs; medical services

Chapter.  11300 words.  Illustrated.

Subjects: Public Economics

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