The government approved a new blueprint Friday for reforming the medical system, highlighted by a plan to require people 75 and older to pay for their own health insurance.

The road map, which officials describe as a "basic principle," calls for establishment of an independent health insurance system for people over 75 by fiscal 2008, a policy aimed at alleviating the burden on the working population in an increasingly graying society.

The plan leaves open some key issues, including the overall cost to the government, the premium to be paid by policyholders and who would run the program.

Officials would only say that government coffers would cover half of the cost, and that a more detailed blueprint will be drawn up later this year.

Health, Labor and Welfare Minister Chikara Sakaguchi has said it is vital that the government come out with a detailed blueprint later this year so it can start revising related laws within two years.

Sakaguchi and other politicians in the ruling coalition who deal with health insurance issues have pledged to release the basic blueprint before April 1, when the percentage of medical fees that health insurance policyholders pay will be raised to 30 percent.

Any delay would give political ammunition to the opposition, a senior coalition official said.

The health ministry initially showed that the proposed insurance program for people over 75 would cost 11 trillion yen, but that figure was dropped from the plan approved Friday. What remains is a government pledge to cover half of the cost of the program.

The plan would require people over 75 to subscribe to an independent health insurance system, which would be jointly financed by the government, subscription fees, the national health insurance and health insurance providers run by big companies and local authorities.

People aged 65 to 74 would join national health insurance and other health insurance systems, and any imbalance in cost-sharing would be adjusted among various insurance providers.

The plan would require dependents of working spouses, who are not required to make financial contributions to health insurance under the existing system, to subscribe to the new program once they reach 75.

It also addresses the issue of consolidating the nation's multiple health insurance systems. There are currently 5,000 health insurance providers, some run by big companies and others by local authorities.

Under the new plan, prefectures would take over all health insurance programs run by municipal governments. These programs are primarily subscribed to by self-employed people.

Prefectural governments would take over public health insurance programs that cover employees of small and medium-size companies which do not have their own insurance programs.

A new region-based health insurance program run by prefectures would be created as a way to consolidate weak health insurance programs run by some big companies.

The plan encourages insurance providers to provide more information to policyholders and consolidate the standards of medical bill payments, which have been criticized for being overly complex.

It calls for setting up an evaluation system on medical technology standards and medical facilities' operating costs, and sharing the information with insurance subscribers.