U.S. won’t breach ‘mixed treatment’ medical insurance rules in TPP talks


The United States will not raise the issue of Japan’s insurance coverage rules for advanced medical treatment during trade talks on the Trans-Pacific Partnership Agreement because of concerns aired by local medical workers, sources involved in Japan-U.S. relations said Sunday.

Assistant U.S. Trade Representative Wendy Cutler informally told Japanese government officials earlier this month that Washington will not take up Japan’s rules on “mixed treatment,” under which the government in most cases denies public insurance coverage even for eligible services when a patient opts to use an uninsured method as part of overall treatment, the sources said.

Uninsured treatments are in high demand but are often expensive and beyond the reach of average consumers. U.S. insurance companies are believed to be keen on entering Japan’s private insurance market to cover uninsured treatments in Japan.

Cutler also told senior members of the Liberal Democratic Party, the main opposition force, that the U.S. has no problem with Japan’s universal health insurance system, said the lawmakers, who visited Washington last week.

The Japan Medical Association, a group of around 165,000 physicians, is opposed to lifting the ban on public insurance coverage in “mixed treatment” rules, as it believes eliminating the system would eventually make it difficult to maintain universal health coverage based on the principle of equality.

The association claims that if the ban is lifted, the number of hospitals offering advanced uninsured treatments would grow and the government would stop raising fees for insured medical services. Cash-strapped hospitals would then go under, threatening the maintenance of the universal health system, the group says.