Japan's health insurance system is considered "universal," since it covers everyone in the country, but it is hardly "free" in the sense of having the government pay for everything with tax revenue.
Anyone who lives in Japan must pay into the system according to their income level. And when people go to the doctor they pay about 30 percent of the cost of treatment and drugs out of their own pockets. Some people pay less and a few pay nothing.
There are basically three types of national insurance plans. The shakai hoken system is for company employees, who pay into the system along with their employers. Another system is reserved for civil servants, school teachers and other public workers. Everyone else belongs to the kokumin kenkō hoken system, which was originally devised for self-employed people. However, over the last two decades, more and more employers have opted to hire nonregular workers, and a larger portion of the workforce is engaging in part-time labor. Many of these people do not receive benefits as regular full-time employees do and thus have to acquire health insurance on their own through the kokumin system.