Japan’s universal health care system could collapse unless the medical expense burden shouldered by elderly patients aged 75 or older is at least doubled, a senior official of a nationwide health insurance group has warned.

Corporate health insurance unions are facing “quite serious” financial conditions amid the country’s graying population, Masahiro Sano, vice chairman of the National Federation of Health Insurance Societies, or Kenporen, said in a recent interview.

“There have been unions that couldn’t hike premiums and had no choice but to dissolve,” Sano said. Kenporen is an umbrella organization for corporate health insurance unions across the country.

Currently, people in the so-called late-elderly group pay 10 percent of their medical bills, with the rest covered by health insurance.

To prevent the universal health care system from collapsing, Sano said that the elderly self-coverage rate should be raised to 20 percent.

He also said there are two other options: covering elderly medical costs with taxpayer money and further increasing insurance premiums for working generations.

“The root of the problem is the (rising) cost of elderly medical expenses, but there’s no prospect for its resolution,” the Kenporen official said.

Since the late-elderly medical care scheme was introduced in 2008, the average annual employee income has fallen by about ¥40,000, while health insurance premiums deducted from their salaries have risen by more than ¥100,000 on average, according to Sano.

Over ¥60,000 of the premium’s increase was meant for contributions to the late-elderly medical scheme, he added.

“Total contributions (to the late-elderly scheme) are expected to be more than ¥1 trillion higher in 2025 than now and this has to be shouldered by the dwindling working population,” Sano said.

“The current system doesn’t seem sustainable at all,” Sano claimed. “I can’t see any ways to avoid (an increase in late-elderly people’s burden).”

Sano referred to a recent Kenporen survey showing that some elderly people are willing to accept a rise in their self-coverage rate. “Many elderly people don’t want to put burdens on their children and grandchildren,” he said.

In the interview, Sano also said a planned consumption tax hike from the current 8 percent to 10 percent in October 2019, chiefly designed to cover swelling social security spending, is indispensable. He even urged the government to consider a further increase.

Kenporen, for its part, will promote efforts to help elderly people stay healthy and raise awareness among young people about medical system issues, Sano said.

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