• Jiji

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The House of Representatives has started deliberating on a bill to double the share of out-of-pocket medical expenses to 20% for people age 75 or older with certain incomes.

The government aims to have the medical system reform bill enacted during the ongoing ordinary session of the Diet, which will run through June 16.

The medical fee hike would start in the second half of fiscal 2022. The specific schedule will be decided under a government ordinance.

The bill calls for a fee hike for older people who live alone and have an annual income of at least ¥2 million. The income threshold would be ¥3.2 million for two-member households in which both are 75 or older.

At a plenary meeting of the lower chamber of the Diet on Thursday, the government gave an explanation on the bill, followed by a question-and-answer session.

The bill is aimed at “curbing rising burdens on the working generation and building a social security system in which all generations can feel safe,” Health, Labor and Welfare Minister Norihisa Tamura said, while noting that social security costs are expected to rise further as postwar baby boomers start to turn 75 in fiscal 2022.

Under the current medical system for people age 75 or older, about 40% of medical costs, excluding those shouldered by the recipients of the service, are covered by contributions from the working generation.

Currently, the share of out-of-pocket medical expenses for older people is set at 10% in principle, except for high-income earners including those who live alone and have an annual income of ¥3.83 million or more.

Such high-income earners pay 30% of their medical treatment costs by themselves. But they account for only 7% of all in the age bracket.

The envisaged cost hike to 20% is expected to affect some 3.7 million people, or 21% of the age group.

For those who would have to pay 20% of medical expenses, the per capita annual burden will increase by about ¥34,000 on average.

The government plans to introduce a mitigation measure for three years after the legislation comes into force so that the increase in out-of-pocket medical expenditures will not exceed ¥3,000 per month.

The medical system reform concerning older people is expected to reduce the working generation’s contributions to the system by ¥72 billion in fiscal 2022.

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