The health insurance system for people aged 75 or over, introduced in April 2008, has proved unpopular because aged people covered by the system feel that they have been herded into a certain category separated from younger generations. They are also angry about the practice of withholding insurance premiums from their pensions at the source. The piecemeal changes the government made to assuage public resentment against the system added complexity to it.

With this situation in mind, health minister Yoichi Masuzoe has made a private proposal to reform the system. Some people say that since it is not an official proposal, it is meaningless to discuss it. But his proposal may serve as a starting point for finding ways to address the public resentment against the system while creating a system acceptable for all the generations.

Mr. Masuzoe's proposal calls for integrating the system for people aged 75 or over with the kokumin kenko hoken health insurance system, which is mainly for self-employed people and younger pensioners and administered by municipalities. Under the proposal, the new system will be administered by prefectural governments. Health insurance societies that mainly insure company employees will offer financial support to the new system. The practice of withdrawing health insurance premiums from pensions at the source will be abolished.

Tax money covers 50 percent of the funds to run the current health insurance system for people aged 75 or over; support money from health insurance societies and premiums fund 40 percent and 10 percent, respectively. While this scheme makes visible the costs and benefits, it could give rise to resentment among younger generations against people aged 75 or over. Mr. Masuzoe's proposal may help lessen generational conflicts over shouldering of the cost burdens.

But Mr. Masuzoe has not estimated how much support money health insurance societies must offer when the new system is created and how to secure enough tax money to cope with rising medical costs. At the very least he needs to clarify these points to help start meaningful discussions about his proposal.