The health insurance plan introduced in fiscal 2008 for people at least 75 years old was unpopular at first because, in principle, premiums are withdrawn from people’s pensions at the source. Nonetheless, the plan appears to have won popular acceptance for the most part.

Recently a study group at the health insurance ministry produced an interim report calling for abolition of this system, in accordance with the Democratic Party of Japan’s manifesto for the 2009 Lower House election. The panel proposes that of some 14 million people aged 75 or over, about 12 million — who are self-employed or jobless — join the kokumin kenko hoken health insurance plan administered by municipalities and some 2 million — who are company employees or dependents of company employees — join corporate health insurance plans.

Under the present system, individual elderly people pay monthly premiums; in this way, they are made aware of the cost of providing medical services to them. This principle would suffer a setback under the proposed system. If those who join kokumin kenko hoken are dependents of their children or spouses, they would be exempted from premium payments because the household heads would pay premiums. Those who join the corporate health insurance system as employees would have half the amount of their premiums paid by their employers. Those who join as dependents would not have to pay premiums.

Under the current system, tax funds as well as support money from the corporate sector’s health insurance associations cover 50 percent and 40 percent, respectively, of health care costs for the elderly. The remaining 10 percent is shouldered by the elderly participants. Under the proposed system, elderly participants would continue to shoulder this 10 percent.

Since medical costs for the elderly will continue to rise, it is clear that not only the premiums that the elderly pay but also the tax funds and the support money from the corporate sector’s health insurance associations will have to increase. The panel must discuss how to secure funds and set down clear rules for allocating tax funds and support money.

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