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Japan gov't ponders raising medical bill self-pay ratio to 20% for advanced seniors

The Central Government Building No. 5 that houses the Health, Labor and Welfare Ministry is seen in this file photo taken in the Kasumigaseki district of Tokyo. (Mainichi/Kimi Takeuchi)

TOKYO -- The Japanese government is set to consider raising the ratio of medical bills that those aged at least 75 are required to pay to 20% from the current 10% in principle, with an eye on possibly introducing the new rate as early as fiscal 2022.

The move comes as calls for raising the self-pay ratio have intensified mainly within the Ministry of Finance and the government's council reviewing social security for all generations, which is chaired by Prime Minister Shinzo Abe. As the rate hike would inflict a greater burden on the elderly, the government is poised to begin coordinating with the ruling parties over when to implement the scheme, among other specifics.

Under Japan's public health care insurance system, those in the active workforce are required to cover 30% of their medical bills. In conjunction with the introduction of the medical insurance system for the elderly aged 75 or older in 2008, the self-pay ratio has basically been set at 20% for those aged 70-74 and 10% for those aged 75 and above. The ratio rises to 30% for those in the latter age group who earn as much income as active workers.

In 2022, baby boomers in Japan, or those born in between 1947 and 1949, will start turning 75, leading to a surge in social security expenditures. Amid these circumstances, the Fiscal System Council, an advisory body to the finance minister, proposed raising the self-pay ratio of medical bills for those aged at least 75 to 20%. At a meeting of a separate council reviewing social security for all generations on Nov. 26, Finance Minister Taro Aso and most of the council members from the private sector -- mainly from the business community -- expressed their support for raising the ratio on the condition that consideration is given to low-income earners.

In response, the Ministry of Health, Labor and Welfare and other government bodies are set to start looking into revising the current system. It is likely that discussions will center around a proposal to raise the self-pay ratio to 20% for people who will turn 75 after the system change, while keeping the 10% ratio for those who are currently 75 or older as it is. Measures such as retaining the 10% ratio for low-income elderly individuals will also be put to debate.

The health ministry is set to deliberate the proposed revision at the Social Security Council, an advisory body to the health minister, early next year. However, the government's council reviewing social security for all generations is demanding that a concrete agenda for the talks on the revision be included in an interim report to be drawn up in December.

(Japanese original by Takuya Murata and Hiroyuki Harada, Lifestyle and Medical News Department)

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