Where Has the Pride of Universal Healthcare Gone?

Japan has long been a nation of universal healthcare, a source of pride for its citizens and the envy of other countries. However, this landscape has drastically changed with the introduction of the medical insurance system for the late elderly. The monthly insurance premiums for the late elderly now average around 6,000 yen nationwide, adding another 4,000 yen for long-term care insurance, totaling 10,000 yen. This presents a significant burden for seniors whose pension income is only a few tens of thousands of yen per month.

It seems like a distant dream when the elderly were once treated so generously, earning Japan the moniker of 'paradise for the elderly.' In recent years, medical cost-sharing for seniors, both for inpatient and outpatient care, has continued to rise. Furthermore, there are 2 million individuals over 75 who have been separated from their dependents. And it's not just the late elderly. Those aged 65 to 74, referred to as 'early elderly,' will also see their national health insurance premiums deducted directly from their income.

The Background of Premium Hikes

Troublingly, the number of people reaching retirement age around 65 is rapidly increasing, and as they all leave their companies, they shift from company health insurance to the national health insurance system. The abolition of the retirement medical system has also significantly altered the financial standing of the national health insurance, leading to premium increases. Both corporate-managed health insurance (kumiai kansho kenko hoken) and government-managed health insurance (seikan kenko hoken) for salaried workers are experiencing a surge in premium hikes.

Originally, over half of the national health insurance members were farmers and self-employed individuals. However, with the rapid increase in retired salaried workers and the growing number of part-time workers and freelancers, often referred to as non-regular employees, joining the system, the situation has changed. Local governments are responding by raising insurance premiums. The reality is that many people are struggling financially due to these premium increases, leading them to reduce their hospital visits or simply endure their ailments. The vision of Japan as a welfare superpower seems to be receding further into the distance. It is perhaps time to renew our strong interest in realizing political change through our own hands.