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Reform of the health care system in Japan - the aims of the June 2006 Partial Amendments to the Health Insurance Act

The Partial Amendments to the Health Insurance Act that were passed by the Diet on June 14, 2006, decided the direction of subsequent health care system reforms in Japan. The amendments were made within a context of steeply rising medical expenditure for the elderly, and consisted mainly of measures to curve the medical expenditure by increasing the size of co-payments by the elderly, and by preventing lifestyle-related diseases.

The main measures decided upon included the following:

(1)the promotion of medical check-ups and health guidance, setting of numerical targets for reducing the incidence of lifestyle-related diseases, and reduction of the time needed for treatment and enhancement of the quality of regional health care, in order to improve patients' quality of life;

(2)the raising of the medical payments of elderly patients by, for example, increasing the co-payment rate of patients aged 70-74 from 10% to 20%, and the partial reduction of the coverage of public insurance benefits; the increase of support for those giving birth to and raising children, as a countermeasure to Japan's declining fertility rate;

(3)the establishment of a medical system for the elderly aged 75 and over, and the collection of new insurance premiums. The Ministry of Health, Labour and Welfare (MHLW) believe that these reforms will lead to an 8 trillion yen saving in the potential amount of medical expenditure made in the year 2025.

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