Japanese Health Insurance: read&learn
Japan produces cars, color TVs and computers, but it also produces the world's healthiest people. It has the longest healthy life expectancy on Earth and spends half as much on health care as the United States.
That long life expectancy is partly due to diet and lifestyle, but the country's universal health care system plays a key role, too.
Population: 127,103,388 (July 2014 est.)
65 years and over: 24.8% (male 14,218,655/female 18,531,653) (2014 est.)
Birth Rate : 8.07 births/1,000 population (2014 est.)
Death Rate : 9.38 deaths/1,000 population (2014 est.)
Life expectancy at birth: 84.46 years
Health Care for Anyone at Anytime
Dr. Kono Hitoshi is a typical doctor. He runs a private, 19-bed hospital in the Tokyo neighborhood of Soshigaya.
"The best thing about the Japanese medical system is that all citizens are covered," Kono says. "Anyone, anywhere, anytime — and it's cheap."
Patients don't have to make appointments at his hospital, either.
The Japanese go to the doctor about three times as often as Americans. Because there are no gatekeepers, they can see any specialist they want.
There are two major types of insurance programs available in Japan
1-Employees Health Insurance (健康保険 Kenkō-Hoken)
2- National Health Insurance ([国民健康保険 Kokumin-Kenkō-Hoken).
National Health insurance is designed for people who are not eligible to be members of any employment-based health insurance program. Although private health insurance is also available, all Japanese citizens, permanent residents, and non-Japanese with a visa lasting one year or longer are required to be enrolled in either National Health Insurance or Employees Health Insurance.
Does not impose penalties
Japan has a universal health care system that mandates all residents have health insurance, either at work or through a local community-based insurer, but does not impose penalties on individuals for not having insurance.
Keep premiums to around $280
The Japanese health ministry "tightly controls the price of health care down to the smallest detail. Every two years, the doctors and the health ministry negotiate a fixed price for every procedure and every drug. That helps keep premiums to around $280 a month for the average Japanese family."
Insurance premiums are set by the government, with guaranteed issue and community rating.
Not allowed to deny claims or coverage
Insurers are not allowed to deny claims or coverage, or to make profits (net revenue is carried over to the next year, and if the carryover is large, the premium goes down).
Around 10% evade the compulsory insurance premium; municipal governments do not issue them insurance cards, which providers require.
Voluntary private insurance is available through several sources including employers and unions to cover expenditures not covered by statutory insurance, but this accounts for only about 2% of health care spending.
In practice, doctors will not deny care to patients in the low-priced universal system because they make up the great majority of patients nationwide, and doctors would not be able to earn enough by serving only the small number of patients with private insurance.
Total spending is around half the American level, and taxpayers subsidize the poor.
An Accommodating Insurance System
Japanese insurers are a lot more accommodating than their American counterparts. For one thing, they can't deny a claim. And they have to cover everybody.
Even an applicant with heart disease can't be turned down, says Ikegami, the professor. "That is forbidden."
Nor do health care plans covering basic health care for workers and their families make a profit.
"Anything left over is carried over to the next year," Ikegami says. If the carryover was big, "then the premium rate would go down."
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