The Health and Global Policy Institute (HGPI) held an expert forum, “Rethinking Social Security: Ensuring an Ideal Balance between Health Insurance Benefits and Premiums – A Multistakeholder Conversation on Japan’s Universal Healthcare System.” A brief report on the discussion at the forum is available for download at the bottom of this page.

 

■Overview
Since the achievement of universal health coverage with the establishment of the National Health Insurance system in 1961, Japan has become one of the healthiest, most active, aging societies in the world. That said, the fiscal sustainability of the healthcare system is now under pressure due to issues stemming from Japan’s falling birthrate and population aging. Healthcare costs are predicted to rise further moving forward, while the working population (ages 20-74) is expected to continue to shrink over the medium to long-term, reducing the total size of payments into the health insurance system. Furthermore, public demand for the highest quality of healthcare continues to drive the introduction of innovative, yet ever more expensive pharmaceuticals and health technologies into the system.

In light of the above issues, and given Japanese Government goals toward the creation of a social security system oriented to all generations in preparation for a future in which the average lifespan is expected to exceed 100 years, there is now an urgent need to advance debate on measures that could help the Japanese healthcare system obtain additional, sustainable sources of revenue.

In relation to that, on June 21, 2019, the Japanese Government issued the Basic Policy on Economic and Fiscal Management and Reform 2019. This Basic Policy outlined the goal of rethinking the fiscal sustainability of the pension and nursing care systems by the end of 2019, and indicated that the 2020 Basic Policy would take up the issue of shifting the balance between benefits and premiums in the national health insurance system.

Any changes proposed to the balance between benefits and premiums in the health insurance system are going to have a major impact on society. It is crucial that sufficient and careful discussion by a wide-range of diverse stakeholders be undertaken before any concrete decisions are made.

This forum was held with the aim of bringing together experts from various sectors to discuss the value of the health insurance system to society, measures to further improve access to healthcare, and policies to secure further funding for the system.

A brief report on the discussion at the forum is available to download at the bottom of this page.

 

■Program
Opening Remarks
Kiyoshi Kurokawa (Chairman, HGPI)

 

Keynote Address 1 “The Current State and Issues of Public Healthcare”
Hisao Endo (Chairman, Social Security Council (Director-General, National Institute of Population and Social Security Research))

 

Keynote Address 2 “Social Security and Government Finances: Issues and Outlook”
Hirotaka Unami (Deputy Director-General, Budget Bureau, Ministry of Finance)

 

Keynote Address 3 “Sustainable Healthcare Provision System in the Age of Innovation”
Masami Sakoi (Assistant Minister, Minister’s Secretariat, Ministry of Health, Labour and Welfare (MHLW))

 

Panel Discussion “Healthcare Access and the Balance Between Benefits and Premiums in the Social Security System”

Panelists:
Satoshi Imamura (Vice-President, Japan Medical Association)
Naomi Sakurai (President, Cancer Solutions Co., Ltd.)
Masahiro Sano (Executive Managing Director, National Federation of Health Insurance Societies (Kenporen))
Kenji Shimazaki (Professor, National Graduate Institute for Policy Studies)
Toshio Nagase (Senior Director, Government Affairs Japan, Gilead Science K.K.)

Moderator:
Joji Sugawara (Senior Associate, HGPI)

 

Closing Remarks
Yasutoshi Nishimura (Member of the House of Representatives/Minister in charge of Economic Revitalization/Minister in charge of Social Security Reform/Minister of State for Economic and Fiscal Policy)