Health and Global Policy Institute (HGPI), an independent, non-profit, and non-partisan think tank, has long been committed to addressing challenges in health and social security. By harnessing the collective intelligence of diverse stakeholders, HGPI aims to present new options for society, fostering citizen-centered health policy.

Japan’s social security system is currently facing structural challenges, including rapid population aging and a shrinking working-age population. With the increasing demand for healthcare and long-term care services due to the growing number of advanced late, social security benefits are projected to reach 190 trillion yen by 2040. Coupled with labor shortages due to the declining workforce, this trend threatens to increase the burden on the working generation and jeopardize the sustainability of the system. On the other hand, proactive efforts are being made by government and private sector experts to address these issues. Technological innovation is accelerating in healthcare and long-term care, giving rise to new services and system innovations. Moreover, policies and initiatives aimed at realizing a symbiotic society are being implemented nationwide, offering hope for a brighter future. These efforts not only have the potential not only to position Japan’s healthcare and elderly care industries as growth sectors but also to revitalize regional communities.

In the past, the National Council on Social Security System Reform, established in 2012, deliberated on the sustainability and future direction of the social security system from a long-term perspective. These discussions laid the foundation for Japan’s social security policy by seeking the optimal balance between “self-help, mutual assistance, and public help” while pursuing system enhancement and efficiency. Building on that momentum, the Meetings on a Social Security System Oriented to All Generations is currently advancing these discussions further. Additionally, the Ministry of Health, Labour and Welfare unveiled the “Future Health and Active Society Strategy” in 2024, presenting a concrete vision for achieving a sustainable social security system. This strategy identifies three primary goals: promoting the growth of the healthcare and long-term care industries, harnessing innovation for societal benefit, and creating a society where individuals can lead healthy and active lives.

Against this backdrop of emerging changes, we have provided a platform for future-oriented discussions through the “HGPI Salon 2025” held in 2025. Under the Chatham House Rule, participants engaged in free and candid dialogue, generating insights and ideas for policy formation through an active exchange of opinions. In 2026, we will expand upon the discussions held during HGPI Salon 2025 by launching “HGPI Salon 2025-2026.” This series will focus on exploring the value of healthcare in a shifting social landscape and envisioning the next generation of medical care. Furthermore, we will delve deeper into the challenges of health policy by revisiting infectious disease control. Ultimately, by synthesizing these discussions, we aim to re-examine the realization of citizen-centered health policy, which remains the core mission of our institute.

The HGPI Salon provides a positive space to share challenges in healthcare and social security while collaboratively exploring solutions for the future. The event is supported by participation fees, which are exclusively allocated to venue and operational expenses. Individual supporting members can attend free of charge. We warmly invite you to join us in envisioning a brighter future for Japan’s social security system.

For this fifth session, Mr. Ataru Igarashi, a Fellow at HGPI, joined us as our guest speaker, with the discussion moderated by Asako Okawa, Senior Associate at HGPI. Mr. Igarashi’s presentation covered policy trends surrounding the reform of Japan’s High-Cost Medical Expense Benefit system, an analysis of medical expense burdens across income brackets using the concept of “catastrophic medical expenditure,” issues related to the reconsideration of insurance coverage for OTC-equivalent drugs, promoting workplace prevention and health creation, and the multifaceted nature of value in healthcare. The presentation also addressed how healthcare value can be understood through multiple lenses, using indicators such as Quality-Adjusted Life Years (QALYs) and Financial Toxicity, as well as the practical challenges of determining priorities within limited resources. Building on these themes, participants engaged in an active discussion on how to incorporate elements that cannot be captured by quantitative indicators alone, including cost-effectiveness, into decision-making processes.

■ Event Information

• Session 5 Speakers

  Guest Speaker: Ataru Igarashi (Fellow, HGPI)
  Moderator: Asako Okawa (Senior Associate, HGPI)

• Date & Time: Monday, June 29, 2026; 18:30-20:30 JST
• Format: In-person Only
• Venue: International House of Japan (5-11-16 Roppongi, Minato-ku, Tokyo 106-0032)
• Rules: Chatham House Rule
• Language: Japanese only
• Participation Fees: Individual Supporting Members and Students (undergraduates only): Free
  General Participants: ¥4,400 (Credit card payments only)
  * Light refreshments were provided at the venue. Participation fees were fully allocated to operational and venue costs.

 

■ Program

 

18:30-18:35	Introduction HGPI Salon Team
18:35-18:40	Opening Remarks Shotaro Tsukamoto (Manager, HGPI)
18:40-20:00	Cross-Session *An interactive discussion involving presentations and audience participation. Theme: “Reflecting on the Present to Shape the Future of Social Security” Guest Speaker: Ataru Igarashi (Fellow, HGPI) Moderator: Asako Okawa (Senior Associate, HGPI)
20:00-20:30	Reception

 

■ Profile

Ataru Igarashi (Fellow, HGPI)

Project Associate Professor, Graduate School of Business Administration, Keio University; Visiting Associate Professor, Graduate School of Data Science, Yokohama City University. Ataru Igarashi graduated from the University of Tokyo Faculty of Pharmaceutical Sciences in 2002 and completed the doctoral course at the University of Tokyo Graduate School of Pharmaceutical Sciences in 2008. He began serving as Assistant Professor and later as Project Associate Professor at the University of Tokyo Graduate School of Pharmaceutical Sciences in 2008. He was appointed Associate Professor of the Yokohama City University School of Medicine Unit of Public Health and Preventive Medicine in 2019, and assumed his current position in 2024. As a specialist in pharmacoeconomics, Professor Igarashi has continuously compiled data to assist decision-making from multiple perspectives. These contributions have included the development of guidelines on health economics, conducting cost-effectiveness evaluations on individual medical technologies, and establishing evaluation indices for quality of life. His published works include I Do Not Understand Medical Statistics (Tokyo Shobo, 2010); Medical Statistics: I Think I Am Starting to Get It (Tokyo Shobo, 2012); and I Do Not Understand Pharmacoeconomics (Tokyo Shobo, 2014).

Asako Okawa (Senior Associate, Health and Global Policy Institute)

Ms. Asako Okawa is a registered dietitian and a holder of a Master of Public Health (MPH) degree. After graduating from the Junior College Division of Food and Nutrition and Faculty of Nutritional Sciences of Nakamura Gakuen University, she joined Nagasaki University Hospital as a registered dietitian. Her responsibilities included meal management, nutritional management, and nutritional guidance. During that period, she also volunteered as a staff member for a summer camp for children with diabetes and for other patient group events. She later led the nutrition department at a chronic care hospital. In 2021, she enrolled in the School of Public Health of the University of Tokyo Graduate School of Medicine, where she was involved in clinical epidemiology research. After completing the program in 2022, she joined Kyoto University Hospital as a registered dietitian. Ms. Okawa joined HGPI in February 2024, where she leads projects in areas like non-communicable diseases (NCDs), drug pricing and discovery, and stabilizing the drug supply.

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