As medical technologies advance and the population continues to age, achieving a balance between the appropriate evaluation of innovation and the sustainability of the healthcare system is an urgent issue for many countries with public health insurance systems. Japan is no exception; there is a pressing need for policy options to ensure a sustainable and effective healthcare system for future generations and to build social consensus required to realize them.

To address this situation, it is essential to foster shared understanding and common perspectives on the boundaries between healthcare supported by society and that entrusted to individuals or the market. This includes clarifying the respective roles of public health insurance, private health insurance, and self-help while remaining grounded in the philosophy of Universal Health Coverage (UHC). Furthermore, policy discussions are expected to evolve into a trusted and inclusive consensus-building process where a wide range of stakeholders—including patients and those most affected—participate and share responsibility across society.

In light of these challenges, Health and Global Policy Institute (HGPI) has compiled key directions for securing a sustainable healthcare system for the next generation. This summary is based on multiple sessions of multi-stakeholder discussions, involving members from industry, government, academia, and civil society, and highlights three perspectives: “benefits,” “burdens,” and the societal implementation process.”

Three Key Objectives for Public Deliberation

Perspective 1: Reexamine the scope of insurance benefits in light of the growing sophistication of healthcare technology and the transition to a super-aging society
1-1: Exclude low-value healthcare and similar services from insurance coverage and concentrate resources on necessary healthcare
1-2: Optimize benefits for pharmaceuticals and strike a balance between innovation and sustainability

Perspective 2: Distribute burden in a more equitable manner in anticipation of longer healthy life expectancy and population decline
2-1: Redefine “senior citizen” in relative terms that reflect the increase in healthy life expectancy
2-2: Achieve a more equitable distribution of burden based on the ability-to-pay principle while taking income and assets into account
2-3: Restructure burden around the premise that Japan has entered an era of population decline

Perspective 3: Leave the next generation a healthcare system that is based on scientific evidence and the formation of societal consensus
3-1: Strengthen the social infrastructure for generating evidence through collaboration among parties like insurers or examination and payment agencies
3-2: Visualize a multi-tracked system and consolidate shared operations for greater efficiency and transparency
3-3: Establish opportunities for national conversations and encourage involvement from young people and members of the working-age generation

For details, please see the PDF below.