Japan Enacts Health Insurance System Reform

Tokyo, May 29 (Jiji Press)–The Diet, or Japan’s parliament, on Friday enacted health insurance system reform bills that call for, among others, raising patients’ out-of-pocket expenses for prescribed drugs with ingredients and effects similar to those of over-the-counter drugs. Starting next March, 25 pct of the prices of such OTC-like drugs will be fully charged to patients as a special fee, while co-payment rates ranging from 10 pct to 30 pct will apply to the remaining 75 pct. About 1,100 drugs, including moisturizers and hay fever drugs, will be subject to the additional burden. Children and patients with intractable diseases will be exempt from the special fee. The measure is aimed at reducing the country’s medical costs and health insurance premiums paid by working generations. The reform legislation also calls for childbearing costs to be fully covered by public health insurance gradually starting around 2028 as a way to address the country’s declining birthrate. Childbirth costs, excluding births by Caesarean section and other special procedures, are currently not covered by insurance and vary by medical institution. A lump-sum childbirth allowance, at 500,000 yen, is sometimes not enough to fully cover costs. The government will set a nationwide uniform price for childbirth costs, which will be fully covered by insurance. It will also give fixed-sum cash handouts to all pregnant women. Financial income, such as stock dividends, will be reflected in insurance premiums and out-of-pocket expenses for those aged 75 or older who are enrolled in the medical care system for the elderly, starting around 2030. Other reform measures include expanding the coverage of children eligible for reduced national health insurance premiums to include those up to high school age, instead of only preschool children at present, starting in fiscal 2027. The legislation also calls on the government to consider the impact on people’s finances when mulling whether to further raise the cap on patients’ out-of-pocket expenses for high-cost medical care. The government plans to raise the ceiling by up to 38 pct by August 2027. END [Copyright The Jiji Press, Ltd.]