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SummaryThe Japanese public medical insurance system and lifting of the ban on mixed medicalcare are historically reviewed.The fundamental issue of medical insurance is how to secure financial resources to compensatefor the increase in medical expenses. In the future, Japan’s low socio–economic growth due to a declining population caused by a falling birth rate and other factors is unlikely to offset the growth in medical expenditure due to the introduction of medical care for the old persons and advanced medical technology and new drugs. To estimate nationalmedical expenses by financial resources, they are divided into three categories, i.e., insurancepremiums, public expenses (taxes), and patients’ expenses. However, issues of burden–sharing and ratio should be continuously discussed.Regarding the issue of the total lifting of the ban on mixed medical care, safety and effectiveness should be secured by the non–insured associated medical expenses system with the universal medical insurance system maintained, to facilitate insurance listing for continued improvement of the quality of medical care (safety and effectiveness), access (fairness),and cost (efficiency).However, the issue of financial resources for medical expenses has generally been discussed with the issue of mixed medical care, because maintaining the universal insurance system (social profit) conflicts with receiving advanced medical care (personal profit). |
