JAPANESE HEALTHCARE Healthcare in Japan is provided under the Japanese universal health insurance system, a type of social insurance system. Japanese law requires that employers provide health insurance for all employees and dependents, through one of the numerous health insurance societies. This system was started in the 1960s and makes healthcare available to nearly all citizens of Japan. Most citizens receive health insurance through their employers. The premiums are based on income level, not the health of the subscriber and/or dependents. A small co-payment (usually around 10-30%) is required when receiving most healthcare services and the over 65 population now has a 30% copayment. The amount of co-payment depends on the type of insurance and is generally greater for dependents. The Japanese social insurance system can be broken down into three basic categories: 1) employees' health insurance (and their dependents) 2) national health insurance, covering self-employed and retired people (and their dependents) 3)an insurance fund for the elderly These health insurance societies have been experiencing large deficits for many years. Now more than 80% of all societies are running a deficit. The deficit is estimated to be in excess of 400 billion yen. A DRG (Diagnosis Related Groups) system is being evaluated in Japan. The current system, however, is a fee-for-service system where every service or material is reimbursed as it is consumed and the reimbursement amount is set by category. Copyright © 2004 Kirk Zeller, All rights reserved