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A look at Japan’s health insurance system

July 1, 2024
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Why this is important to Wisconsin: Wisconsin firms in the fintech sector may find partnership options in Japan.

Japan—where residents have some of the longest life expectancy in the world—is drawing attention for its universal health coverage, the World Economic Forum says.

Since 1961, Japan has required everyone who lives in the country for at least three months to participate in its universal health care system, which is funded primarily by taxes and individual premiums and coinsurance payments.

Japan’s statutory health insurance system covers 98.3% of the population; the remaining 1.7% use a separate program that’s designated for low-income residents. Benefits include hospital, primary care, specialty services, home health care, mental health care, dental care, and prescription drugs. Plans are assigned based on a person’s employment status, age, and residence but there are no restrictions on which medical providers can be seen or how many times a patient visits them. Total patient costs are limited by a designated maximum.

The main government system includes employment-based plans, which cover nearly 60% of the population, and residence-based plans, including a health insurance plan for those who are at least 75 years old—nearly 13% of the population. Each of Japan’s 47 prefectures, or regions, has its own residence-based insurance plan, and there are more than 1,400 employment-based plans.

The national and local governments are required by law to ensure a system that efficiently provides good-quality medical care. The national government establishes the fee schedule, and provides subsidies to local governments, insurers, and providers.

In the larger financial technology (fintech) arena, Japan is experiencing increased adoption of fintech solutions in payment systems, as well as digital banking and blockchain technology.

Wisconsin fintech companies may find opportunities to seek partnerships with health care firms or researchers in Japan.

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