Natl Insurance Outline Drafted; Panel Urges Prefectures To Take Over Coverage For Self-Employed

The national health insurance program for self-employed people now managed by 3,200 municipalities nationwide should be integrated into prefectural programs, according to a recommendation to be made by a Health, Labor and Welfare Ministry panel on medical system reform.
The panel, headed by Health, Labor and Welfare Minister Chikara Sakaguchi, will incorporate the recommendation into a report on medical system reform to be issued in September.

The panel’s experts drafted an outline at a meeting on Wednesday morning.
The experts proposed the establishment of a new corporation in each prefecture to take over the national health insurance program.
They also proposed the establishment of a new corporation to singlehandedly run government-run health insurance programs, mainly for small and medium-sized corporations, health insurance cooperatives attached to individual business establishments or to entities of more than one business in the same sector and for salaried workers at large companies and mutual aid associations for government employees.

With medical expenses rising due to the graying society and weakening the financial strength of all health insurance programs, the integration and unified management of health insurance programs are aimed at cutting costs to stabilize the finances of health insurance programs.
The ministry plans to map out basic policies within this fiscal year for a drastic reform based on the report, ministry officials said.
Since May, the panel’s five experts, including Sophia University Prof. Yasuhiko Yamasaki and Kyoto University Prof. Shuzo Nishimura, have been studying drastic medical reform, focusing on what form the medical insurance system should take, a review of the organization of the government-administered health insurance and the establishment of a medical system for the elderly.

The outline proposes that the nation’s 5,000 health insurance programs should be integrated into regional insurance and employee insurance programs to balance benefits with the burden of premiums.
Regarding employee health insurance, the outline suggests that the government-run health insurance program for employees of small and medium-sized firms be divided into prefectural programs.
Furthermore, it calls for the formation of a corporation in each prefecture to unify and run government-administered health insurance, the nation’s about 1,700 insurance cooperatives connected to major companies and government employees’ mutual aid associations.

By integrating the government-administered health insurance into prefectural programs, the envisaged regional health insurance program is expected to reduce the 4.4-fold gap between municipalities with the lowest per capita medical expenses and those with the highest to within twofold.
However, because the income discrepancies between policyholders under regional health insurance and employee insurance programs are great, the envisaged regional health insurance program, as it covers elderly people who tend to fall ill more easily, will have more financial troubles than the employee health insurance program.

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