Financing

Health Expenditures

Health spending in Japan is generally considered low when compared to other advanced economies, yet costs exceed OECD averages in the areas of pharmaceutical expenditures and public expenditures on health. Public sources fund 82% of health spending in Japan. In recent years, total health expenditures (all money spent on medical goods and services) as a part of GDP has been on the rise in Japan. Between 2008 and 2012, health spending rose from 8.5% to 10.1% of GDP surpassing the 2012 OECD average of 8.9% (OECD data 2015). Health spending in 2014 is estimated Continue reading...

Payment System

Medical service fees are defined as the fees received by a medical facility or pharmacy in exchange for insured medical services or products provided to an insured person. These fees are overseen by the Ministry of Health, Labour, and Welfare (MHLW), which sets the fee schedule and determines the billing conditions for medical services, medical devices, and pharmaceuticals all providers must adhere to. There are prohibitions against setting fees higher than those in the fee schedule and providers are restricted from combining non-listed services and products with listed Continue reading...

Cost Control

Fees for medical services, products, and pharmaceuticals delivered by almost all providers are dictated by a national fee schedule. Every two years, the fee schedule along with conditions for billing are reviewed and revised by the MHLW. This process, which begins in the spring of odd-numbered years and finishes in April of the following year, sets fees and policies that dictate the healthcare benefit package as well as nearly all provider and medical facility income. This policy tool acts as the government’s cost control lever as both overall costs and line-item costs can be adjusted Continue reading...