The world s third largest spender on healthcare after USA and China Deloitte Touche Tohmatsu LLC, Partner, Leader in Japanese Healthcare Industry Group Yoritomo WADA 14 th March 2018 That article is a personal opinion of the author, this is not official view on Deloitte Touche Tomatsu LLC.
Outline What s Happening in Japan - Super-aged Society Health System - Health Insurance - Long-Term Care Insurance System Our Challenging - Where we go? - Healthy Ageing 2
Basic Statistics Japan England(*2) America(*2) China(*2) Population(million) 127 65 321 1,383 Life expectancy Both sexes Man Women 83.8 80.9 87.1 (*1) 81.2 79.4 83.0 79.3 76.9 81.6 76.1 74.6 77.6 Healthy life expectancy Both sexes 74.9 (*2) 71.4 69.1 68.5 Aging rate 26.8% 18.5% 15.4% 10.6% Source: (*1) Ministry of Health Labour and Welfare, (*2) World Health Statistics 2016 3
Japan has experienced rapid demographic change. The aging of society is by no means limited to Japan and other countries Aging rate% 35 30 25 20 JP CH EN US Super-aged society 30% Super-aged society 21% 15 10 Aged Society 14% 5 0 1960 1980 2000 2020 2040 2060 2080 2100 2120 JP: Japan EN: England US: United States CH: China Year Source:World Population Prospects: The 2015 Revision http://www8.cao.go.jp/kourei/whitepaper/w-2016/html/zenbun/s1_1_5.html 4
The increasing healthcare expenditure has placed a significant strain on the national health system in Japan National Medical Expense Long-term Care Benefit Expense (Billion GBP) (Billion GBP) 150 JPY = 1GBP 500.0 400.0 Approximately 1.5 times increase in 10 years 400.0 500.0 400.0 300.0 200.0 256.7 272.0 300.0 200.0 Approximately 2 times increase in 10 years 140.0 100.0 100.0 54.7 66.7 0.0 2011 2014 2025 0.0 2011 2014 2025 Source : National Institute of Population and Social Security Research, prepared by Ministry of Health, Labor and Welfare documents 5
Healthcare System 6
Health Insurance in Japan and United Kingdom Coverage Japan United Kingdom Co-Payment Over 75 years old 10% 70-74 years old 20% Worker 30% Under 6 years old By municipality Source : Created by DTT in reference of Japan Ministry of Health Labour and Welfare England https://www.nhs.uk/nhsengland/thenhs/about/pages/overview.aspx 7 Prescriptions, Optical services and Dental services 100% paied by patients
Healthcare system in Japan and England Patients Clinic Large Hospital Patients General Practitioner (Primary Care) Large Hospital Free access Medical Appointment Referral Free access Anyone enables to access medical institutions, anywhere, anytime Some large hospitals are required a referral letter and a first visit fee ( 35)since 2016 Source : Created by DTT in reference of International comparison of medical system, Ministry of Finance https://www.nhs.uk/nhsengland/thenhs/about/pages/nhsstructure.aspx 8 CCG* are responsible for the commission to most secondary care services *CCG : Clinical commissioning groups
Long-term care insurance system in Japan Enforced the system in 2000 Required to receive a long-term care certification Subscriber Long term care needed Level 1-5 Monthly Benefits Level1 1,113 Level2 1,308 Level3 1,795 Level4 2,054 Level5 2,404 Patient's Pay Mainly 10% Services Residential Services Home care services Community-oriented service Municipal governments Support needed Level 1&2 Level1 334 Level2 698 Mainly 10% Home care services Community-oriented service 9 Not applicable Source : Created by DTT in reference of Japan Ministry of Health Labour and Welfare http://www.mhlw.go.jp/file/06-seisakujouhou-12300000- Roukenkyoku/201602kaigohokenntoha_2.pdf Depend on municipality 150 JPY = 1 GBP Depend on municipality Living support Service program Preventive program
Our Challenges 10
Where we go? Vision of 2025 : Improve medical supply and demand balance in a community General acute hospital bed 2015 2025 Long-term care Nursing Care Hospital Beds Nursing home High Acute Phase Residential services General acute phase Subacute phase Strengthen regional inclusive care system Differentiation of inpatient medical function Strengthen coordination of each medical function Enhance long-term care facilities High Acute Phase General acute phase Subacute phase Long-term care Nursing home Residential services From Facility to Familiar area From Medical care to Nursing care Home service Home service Source : Created by DTT in reference of Japan Ministry of Health Labour and Welfare http://www.mhlw.go.jp/stf/shingi/2r98520000036ye0-att/2r98520000036yiu.pdf 11
Collecting, storing, analyzing and sharing healthcare records Digital Healthcare Network (PHR&EHR) In Progress Healthcare portal site Analysis service Research service Provide a third party Healthcare record shared service EHR Emergency medical record shared service Personal Health Record Clinic Hospital Data Center Pharmacy Clinic Hospital Residents Patients Source : Created by DTT in reference of Future Investment Conference, Cabinet Public Relations Office, Cabinet Secretariat http://www.kantei.go.jp/jp/singi/keizaisaisei/miraitoshikaigi/dai7/siryou5.pdf 12
Promote elderly people social participation in diverse ways Active ageing Retirement Birth 20 40 60 Healthy life expectancy 74.9 Life expectancy 83.8 100 65 Job opportunities for retired elderly people How to live Shorten care period Extend 13
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