Health Care for Elderly
Public health insurance for the elderly falls into two categories: one for people aged 75 or older, and the other for those aged 65 to 75. As of March 2009, about 13.5 million people were covered by the schemes. Benefits are financed 50 percent by taxpayers money, about 40 percent by contributions from the working population, and about 10 percent by the insured people's own premiums.
Premiums paid by individual are set by prefectural governments. In fiscal 2008, medical expenditures from the scheme totaled about $100 billion, or 33.5 percent of total medical care expenditures.
The system has been somewhat in disarray since the introduction of a new system in the spring of 2009 that aimed to get the elderly to pay a greater share of their health care and reduce the burden on future generations. The government elected in August 2009 said it would overhaul the system yet again and “abolish the system of categorizing people by age."
Gastrostomy---the insertion of a feeding tube directly into the stomach---is a fairly common procedure among the elderly in Japan. About 400,000 people have been treated with the procedure. It allows people that can't swallow or eat to get nourishment and helps keep many people alive---many suffering from dementia or severely debilitated after a stroke---much longer than they would if they didn't have the procedure. In countries such as France, Sweden and the Netherlands the procedure is not carried out on patients with advanced dementia but in Japan it is.