Deal-Making at Mar-a-Lago*

Experts predict that health care spending in the US will jump as high as $3.6 trillion in 2016, up from $3.2 trillion in 2015. Both Democrats and Republicans believe such increases are unsustainable, but how to achieve savings while preserving access and quality health care under a national program remains a growing concern.

Beneath this cloud, ConfrontingAging’s mole deep inside Mar-a-Lago reports that President Trump cornered Japanese Prime Minister Shinzo Abe in the bathroom during their dinner last Saturday night to seek advice on how to replace Obamacare with a more cost-effective plan. Abe sympathized with Trump, acknowledging that health care costs in Japan were also spiraling out of control even with lower overall health care costs than the US, and with the government setting the fees that health care providers charge for medical services and doctor salaries.

In 1961 Japan implemented an obligatory Universal healthcare system of which 50 percent of the cost was financed from insurance premiums, and the rest was shared equally by national and local governments.
Under the system, recognized as the third best in the world, Japanese citizens pay up to 30 percent of service costs until the age of 70, 10 to 20 percent between age 70 and 74, and 10 percent for those age 75 and above. Higher income elderly pay a maximum of 30 percent, and since the year 2000, all citizens above the age of 40 had to pay an extra tax to be enrolled in long term care insurance.

To close the funding gap, Abe said his government planned to make the 64 to 74 age group pay a higher percent of the service costs, and several municipalities were planning to de-regulate long-term care services to promote a mixed, public and private, care service provision.

Further, his government was considering several more novel approaches including a voluntary-payment scheme that enabled people to pay more for medical services that go beyond basic coverage. Such schemes have already been adopted in countries such as Germany and Switzerland, and could reduce Japan’s health care funding gap by as much as 25 percent by the year 2035, according to experts.

“Reforms will involve more struggles for the elderly,” Abe lamented, recognizing that more than 25 percent of Japan’s population was over the age of 65, the highest in the world. However, he reiterated that it was the “government’s responsibility” to serve all of the people, and keep them safe and in good health--effectively, efficiently and with equity.

Grateful for Abe’s insight, Trump promised to support Japan 100%. While they were shaking hands to cement the deal, one of Trump’s aides burst into the bathroom. “We need you back at the dinner table,” he said with rising urgency. “North Korea just fired a ballistic missile.”

* This blog is a work of fiction. References to real people, events, and establishments are only provided for a sense of authenticity and are used fictitiously.
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Learn More:
http://patimes.org/japans-health-care-support-elderly-revisited/
http://www.nyu.edu/projects/rodwin/lessons.html
https://www.umhs-sk.org/blog/health-care-around-world-japan/Caribbean-Medical-Schools
http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/improving-japans-health-care-system
http://trojanhealthconnection.com/?p=468
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