New trends in the Japanese medical system in 2002.

The Japanese have enjoyed the longest average life span in the world for these ten years. The universal health insurance system with free access and low cost seems to play the most important role among the proposed causes. We didn't need to worry about the charges at hospitals when we consulted a doctor, although we had to pay a premium in proportion to our income, and we received a national benefit which was money-paid by tax-payers. Unfortunately, the economic depression started around 1990 has driven us to a difficult situation. We are now planning several new policies to prevent the bankruptcy of the universal health insurance system due to the reduction of the medical expenditure. New attempts, such as reduction in the number of hospital beds, shortening of the average hospital stay, introduction of a long-term care insurance system, and the reduction of fee schedule by 2.7% from April 2002, and so on are being considered. On the other hand, the percentage of medical expenditure to GDP in Japan is the lowest, along with England, among the developed countries. Having realized that the poor medical system was due to low medical expenditure, the British government decided to raise the budget of the national health service. The situation concerning medical expenditure in Japan might become the worst among developed countries in the near future.