The world s third largest spender on healthcare after USA ... £698 Monthly Benefits Depend on municipality Patient's Pay Mainly 10% Mainly 10% Depend on Services Residential ... Emma

The world’s third largest spender on healthcare after

USA and China

14th March 2018 That article is a personal opinion of the author, this is not official view on Deloitte Touche Tomatsu LLC.

Deloitte Touche Tohmatsu LLC, Partner, Leader in Japanese Healthcare Industry Group

Yoritomo WADA

© 2018. For information, contact Deloitte Touche Tohmatsu LLC.

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

Outline


© 2018. For information, contact Deloitte Touche Tohmatsu LLC.3

Population(million)

Life expectancy

Both sexes

Man

Women

Healthy life expectancy

Both sexes

Aging rate

83.8

80.9

87.1

74.9

26.8%

Basic Statistics


England(*2) America(*2) China(*2)

65 321 1,383

Japan

127

81.2

79.4

83.0

71.4

18.5%

79.3

76.9

81.6

69.1

15.4%

76.1

74.6

77.6

68.5

10.6%

Source： (*1) Ministry of Health Labour and Welfare, (*2) World Health Statistics 2016

(*1)

(*2)


0

5

10

15

20

25

30

35

1960 1980 2000 2020 2040 2060 2080 2100 2120

4

Japan has experienced rapid demographic change. The aging

of society is by no means limited to Japan and other countries

Aging rate%

YearJP: Japan EN: England US: United States CH: China

Aged Society

14%

Super-aged

society

21%

Super-aged

society

30%

Source：World Population Prospects: The 2015 Revision

http://www8.cao.go.jp/kourei/whitepaper/w-2016/html/zenbun/s1_1_5.html

JP ENCH

US


National Medical Expense

The increasing healthcare expenditure has placed a

significant strain on the national health system in Japan

Source ： National Institute of Population and Social Security Research, prepared by Ministry of Health, Labor and Welfare documents

Long-term Care Benefit Expense

256.7 272.0

400.0

0.0

100.0

200.0

300.0

400.0

500.0

2011 2014 2025

54.7 66.7

140.0

0.0

100.0

200.0

300.0

400.0

500.0

2011 2014 2025

Approximately 1.5 times

increase in 10 years

Approximately 2 times

increase in 10 years

（Billion GBP） 150 JPY = 1GBP（Billion GBP）


Healthcare System

6 © 2018. For information, contact Deloitte Touche Tohmatsu LLC.


Japan

Health Insurance in Japan and United Kingdom

Coverage

Co-Payment

United Kingdom

Over 75 years old

70-74 years old

Under 6 years old

Prescriptions , Optical services and

Dental services 100% paied by patients

30%Worker

By municipality

20%

10%

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


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

Healthcare system in Japan and England

Anyone enables to access medical

institutions, anywhere, anytime

ClinicLarge

HospitalPatients

Some large hospitals are required a referral

letter and a first visit fee (£３５)since 2016

General Practitioner

(Primary Care)

Medical

Appointment

Large

HospitalPatients

CCG* are responsible for the

commission to most secondary care

services

Free access

Free access

Referral

*CCG : Clinical commissioning groups


Enforced the system in 2000

Long-term care insurance system in Japan

Required to receive a long-term care certification

Subscriber

Municipal governments

Long term care

needed Level 1-5

Support needed

Level 1&2

Not applicable

150 JPY = 1 GBP

Level1 £1,113

Level2 £1,308

Level3 £1,795

Level4 £2,054

Level5 £2,404

Level1 £334

Level2 £698

MonthlyBenefits

Depend on

municipality

Patient'sPay

Mainly 10%

Mainly 10%

Depend on

municipality

Services

Residential

Services

Community-oriented

service

Home care

services

Community-oriented

service

Home care

services

Living support

Service program

Preventive program


http://www.mhlw.go.jp/file/06-Seisakujouhou-12300000-

Roukenkyoku/201602kaigohokenntoha_2.pdf


Our Challenges



Vision of 2025 : Improve medical supply and demand balance in a community

Where we go？

Nursing Care Hospital Beds

2015 2025

High Acute Phase

General acute phase

Subacute phase

Long-term care

Nursing home

Residential services

Home service

Fro

m Fa

cility to

Fam

iliar a

rea

Fro

m M

ed

ical ca

re to

Nu

rsing

care


http://www.mhlw.go.jp/stf/shingi/2r98520000036ye0-att/2r98520000036yiu.pdf

Home service

Residential services

Nursing home

Long-term care

General acute hospital

bed

High Acute Phase

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


Digital Healthcare Network (PHR＆EHR)

Collecting, storing, analyzing and sharing healthcare records

Residents

Patients

Clinic HospitalPharmacy Clinic Hospital

Data Center

EHR

Healthcare

record shared

service

Emergency

medical record

shared service

Personal

Health Record

Healthcare

portal site

Analysis

serviceResearch

service

Provide a

third party

In Progress

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


Active ageing

Promote elderly people social participation in diverse ways

Birth 20 40 60

Retirement

65

Healthy life

expectancy

10074.9

Life expectancy

83.8

Job opportunities for retired

elderly people

How to live

Extend

Shorten care period

© 2018. For information, contact Deloitte Touche Tohmatsu LLC.14 © 2018. For information, contact Deloitte Touche Tohmatsu LLC.


Thank you ☺


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The world s third largest spender on healthcare after USA ... £698 Monthly Benefits Depend on municipality Patient's Pay Mainly 10% Mainly 10% Depend on Services Residential ... Emma