JAPANESE HEALTH-CARE SYSTEM - IN-VITRO DIAGNOSTIC-TESTS AND REIMBURSEMENTS

In 1961, a new and mandatory National Health Insurance plan was enacte d in Japan. This healthcare system has succeeded in providing universa l coverage while also containing the growth of national medical expend itures (NME) to the rate of growth of the gross national product (GNP) , namely, similar to 4-5% annually, for several decades. All Japanese medical procedures, including dental procedures, prescription drugs, a nd diagnostic tests, are reimbursed by a fee schedule set by the Minis try of Health and Welfare. The combination of strict fee control and l ow administration costs has kept the Japanese NME growth below that of the GNP. In 1990, NME was 20.6 trillion yen ($187 billion), total dia gnostic testing expenditures (DTE) were 2.3 trillion yen, representing 11.2% of national medical expenditures (NME). Of this amount, in vitr o diagnostic testing accounted for 1.4 trillion yen, representing 61% of DTE and 6.8% of NME. Annually, 1.8 billion in vitro diagnostic test s are performed.