Yoshida Masahiro, Takada Tadahiro, Kawarada Yoshifumi, Hirata Koichi, Mayumi Toshihiko, Sekimoto Miho, Hirota Masahiko, Kimura Yasutoshi, Takeda Kazunori, Isaji Shuji, Koizumi Masaru, Otsuki Makoto, Matsuno Seiki
Department of Surgery, Teikyo University School of Medicine, Itabashi-ku, Tokyo 173-8605, Japan.
J Hepatobiliary Pancreat Surg. 2006;13(1):7-9. doi: 10.1007/s00534-005-1046-4.
The health insurance system in Japan is based upon the Universal Medical Care Insurance System, which gives all citizens the right to join an insurance scheme of their own choice, as guaranteed by the provisions of Article 25 of the Constitution of Japan, which states: "All people shall have the right to maintain the minimum standards of wholesome and cultured living." The health care system in Japan includes national medical insurance, nursing care for the elderly, and government payments for the treatment of intractable diseases. Medical insurance provisions are handled by Employee's Health Insurance (Social Insurance), which mainly covers employees of private companies and their families, and by National Health Insurance, which provides for the needs of self-employed people. Both schemes have their own medical care service programs for retired persons and their families. The health care system for the elderly covers people 75 years of age and over and bedridden people 65 years of age and over. There is also a system under which the government pays all or part of medical expenses, and/or pays medical expenses not covered by insurance. This is referred to collectively as the "medical expenses payment system" and includes the provision of medical assistance for specified intractable diseases. Because severe acute pancreatitis has a high mortality rate, it is specified as an intractable disease. In order to lower the mortality rate of various diseases, including severe acute pancreatitis, the specification system has been adopted by the government. The cost of treatment for severe acute pancreatitis is paid in full by the government from the date the application is made for a certificate verifying that the patient has an intractable disease.
日本的医疗保险制度基于全民医疗保险制度，该制度赋予所有公民根据自己的选择加入保险计划的权利，这是由日本宪法第25条的规定所保障的，该条规定：“所有国民均享有维持健康且文化生活的最低标准的权利。”日本的医疗保健系统包括国民医疗保险、老年人护理以及政府对疑难病症治疗的支付。医疗保险规定由主要覆盖私营公司员工及其家属的雇员健康保险（社会保险）以及满足个体经营者需求的国民健康保险来处理。这两种保险计划都有针对退休人员及其家属的医疗服务项目。老年人医疗保健系统覆盖75岁及以上的人群以及65岁及以上的卧床不起的人群。还有一种制度，即政府支付全部或部分医疗费用，和/或支付保险未涵盖的医疗费用。这统称为“医疗费用支付制度”，包括为特定疑难病症提供医疗救助。由于重症急性胰腺炎死亡率高，它被指定为疑难病症。为了降低包括重症急性胰腺炎在内的各种疾病的死亡率，政府采用了指定制度。从申请确认患者患有疑难病症的证明之日起，重症急性胰腺炎的治疗费用由政府全额支付。
