health insurance managed by association for employees of large scale establishments where health insurance associations are set up according to the Health Insurance Act, and the Japan health insurance association-managed health insurance for employees of medium and small establishments where health insurance associations are not set up). ○ The Japan health insurance association-managed health insurance for day workers. ○ Seamen's insurance (sickness section) and various mutual aid associations for the national and local government employees as well as the private school personnel. ○ National health insurance for general residents other than the above (There are the national health insurance for specific occupations such as construction industries, medical doctors, etc. and the national health insurance for the ordinary persons other than the above). Further, those persons aged 75 and over are covered by the long life medical care system (medical care system for elderly in the latter stage of life). Public pension The public pension, formerly, originates in pension and retiring pension system. Some systems were established sequentially and then unified. At present, it consists of the National Pension and the Employees’ Pension Insurance. The Employees’ Pension Insurance is the system in which all employee enroll by unifying of the employees’ pension (generic term for the pensions excluding the National Pension) in October 2015. Pensioners here refer to those who have the rights to receive the pension and whose receipt of the benefit was decided after their own request (including those whose pension is completely suspended); and recipients refer to those pensioners whose pension is not completely suspended. Nursing-care insurance for the elderly The Nursing-Care Insurance System for the Elderly started in April 2000 as a new system to support the nursing-care for the elderly by all the people of country by consolidating the old nursing-care systems, which had been separated into medical care and welfare care. The insurer is the municipalities (shi, machi, and mura, including the special wards of Tokyo), and the insured persons consist of the first category who are 65 years old and over, and the second category who are the participants of the medical insurance and in the age bracket of 40 or more but less than 65 years of age. Persons who need nursing-care Persons of 65 years or older who are in need of nursing care, and persons of 40 years or older but below 65 who are in need of nursing care due to physical or mental disability caused by aging-related diseases specified by the Cabinet Order. Persons who need support Persons of 65 years or older who are in need of support, and persons of 40 years or older but below 65 who are in need of support due to physical or mental disability caused by the specified diseases. National Medical Care Expenditure National medical care expenditure is estimated every year by the Ministry of Health, Labour and Welfare as the total of all expenses associated with medical treatment of diseases and injuries that is eligible to be covered by health insurance at medical institutions, etc. during the relevant fiscal year. The amount includes expenditure for medical and dental examinations and treatments, dispensing in pharmacies, inpatient meal service, living support, home-visit nursing medical care, etc. The estimates are the sum of benefits provided under the medical care insurance system, etc., benefits provided under Advanced Elderly Medical Service System and public funding medical system, and medical care expenditures paid by patient copayment, etc. Report on Social Welfare Administration and Services The Report on Social Welfare Administration and Services is conducted by the Ministry of Health, Labour and Welfare to clarify the actual administrative performances based on the social welfare laws and regulations in the prefectures, designated cities and core cities, and to obtain basic data for the 23 Social Security 535
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