The new health insurance scheme for people aged 75 or over that began April 1 has been thrown into confusion due to the central and local governments' failure to adequately prepare. New health insurance cards failed to reach some 63,000 people in time, and chaos continues even though the health ministry told prefectural governments to ask hospitals to accept elderly people still waiting for new cards. If the problem is not resolved soon, it could undermine the people's trust in the nation's social welfare system.

Under the new scheme, premiums paid by pensioners are withdrawn at the source in principle. But many people complain that the new system reduces their income. Some people even feel that the scheme is designed to abandon the elderly. A Kyodo News survey also found that 64 municipalities in 19 prefectures withdrew premiums from the wrong people or deducted incorrect amounts.

The health ministry has said that the new scheme will decrease the financial burden of low-income people, while increasing the burden shouldered by high-income people. But in some areas like Tokyo, Yokohama, Kobe and Hiroshima, the amount paid by low-income people is likely to increase because local measures to lower their costs in the health insurance scheme for the self-employed or unemployed do not apply under the new plan. Under the new scheme a patient can opt for a system under which he or she pays a uniform ¥600 a month and receives tests and treatment for certain types of chronic diseases. But there is no guarantee that patients will receive adequate tests and treatment since the doctor, who receives a fixed remuneration of ¥6,000, may restrict tests and treatment to avoid financial losses.