Japan’s health insurance system has a pluralistic administrative structure. Although every people is guaranteed coverage by any of the insurance system, it does NOT mean that the entire 127 million population is covered under a single insurer, nor the financial burden of health care cost is spread equally over the nation.

Japan’s health insurance system consists of two pillars: one for the employed working population [collectively called Hiyosha Hoken] and another for the population without employment status [Kokumin Kenko Hoken]. In the graph, HiyoshaHoken is painted pink and Kokumin Kenko Hoken is painted blue showing their share of 2:1.