The Finance Ministry has proposed reviewing public support for Japan's metabolic screening and health guidance program, including the option of ending it, arguing that it does too little to cut medical costs to justify continued heavy public spending.
At a subcommittee of the Fiscal System Council, an advisory body to the finance minister, on Wednesday the ministry said there is no demonstrated empirical or quantitative evidence that the program's savings exceed its cost. It cited research on the cost-effectiveness of preventive medicine, including studies finding that many such measures raise medical spending rather than lower it.
The program, known as tokutei kenshin (metabolic checkups) with follow-up tokutei hoken shido (specific health guidance), began in fiscal 2008. It targets employees aged 40 to 74 covered by health insurance associations and mutual aid associations, with a focus on preventing lifestyle diseases and metabolic syndrome — the cluster of risk factors linked to excess belly fat.
Checkups measure waist circumference and body mass index to select people for health guidance, which has been delivered through interviews and other sessions aimed at improving habits.
The ministry puts national fiscal support for the program at ¥17.5 billion in the fiscal 2026 budget, rising to ¥30.7 billion when local contributions for municipal national health insurance are included.
The Health, Labor and Welfare Ministry's own plan projects that the program will cut medical spending by only about ¥12 billion a year in fiscal 2029. On a simple calculation, that recovers roughly 40% of the public money spent, leaving the public share far larger than the savings.
"Preventing illness and promoting health are important, but we should shift to and focus on measures with high cost-effectiveness," the ministry said in raising the issue.
Fee proposal for welfare recipients without digital ID
The ministry also presented a plan at the subcommittee to charge a fee to welfare recipients who have not registered their My Number cards for use at medical institutions. Fewer than half of recipients have registered, which it says hampers early detection of excessive doctor visits and leaves administrative work on paper, adding cost.