Foreign residents in Japan may soon face changes to healthcare and long-term care costs as the country's medical system grapples with rising operational expenses and an aging population. Recent government discussions signal potential increases in insurance burdens and shifts in how medical services are compensated, developments that could affect expats' household budgets and access to care. According to NHK, Japan's leading medical associations—including the Japan Medical Association, Japan Dental Association, and Japan Pharmaceutical Association—met with Prime Minister Takaichi on November 20, 2025, requesting substantial financial support through supplementary budget measures. The organizations emphasized that medical facilities are experiencing severe financial strain due to rising prices affecting everything from utilities to medical supplies. This pressure on healthcare providers comes at a time when the system is already stretched thin by demographic challenges. The Ministry of Health, Labour and Welfare (MHLW) is simultaneously advancing two significant policy discussions that will shape healthcare costs for residents. On November 20, the ministry presented a draft framework for the 2026 medical fee revision, which determines how much healthcare providers are reimbursed for services. According to NHK, this revision will consider the impact of inflation and aim to support wage increases for medical staff while promoting operational efficiency in medical facilities. These fee revisions, conducted every two years, directly influence the overall cost structure of Japan's national health insurance system. More immediately concerning for some foreign residents may be proposed changes to long-term care insurance. The MHLW convened an expert panel on November 20 to discuss expanding the population required to pay higher out-of-pocket costs for nursing care services, as reported by NHK. Japan's long-term care insurance system, which all residents aged 40 and above must join, currently requires most users to pay 10% of service costs, with higher earners paying 20% or 30%. The ministry is exploring whether to lower income thresholds that trigger these higher payment rates, effectively increasing costs for middle-income households. For expats living in Japan, these developments carry several practical implications. First, the financial difficulties facing medical facilities could potentially affect service availability or quality if institutions struggle to maintain operations or retain staff. The medical associations' appeal for government support suggests the situation is serious enough to warrant high-level intervention. Second, the upcoming medical fee revision could influence national health insurance premiums, which are calculated based on income and vary by municipality. While the revision aims to support healthcare workers and facility operations, any increases in the overall fee structure may eventually translate to higher insurance costs for residents, including foreign nationals enrolled in the system. Third, expats approaching or over age 40 should pay particular attention to long-term care insurance discussions. Those in middle-income brackets may see their potential future nursing care costs increase if the government proceeds with expanding higher co-payment categories. This is especially relevant for foreign residents planning long-term stays in Japan or those already utilizing care services for elderly family members. The timing of these discussions reflects broader economic pressures facing Japan. Inflation, which has affected household budgets across the country, has equally impacted healthcare institutions that must absorb higher costs for energy, equipment, and supplies while operating within the constraints of government-set fee schedules. As these policy discussions progress through 2026, foreign residents should monitor their insurance premium notices and stay informed about changes to co-payment structures. While Japan's universal healthcare system remains comprehensive and relatively affordable by international standards, the current pressures suggest adjustments are likely as the system adapts to economic realities and demographic demands.