The amount of the fixed medical expense contribution for each fiscal year from fiscal year 1987 through fiscal year 1989 is, notwithstanding Article 56, paragraph (1) of the New Elderly Health Act, to be an amount equivalent to 7/10 of the sum total of the amounts set forth in the following items.

①The amount of the estimated medical expense contribution for fiscal year 1986 pertaining to an Insurer that falls under the requirements specified by Ministry of Health and Welfare Order as an Insurer for which the amount (hereinafter in this paragraph referred to as the "amount of increase") obtained by deducting the amount of the estimated medical expense contribution for fiscal year 1986 calculated based on the provisions of Article 55, paragraph (1) of the Former Elderly Health Act from the amount equivalent to the amount of the estimated medical expense contribution for fiscal year 1986 calculated based on the provisions of Article 4 of the Supplementary Provisions (hereinafter in this paragraph referred to as the "amount equivalent to the estimated contribution") is expected to become extremely large is, notwithstanding Article 4 of the Supplementary Provisions, to be the amount obtained by deducting a portion of the amount of increase pertaining to that Insurer, as specified by Ministry of Health and Welfare Order, from the amount equivalent to the estimated contribution pertaining to that Insurer.

②The amount of the fixed medical expense contribution for fiscal year 1986 pertaining to an Insurer that falls under the requirements specified by Ministry of Health and Welfare Order as an Insurer for which the amount (hereinafter in this paragraph referred to as the "amount of increase") obtained by deducting, from the amount equivalent to the amount of the fixed medical expense contribution for fiscal year 1986 calculated based on the provisions of Article 5 of the Supplementary Provisions (hereinafter in this paragraph referred to as the "amount equivalent to the fixed contribution"), the amount calculated in the same manner as under the provisions of Article 56 of the Former Elderly Health Act with regard to the amount of expenses required for medical care and the payment of specified medical expenses (including payment of medical expenses) provided to participants, etc. aged 70 or older pertaining to the Insurer, which a municipality bore in fiscal year 1986 was extremely large is, notwithstanding Article 5 of the Supplementary Provisions, to be the amount obtained by deducting a portion of the amount of increase pertaining to that Insurer, as specified by Ministry of Health and Welfare Order, from the amount equivalent to the fixed contribution pertaining to that Insurer.

①The amount of the estimated medical expense contribution for fiscal year 1987 pertaining to an Insurer that falls under the requirements specified by Ministry of Health and Welfare Order as an Insurer for which the amount (hereinafter in this paragraph referred to as the "amount of increase") obtained by deducting, from the amount set forth in item (i) (hereinafter in this paragraph referred to as the "amount equivalent to the estimated contribution"), the amount set forth in item (ii) is expected to become extremely large is, notwithstanding Article 6 of the Supplementary Provisions, to be the amount obtained by deducting a portion of the amount of increase pertaining to that Insurer, as specified by Ministry of Health and Welfare Order, from the amount equivalent to the estimated contribution pertaining to that Insurer.

②The provisions of the preceding paragraph apply mutatis mutandis to the fixed medical expense contribution for fiscal year 1987. In this case, the phrase "amount equivalent to the estimated contribution" in that paragraph is deemed to be replaced with "amount equivalent to the fixed contribution"; the phrase "is expected to become extremely large" with "was extremely large"; the phrase "estimated medical expense contribution" with "fixed medical expense contribution"; the phrase "Article 6 of the Supplementary Provisions" with "Article 7 of the Supplementary Provisions"; the phrase "is to bear" with "bore"; the phrase "the amount calculated as specified by Ministry of Health and Welfare Order as the estimated amount of expenses" with "the amount of expenses"; the phrase "fiscal 1987 estimated elderly medical expenses" with "fiscal 1987 elderly medical expenses"; the phrase "estimated participant adjustment rate under Article 55, paragraph (3) of the New Elderly Health Act" with "fixed participant adjustment rate under Article 56, paragraph (2) of the New Elderly Health Act"; the phrase "average estimated elderly medical expenses per person" with "average elderly medical expenses per person"; and the phrase "estimated medical expenses outside adjustment" with "medical expenses outside adjustment".

With regard to the calculation of the amount of the estimated medical expense contribution or the amount of the fixed medical expense contribution pertaining to Insurers other than the Insurers to which the provisions of the preceding two Articles apply, special provisions on the provisions of Article 4 or Article 5 of the Supplementary Provisions or Article 6 or Article 7 of the Supplementary Provisions that are necessary in association with the measures under the preceding two Articles, and other matters, are specified by Cabinet Order.

①The Social Insurance Medical Fee Payment Fund under the Act on Social Insurance Medical Fee Payment Fund (Act No. 129 of 1948) must, without delay after the enforcement of this Act, change the amount of the contribution each Insurer is to pay for fiscal year 1986, and notify each Insurer concerned of the amount of the contribution after the change.

②The provisions of Article 59, paragraph (3) of the New Elderly Health Act apply mutatis mutandis to the case referred to in the preceding paragraph.

Insofar as a person designated by the Minister of Health and Welfare trial-implements, before the enforcement of the provisions of Article 4 (excluding the provisions amending as set forth in Article 1, item (i) of the Supplementary Provisions; the same applies hereinafter), a business of operating a health care facility for the elderly prescribed in Article 6, paragraph (4) of the Act on Health and Medical Services for the Elderly as amended by the provisions of Article 4, that person may, notwithstanding the provisions of the Medical Care Act, establish a facility equivalent to a health care facility for the elderly referred to in that paragraph.

At the time of the enforcement of the provisions of Article 4, the Minister of Health and Welfare must report to the Diet on the state of the trial implementation of the business of operating health care facilities for the elderly under the provisions of the preceding Article and on the basic matters concerning the operation, etc. of health care facilities for the elderly.

Taking into consideration the trends in medical expenses for the elderly after the enforcement of this Act, the state of operation of each medical insurance such as the state of settlement of accounts of health insurance societies, the trends in the amount of medical expense contributions under the Act on Health and Medical Services for the Elderly, etc., the government is to conduct a review, by fiscal year 1990, of the method of calculating the contributions of Insurers and other matters concerning the amendments made by this Act, and to take required measures based on the results.

In view of the fact that, where the amount of expenses required for the benefits prescribed in Article 28, paragraph (1), item (i) of the New Elderly Health Act is low, the ratio of the amount of the co-payment prescribed in that item to that amount may become remarkably high, the government is to, when it finds it necessary, review how the co-payment referred to in that item should be and take required measures based on the results.

At an appropriate time after the enforcement of the provisions of Article 4, the government is to, when it finds it necessary in consideration of the state of health care facilities for the elderly, review how health care facilities for the elderly should be and take required measures based on the results.