Thirdly, the aging of the aged population itself deserves special attention. As shown in Table 1, the proportion of those aged 75 and over in the population aged 65 and over grows rapidly after the turn of the century. It is projected to rise from 39.9 percent in 2000 to 56.6 percent in 2025. A close examination of this projected result and country-specific data produced from the recent population projection prepared by the United Nations (1996) reveals that Japan's level for 2025 is likely to be by far the highest in the world, followed by Sweden (51.1 percent). Obviously, this marked age compositional shift of the Japanese population will generate a substantial effect on the pattern and level of demand for medical care services, as will be discussed in the next section.
Fourthly, it should be noticed that the total dependency ratio is relatively low until the turn of the century. It is one of the lowest levels in the contemporary developed world (United Nations, 1996). In the next century, however, the index is expected to increase continuously, thus reaching its peak value of 66.9 in 2025, which will be the highest among all the industrialized nations at that time. In view of these projected results, appropriate policies should be formulated before the end of this century to cope with the negative effects of the anticipated acceleration in population aging.
It is interesting to note that the peak of total dependency over the projected period is comparable to Japan's highest level (71.6) recorded in 1920. It has been observed in a few existing studies (Wander, 1978) that the average per capita total expenditure (private and public) is roughly equal between young and old dependents. If this observation holds true for Japan, one may say that because Japan had already experienced greater total dependency in the prewar period, the rising total dependency burden to be placed upon the productive population in 21st-century Japan will be within a manageable range. It should be stressed, however, that over the next three decades, Japan's tempo of the increase in total dependency is the fastest among all the industrialized nations, thus suggesting that Japan, compared with other developed nations, is likely to face more formidable adjustment problems in reallocating resources among various age groups.
