What 700 Million Yen Cannot Buy Back: Japan Raises Its Medical Cost Cap, and a Famous Saver Says He Wishes He Had Spent More

Table of Contents

Key Points

・On July 27, 2026, Hiroto Kiritani, a 76 year old former professional shogi player who became a household name in Japan for living almost entirely on shareholder perks, disclosed that he had been treated for prostate cancer and colorectal cancer, and said he slightly regretted not spending more on good meals and hot spring trips while he was healthy.

・On August 1, 2026, Japan raised the monthly out-of-pocket ceilings under its high-cost medical expense benefit, while leaving intact the structure that keeps insured medical bills from climbing without limit.

・Japanese households sit on one of the world’s more protective health insurance systems and still draw down very little of their savings in old age, which moves the question away from how much to save and toward when the money is supposed to be used.

A Famous Saver Discloses Two Cancers, and the Medical Cost Cap Rises

Hiroto Kiritani, 76, a former professional shogi player known in Japan for a life funded by shareholder perks, disclosed treatment for prostate cancer and colorectal cancer on July 27, 2026. The disclosure came in an episode of the Nippon TV program Getsuyo kara Yofukashi and in an interview published the same day by the personal finance magazine Diamond ZAi.

The prostate cancer was found in early 2026. During tests to check whether it had spread, colorectal cancer was detected as well. The colon was treated first, with surgery in late June that removed 40 to 60 centimeters of intestine. Spread to lymph nodes was confirmed. Chemotherapy to prevent recurrence began on July 27 and is scheduled to run for six months. Surgery on the prostate was postponed.

In the interview, Kiritani looked back on years of refusing to spend cash out of stubborn commitment to the shareholder perk lifestyle, and said he slightly regretted not having enjoyed more meals out and more trips to hot springs. He added that he now intends to be more selective about work and to spend a little and enjoy himself.

On August 1, 2026, a revision to Japan’s high-cost medical expense benefit took effect. Monthly ceilings on out-of-pocket payments rose, applying to care received from that month onward. An annual ceiling, running from August through the following July, was created at the same time.

Keigo Higashino Dies of Colorectal Cancer at 68: Why Japan Screens People Who Feel Perfectly Well

Japan’s Japanese Population Falls Below 120 Million: What Is Already Fixed, and What Can Still Be Chosen

How Japan Caps Medical Bills, and Why the Cap Just Moved

Who Hiroto Kiritani is

Kiritani left professional shogi for stock investing and became widely recognized in Japan through television, where he was shown living on shareholder perks rather than cash. Listed Japanese companies routinely send shareholders vouchers, gift cards, meal tickets and product samples, a practice called kabunushi yutai that has few close equivalents outside Japan. Kiritani built a portfolio large enough that these perks covered most of his daily consumption.

He was born in October 1949 and retired from professional play in 2007, holding the rank of eighth dan under the 2025 promotion rules for retired players. He began investing in 1984. His assets are reported at around 700 million yen, though the composition and the basis for that figure have never been published.

His refusal to spend cash had a specific origin, which he described in the interview. After his first appearance on the program in 2013, viewers told him that living on perks alone was impossible and that he was lying, and he dug in. Shortly after retiring from shogi he had gone through a period of real hardship, selling perk gift cards at discount shops to help cover rent.

The system behind the story

Japan achieved universal health coverage in 1961. Every resident is enrolled in public insurance and can in principle be seen at any medical institution with a single insurance card. That foundation underpins a life expectancy that has stayed among the highest in the world.

The last line of defense against unlimited bills is the high-cost medical expense benefit, known in Japanese as kogaku ryoyohi. It sets a ceiling on what a patient pays out of pocket in a single calendar month for insured care, varying by age and income. For a patient under 70 in the roughly 3.7 to 7.7 million yen income band, a month with one million yen of total medical costs leaves an out-of-pocket payment of about 90,000 yen.

In the United States, where private insurance dominates, surveys have found that roughly four in ten adults carry debt related to medical or dental care. A design in which illness rarely lands directly on the household budget is an invisible premise of living in Japan.

The ceiling covers insured care only. Private room charges, the technical fees for advanced treatments outside the insurance schedule, meals and transport fall outside it, and lost income during treatment belongs to separate programs such as injury and sickness allowance. Kiritani, at 76, falls under a different calculation applied to those aged 70 and over, and neither his treatment costs nor how the system applied to him has been made public.

Why the ceilings rose in August 2026

Maintaining this safety net has grown more expensive each year. Payments under the high-cost benefit have been growing at roughly twice the pace of total medical spending, driven by an aging population and the spread of very expensive new drugs, and that cost lands on the insurance premiums of the working generation.

The government tried to raise the ceilings in 2025 and shelved the plan after opposition from cancer and rare disease patient groups. The redesigned version cut the increase to about 7 percent, held the existing relief for long-term patients in place, added the new annual ceiling, and took effect on August 1, 2026. In the example above, the monthly ceiling moved from 87,430 yen to 92,940 yen, an increase of 5,510 yen. The new annual ceiling for that income band is 530,000 yen.

A second stage is scheduled for August 2027, splitting income brackets more finely, with larger increases in the higher bands. The recalibration of who pays how much is not finished.

The Safety Net Held, and the Anxiety Did Not Fall

A revision that failed in 2025 passed in 2026 because the process changed, not only the numbers

The 2025 attempt collapsed in part over how it was decided, with criticism that patients had not been heard before the plan advanced. In the second round, patient groups sat on the expert committee as members, and the increase, originally as high as 15 percent, came down to about 7 percent.

Parts of what patients asked for entered the design. The relief for people who hit the ceiling repeatedly was left untouched, and the annual ceiling was created. The Japan Federation of Cancer Patient Groups, which opposed the increase itself, has said it values those two elements. This is a working example of a social insurance cost increase landing on a negotiated point between refusal and concession.

The case for the revision has not gone away either. With high-cost benefit payments growing at twice the pace of medical spending overall, and with the government pointing to ultra high priced drugs, the pressure to redraw the line between benefits and contributions will keep returning as long as holding down working-age premiums stays a policy goal.

There is also a practical gap between the monthly and annual ceilings. The monthly ceiling stops the payment at the counter, provided the patient uses the digital insurance card or an eligibility certificate. The annual ceiling is expected to start as an application based process. That means paying the monthly ceilings first and receiving the excess back later. Nothing comes back to those who do not apply, and the household carries the money in the meantime. A benefit that reaches only those who know it exists leaves questions of cash flow, paperwork and public awareness open.

The cap makes the worst case readable, which is not the same as making it light

The core of Japanese public health insurance is less the size of the number than the fact that the number can be known in advance. There is a wide gap between the vague dread attached to the word cancer, where millions of yen seem to be at stake, and an actual insured out-of-pocket payment in the 90,000 yen range for the month. The further fear runs ahead of the real figure, the larger the buffer people build.

What is readable, though, is one month of insured care. Long treatments stack those monthly payments across months, uncovered costs and lost income are added on top, and the total as the household experiences it cannot be read off a single monthly figure.

WHO estimates put the share of people in Japan whose out-of-pocket health spending, excluding premiums, exceeds ten percent of total household spending at somewhat over ten percent, and that share has been rising over the past decade. In small households, routine outpatient visits and prescriptions alone can reach that level. A readable ceiling and a light burden are different things.

Households in Japan hold the assets and do not spend them

Japanese households use surprisingly little of what they accumulated once they are old. According to the Cabinet Office’s annual economic and fiscal report, household financial assets peak in the early sixties at a little over 18 million yen and are down only in the mid teens of percent even past age 85. Deposits alone barely fall with age at all.

That figure compares age groups at a point in 2019 rather than following the same households through time. Even so, the report itself concludes that accumulated assets are used for economic activity in old age only to a limited degree.

Economists call the behavior of holding down consumption against future medical, nursing care and income risks precautionary saving. In a 2023 survey by the Central Council for Financial Services Information, 67.4 percent of respondents named funds for life after retirement as a purpose of saving and 48.0 percent named preparation for illness or unexpected disaster. In the age breakdown from the 2021 round, preparation for illness rises rather than falls among people in their sixties and seventies.

Anxiety is not the only reason the money stays put. A little over ten percent cite leaving an inheritance, and appetite and physical capacity for consumption themselves decline with age.

Still, eight to nine out of ten people say they are worried about old age. As long as longevity, nursing care and lost income are bundled together under the single label of retirement anxiety, no target figure settles. Drawing on a 2025 survey, the Dai-ichi Life Research Institute found that the share of people setting 20 million yen as their retirement savings goal rose from 31.2 percent in 2018 to 49.9 percent.

No survey yet shows how the August revision affects this psychology. It would not be surprising, though, if the message that the system may not always take its current shape weighed more than the 5,510 yen itself. The saving is rational. The open question is its total size, and the fact that the timing of spending tends to be left undesigned.

A carefully limited regret became a blunt one as it spread

What Kiritani actually expressed was a bounded regret: that he could have set aside his stubbornness, spent more cash on good food and hot springs, and that he slightly regrets it. In the same breath he looked forward, saying he would stop holding back so much, be selective about work, and spend a little to enjoy himself.

What circulated on social media was a different sentence, a blunt line about how he should have stopped doing something foolish and spent his money on what he liked. That version was produced by aggregator sites for headline use. He did not say it. A mild, specific regret was amplified into a repudiation of an entire life.

One investor’s experience cannot establish that Japanese households in general save too much. Some people who go through cancer come away feeling that their assets are exactly what let them concentrate on treatment, and some do not change their views at all. In Kiritani’s case the perk lifestyle was a proven technique that carried him through a hard period after leaving professional shogi, and treating it as simple frugality addiction misreads it. What the right allocation would have been for him is not something outsiders can decide.

The case does illuminate one thing. Building assets and deciding when to use them are two separate decisions. Kiritani was a master of the first, while the second was left to a response to an image, the stubbornness of the perk champion. Assets reported at around 700 million yen buy a great deal, but not the years when he was healthy.

There is a real case on the side of holding the money

Savings widen the choices available during illness. Cancer treatment often runs long, and the hit to a household can come less from treatment costs than from reduced income as work changes. Changing how you work, taking time off, keeping a family’s life stable: room to do those things comes from assets on hand.

Preparing for nursing care and for a long life has its own logic. How many years care lasts and how long a person lives are areas without a readable ceiling, unlike insured medical costs, and building a thicker buffer there is prudent. The August revision is itself a demonstration that systems change.

So the question here is not whether to prepare. Both the person who looks back and is glad the money was there, and Kiritani looking back and wishing he had spent more, are making judgments only they can make. What differs is the size of the buffer and the design of when it gets used.

A plan is finished when it says when the money will be spent

The American investor Bill Perkins argued in Die With Zero that the same experience yields more satisfaction the healthier you are when you have it, and that experiences carry expiration dates. It supplies the time axis that discussions of saving tend to drop.

Taking the title at face value, as if approaching zero at death were the goal, goes too far. Savings and insurance are money meant to be used, and at the same time the existence of a balance supports peace of mind on its own. That reassurance is hard to measure on the same scale as consumption.

Japan’s institutional environment gives that time axis something to stand on. A public pension paid for life carries the base of living costs, and out-of-pocket payments for insured care have the high-cost ceiling above them. Two of the least readable risks, longevity and medical costs, have their floors partly held by public systems.

Separating the components brings the shape into view. On the base the pension covers, uninsured costs and lost income are met by savings or private insurance, nursing care is estimated separately, and the balance a person wants to keep on hand purely for peace of mind is recognized as its own line item. What remains after each risk has a place assigned is the budget available for the healthy years now.

How much preparation is needed still varies with age, family and work. No universal line for surplus that is safe to spend can be drawn from this material. What can be drawn is the design principle that preparation and enjoyment should not be made to fight over the same undivided pot.

Knowing the Reach of the Safety Net Is Where the Design Starts

The August increase is not trivial, and the second stage in 2027 will reach further. Even so, the fact that a mechanism keeping worst case medical costs inside a defined range is still standing remains a substantial premise of living in Japan.

Kiritani’s slight regret is not a story about frugality gone wrong. It points at something independent of how much anyone has: the technique of accumulating money and the design of allocating it across the years that remain are different skills. Healthy time has a deadline, and no amount of assets extends it.

Save against illness, or trust the buffer and enjoy the present. Knowing how far the safety net actually reaches turns that binary into a design question: how much to hold against which risk, and when to spend the rest.

What 700 Million Yen Cannot Buy Back: Japan Raises Its Medical Cost Cap, and a Famous Saver Says He Wishes He Had Spent More

Key Points

A Famous Saver Discloses Two Cancers, and the Medical Cost Cap Rises

Related Articles