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Japan’s “universal” health-care system, like all such systems the world over, is in trouble, with costs rising and the population aging. Nearly 25 percent of Japanese are over the age of 60, a proportion expected to increase to 40 percent over the next 50 years. Since the old generally require more — and more expensive — medical treatment than the young, the increasingly aged population is putting a severe strain on Tokyo’s health-care budget. End-of-life care, which can last for months at great expense, is especially problematic.