What will happen to Japans 'universal' healthcare if it continues this demographic trend?

Question

Most nations are heading this way, but Japan is an extreme example...

http://upload.wikimedia.org/wikipedia/en/3/31/Japanese_Population_chart.png
http://upload.wikimedia.org/wikipedia/en/4/40/Japanese_Birth_and_Death_rates.png
http://en.wikipedia.org/wiki/Demographics_of_Japan

" Assuming current birth and death rates and no major change in immigration policies, the 2005 population of 127 million will decline to 100 million in 2050, and 64 million in 2100—keep falling. The main problem will be the financial crisis that comes from having a higher and higher dependency ratio (that is, nonworking young and old compared to working ages.)"

What will happen if Japan has a shrinking productive class? Cost of medical rises with age, and taxes are accrued primarily through the productive class. What is the obvious conclusion of their path? Details....
Given America is heading this way demographically...is it wise to follow that sort of medical policy? Or is their an alternative?

Answer 1

People in Japan and other countries with "universal health care" are turning more and more to private medicine. The government system will suffice as a safety net, but people do tend to their own self interests, even in Japan.
I have been hearing more and more about medical tourism. You can get some common operations done in third world countries by highly certified physicians for a fraction of the cost. Some insurance companies like the idea so much they will throw in in air fare and a paid vacation.