Note 2-19

(19) With regard to the deductions related to pension, while pension contributions are excluded from the tax base in calculating a taxable income in Japan, they are in principle included in the tax base in the United States. As to deductions related to medical expenses, they are in principle covered by social insurance premiums and are excluded from the tax base as "deduction for social insurance premiums" except for the portion of co-payment in Japan. On the other hand, there are only two public-run medical insurance systems--Medicare for the aged and Medicaid for low income earners--and medical expenses of other people are covered by after-tax income of the people.