Abstract
It is widely recognised that the Japanese healthcare system has been ranked as one of the best in the world because of its excellent efficiency and equity. The longevity and low infant mortality of the Japanese population have been achieved with a relatively low ratio of health expenditure to gross domestic product. All Japanese are covered by universal medical care insurance and all are provided with completely free access to the same medical care.
Nevertheless, it should be pointed out that the medical care service is not as good as it looks. Owing to lack of competition between both hospitals and powerless insurers — the outcome of too many regulations — there is only a small incentive to improve the efficiency and quality of medical service. Furthermore, because of Japan’s rapidly aging society and low birth rate, together with the long depression the economy has experienced, it is very difficult to maintain the ‘pay-as-you-go’ health system.
For health system reform, our proposals are as follows: deregulating health markets, including pharmaceutical markets; strengthening the role of insurers; introducing information technology; and restructuring the healthcare of the elderly. We are expecting the new cabinet, which enjoys much popularity, to have the courage to initiate health reform along these lines, in spite of opposition from powerful interest groups, bureaucrats, and even members of ruling parties.
Similar content being viewed by others
Notes
Of the many papers and books concerning reference pricing, one of the most noteworthy may be the paper by Dickson and Redwood.[9]
References
Ministry of Health, Labor andWelfare (MHLW). Annual report on health and welfare 1998–1999: social security and national life. Tokyo, Japan: International Corporation of Welfare Services, MHLW, 2000
Tokita T. Health policy in Japan: from the view point of public economics [in Japanese]. Econ Rev 2001; 52 (3): 205–19
Campbell JC, Ikegami N. The art of balance in health policy: maintaining Japan’s low-cost, egalitarian system. Cambridge: Cambridge University Press, 1998
Kawabuchi K. Introduction to health care economics in Japan: understanding Japanese health care reform. Tokyo, Japan: Yakuji-Nippo, 1998
Tokita T, Chino T, Kitaki H, et al. The present and future national medical expenditure in Japan. Tokyo, Japan: Economic Research Institute, Economic Planning Agency, 1997
Ministry of Health, Labor and Welfare (MHLW). Patient Survey [in Japanese]. Tokyo, Japan: Statistics and Information Department, Minister’s Secretariat, MHLW, 1993
Tokita T, Nakayama N. Regulations in Japanese health market. Institute of economic research [in Japanese]. Tokyo, Japan: Hitotsubashi University, Mar 2001: Discussion paper No. 25
Tokita T, Chino T, Kitaki T. Health expenditure and the measure determinants in Japan. Hitotsubashi J Econ 2000; 41 (1): 1–16
Dickson M, Redwood H. Pharmaceutical reference prices. How do they work in practice? Pharmacoeconomics 1998; 14 (5): 471–9
Tokita T. Towards the Japanese health reform for the patients and people [in Japanese]. J Health Care Soc 2001; 10 (4): 1–12
Acknowledgements
This study is supported by two grants from the Ministry of Education and Science and also the Ministry of Health, Labor and Welfare. It is also supported by three institutions: the Contemporary Research Network (of the Graduate School of Economics, Hitotsubashi University), the Health Care Science Institute and the Policy Innovation Forum. The author appreciates many valuable comments from the reviewers and the editor. He is thankful for much useful advice from Prof. K. Otsuka, Prof. K. Nishimura, Mr Nakaizumi and many other people. The author also expresses his special thanks to Dr T. Hitiris, Mr. H. Konno and Mr. K. Hosoya The author has provided no information on conflicts of interest directly relevant to the content of this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tokita, T. The Prospects for Reform of the Japanese Healthcare System. Pharmacoeconomics 20 (Suppl 3), 55–66 (2002). https://doi.org/10.2165/00019053-200220003-00005
Published:
Issue Date:
DOI: https://doi.org/10.2165/00019053-200220003-00005