Chapter Sixty. The public health-care system—A financial perspective

Abstract

Most health-care services in Japan are provided through the public health insurance system. Japan enjoys the lowest infant mortality rate and the longest life expectancy in the world. This chapter describes the historical development of the public health-care system and evaluates problems up to the present day. It then discusses current and future reforms from a financial perspective. Japan's public health insurance for private sector employees was introduced by the Health Insurance Law of 1922. The health insurance system faced a financial crisis shortly after its establishment in 1929 resulting from the global Great Depression, but it gradually regained financial stability as the nation's economy started to grow again. Universal health care coverage through a public health insurance scheme with fee-for-service payment is the basic definition of the Japanese system, which has contributed to the equitable distribution of health services and relieved families from old-age support. Keywords: financial stability; Japan's public health insurance; public health-care system