Japan's epoch-making health-insurance reforms, 1937–1945

Abstract

This article presents an examination of Japan's epoch-making health-insurance reforms undertaken during the Asia-Pacific War between 1937 and 1945. These reforms culminated in amendments to the Health Insurance Law and the National Health Insurance Law in 1942, along with the enactment of the National Medical Treatment Law. The issues addressed in this article are, firstly, the kind of reforms of Japan's health-insurance programs that took place during this period, and secondly, the historical significance of these reforms. Focusing on three elements of the wartime health-insurance reforms – expansion of the number of insured people, transformation of payment system to physicians and provision of easy access to medical institutions – this article examines the following hypothesis: Japanese Health Insurance, established in 1922, which primarily aimed at maintaining and restoring workers’ health and physical work capability, and providing them with economic assistance during those times when they suffered from sickness or injury, was qualitatively transformed to quasi-public-assistance programs with financial dependence on the state during wartime, which established an institutional setting that contributed to the rise of health-insurance expenditure in the post-war era.