The health status of the Japanese is one of the best in the world. The healthcare system has no doubt contributed to this, though the current state of research in health economics does not permit the determination of the extent of such contribution. The Japanese system, based on social insurance, has provided both basic care and free choice of doctors to every citizen at affordable costs. It has, however, become increasingly clear that the Japanese system has failed to allocate resources properly, ensure financial equity and adapt to changing patterns of demand. This paper first explains how a system that once seemed to function well has become inappropriate, then how policies have tried to overcome some of the problems. The paper concludes with key considerations shaping future reform ...

Réforme du système de santé au Japon

L’état de santé de la population japonaise est un des meilleurs du monde. Le système de santé a sans aucun doute contribué, même s’il est difficile de déterminer le rôle respectif du fonctionnement du système de santé par rapport aux autres facteurs. Le système de santé japonais, basé sur l’assurance sociale, assure la l’offre universelle des soins de base ainsi que le libre choix du docteur à un coût raisonnable. Il est néaumoins devenu de plus en plus évident que le système de santé japonais a échoué dans la repartition efficace des ressources nécessaires, ainsi que dans l’équité du financement, et est mal adapté à la mutation de la demande de soins. La première partie de ce document de travail explique comment un système qui, auparavant, fontionnait bien est devenu inapproprié, puis comment les politiques ont essayé de résoudre certains problèmes. La dernière section traite des éléments dont il faudra nécessairement tenir compte pour l’élaboration des mesures futures de réforme ...

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Paper provided by OECD, Economics Department in its series OECD Economics Department Working Papers with number 321.

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Keywords: health care systems; Japan; Japon; système de santé;

Find related papers by JEL classification:
I10 - Health, Education, and Welfare - - Health - - - General
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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1. Adam Wagstaff, 2007. "Health systems in East Asia: what can developing countries learn from Japan and the Asian Tigers?," Health Economics, John Wiley & Sons, Ltd., vol. 16(5), pages 441-456. [Downloadable!]
   Other versions:
   • Wagstaff, Adam, 2005. "Health systems in East Asia : what can developing countrieslearn from Japan and the Asian tigers ?," Policy Research Working Paper Series 3790, The World Bank. [Downloadable!]
2. Paresh Kumar Narayan, 2007. "Do health expenditures 'catch-up'? Evidence from OECD countries," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 993-1008. [Downloadable!]

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