Japan’s healthcare system has kept the country remarkably healthy with relatively minor changes for nearly six decades. The system provides universal care, generous coverage and the most innovative treatments at a cost that is accessible to all.

Yet the very scope of coverage in the Japanese system obscures the extent to which policymakers have put off making necessary but difficult choices. In particular, the lack of regulation of demand for health services, the pressures of an ageing population and the underdeveloped system for evaluating efficiency and effectiveness of medical products and services could paralyse Japan’s healthcare system as the cost of state-of-the-art medical treatments increase. The economic consequences of this would inevitably reverberate beyond the health system itself.

Without changes in the incentives built into the current system, Japan will struggle to take advantage of medical innovation and to maintain its ability to deliver high-quality, accessible care in the future. As our Health system sustainability in Japan scorecard shows, there are signs that significant fixes to the system may be necessary. Although Japan compares well in many respects to the more expensive and fragmented system in the US, it lags significantly behind the UK and France, and slightly behind neighbouring South Korea, in four of the five principal scoring domains.

Japan’s health system compares especially unfavourably with regard to progress in integrated healthcare and research preparedness, but it also has ground to make up in adequate workforce staffing and in the accountability and patient-centredness of the system. At the same time, it scores well in the provision of a long-term care network. We highlight the report’s key findings below.

Key findings:

Japan’s health financing system is becoming increasingly unsustainable. The country’s existing price review process acts as a brake on structural health system reform. Different incentives are needed to efficiently use medical workforce and hospital resources. Japan’s long-term care system can be a model for other countries but needs better integration with primary care. Japan lags behind developed country peers in the area of research.

Download the report to find out more.