1. The Political Process Involved in Formulating Healthcare Policy in Japan: With a Particular Focus on Advisory Councils, Interest Groups and Medical Officers
- Author:
- Yukio Sakurai
- Publication Date:
- 01-2025
- Content Type:
- Journal Article
- Journal:
- The Rest: Journal of Politics and Development
- Institution:
- Centre for Strategic Research and Analysis (CESRAN)
- Abstract:
- Japan’s healthcare policy is defined by a universal health insurance system that guarantees affordable healthcare for all citizens at any time and in any location. The system was established in 1961 and has since undergone a process of evolution through the implementation of national healthcare policies. Despite the existence of conflicts and issues, the mechanism of the Central Social Insurance Medical Council (“Chuikyo”) has continued to advance national healthcare interests. Nevertheless, this resulted in the commencement of criminal proceedings in 2004. The current demographic shifts present a challenge to the long-term sustainability of the national health insurance system, the long-term care insurance system, and the public pension system. This is occurring against a backdrop of rising costs associated with healthcare and long-term care, as well as an unsustainable national budget. The Chuikyo system is confronted with a multitude of challenges. This paper analyses the roles of three key actors in the Japanese national healthcare policy-making process. These actors include advisory councils such as Chuikyo, interest groups such as the Japan Medical Agency, and medical officers of the Ministry of Health, Labour and Welfare, who play a pivotal role in the policy-making process. The incremental improvements that Chuikyo produces are insufficient to address the long-term challenges facing the national healthcare policy. Japan’s healthcare model requires reconstruction to align it with the needs of an ageing society with a declining birthrate. Prior to embarking on this important policy work, it is essential to determine who should lead it. It is recommended that the Prime Minister and the Cabinet Office spearhead a study on radical reform, with strong political leadership and a capable technocrat team to facilitate collaboration with the National Diet and the public. Furthermore, it would be crucial to achieve a consensus through national forums on the fundamental concepts that citizens, as consumers, desire and are prepared to forego from a bottom-up approach. It is essential that the governance structure of the national healthcare system is changed to a decentralised structure so that citizens can be proactively involved in healthcare issues and make autonomous decisions.
- Topic:
- Politics, Insurance, and Healthcare System
- Political Geography:
- Japan and Asia