An overview of the role of government in the organisation and provision of health services in Japan

Abstract

This article is illustrated with reference to health services in the Tokyo Prefecture.It seeks to describe the role of government in the organisation and provision of healthservices in Japan. It is based on experiences gained from a three-month placementat the Tokyo Metropolitan Government Bureau of Public Health in late 1994.Wherever possible the article identifies similarities and differences between theJapanese and Australian health care systems. Part of the analysis has been to identifyareas where opportunities exist for Australian health service providers to developfurther cooperation with particular sectors of the Japanese health system and alsowhere the potential for the export of health services may exist.The health systems of Australia and Japan have points of similarity anddifference. Essentially both systems operate within the context of a compulsoryuniversal health insurance system. However, unlike Australia, the bulk of serviceprovision in Japan is left to the private sector, while government retains the primaryrole of regulator. It is interesting to observe that while the Australian health caresystem is currently exploring options to expand the service range and level ofparticipation of private sector services in health care delivery (within the context ofuniversal health insurance), the Japanese health care system appears to be examiningoptions through which further government intervention can improve service accessand service efficiency. Japan presents opportunities to observe the benefits anddisadvantages of predominantly private sector provision within the context ofuniversal health insurance coverage.