Abstract - Comparative Health Systems In Asia (Japan)

Population ageing is occurring faster in a shorter time-span in Asia compared to the developed Western countries. Asia's elderly population is projected to reach 922.7 million by the middle of this century, from just 57.6 million in 1950. Though population age structures of Asian countries vary widely, the rapid demographic ageing of many Asian countries has meant a ubiquitous challenge of limited resources to meet financial demands of a health and social care system for an ageing population. They suggest a need for an evidence-based public policy formulation processes in the care system. To contribute to this evidence base, this presentation examines Japan's health and social care delivery systems using the template adapted from Sameen Siddiqi's et al.'s "Framework for assessing governance of the health system in developing countries: Gateway to good governance". The framework examines provision, financing and regulation across the healthcare continuum.

Japan has one of the highest proportion of elderly population in the world. The challenges of meeting the needs of its ageing population include maintaining incomes of older people through public pensions and enhanced employment opportunities, providing good medical care at a reasonable cost and ensuring older people weakened by physical or mental disabilities have a good quality of life.

Following an evaluation of the system, it was found that although there is free access to medical care for majority of the population, there is some geographical inequity in access between rural and urban areas. The lack of "gatekeeping" in Japan's healthcare system has also created issues of moral hazard. Together with the issue of a shrinking workforce, these factors contribute to the increasing pressure on the financial sustainability of Japan's health insurance system. The Japanese health system is also faced with poor measurement and evaluation of quality, with very few hospitals undergoing formal quality assurance programmes. Nevertheless, the imperative step towards the integration of health and social care for an ageing population has been established in Japan - the Long Term Care Insurance (LTCI) scheme, through a unified financing scheme for health and social care services.

About the Speaker - Prof Thang Leng Leng

Associate Professor
Department of Japanese Studies
National University of Singapore, Singapore