Japan

The health care system in Japan is universal and mandatory, and is a hybrid system where funding comes from job-based insurance premiums and taxes. There are a total of eight health insurance systems in Japan, organized in two categories, Employee’s Health Insurance (健康保険 Kenkō-Hoken) and National Health Insurance (国民健康保険 Kokumin-Kenkō-Hoken), for corporate employees and self-employed people and students, respectively.

The first Employee Health Insurance Plan, known as ‘kaihoken’, was created in 1927 and expanded in 1961, with costs starting to increase in the 1980s. The word ‘kaihoken’ means ‘healthcare for all’; it is a universal system based on compulsory insurance plans that covers employees (under 70 years old, the so-called ‘pre-elders’) and their families, with patients paying around 30 percent of medical costs. Within the National Health Insurance (NHI) scheme, patients enjoy total freedom to choose doctors, specialists and to decide where they receive treatment. However the universal healthcare system, which has been in place for 50 years, is showing signs of strain. In a country with the world’s oldest population, the disease mix is becoming more difficult to treat, with rates of cancer, stroke and Alzheimer’s disease on the rise, and doctors and hospitals are increasingly strained. Emergency care and serious medical conditions are sometimes overwhelmed by large numbers of patients seeking routine care.

The Japanese pharmaceutical market is the second largest in the world, after the United States, worth around $96.5bn in 2010, according to IMS Health. Recent growth rates have been significantly affected by currency fluctuations between the yen and U.S. dollar. Even with the devastating aftershocks of the 2011 earthquake, Japan managed to resume economic production and the pharmaceutical industry, showing it has been built on a solid foundation.