Health Policy in Japan - Current Situation and Future Challenges

Demographics and disease structures have a great influence on medical service delivery systems and their finances. Japan has a rapidly aging population, with those aged 65 or over accounting for 27.4% of the population. Total Fertility Rate was 1.44 in 2016 and these combined factors, fertility rate and aging population, have seen the total population fall since 2006. Consequently, there is an increase in users of social and health services and a decrease in tax payers. This requires the Japanese government to reorganize its social security system. In order to reorganize the health service delivery system, the Ministry of Health, Labor and Welfare (MHLW) has started to collect data in the form of Diagnosis Procedure Combination data and the National Receipt Database. The former gathers around 11 million discharged cases from around 3,000 acute care hospitals annually. The latter gathers more than 1.7 billion claims data from all medical facilities each year. Using these methods, the Japanese government is trying to proceed with a data-driven health reform. As the principle of the Japanese healthcare system is a private dominant supply system under public financing, the existence of appropriate information regarding health needs is crucial for reliable administration. The success of this policy depends on strong leadership by politicians with a clear direction for the future. Additionally, it is necessary to improve the ability to utilize information in society as a whole. The author believes that strengthening the foundations of health service research is crucially important for public health administration in Japan.