ABSTRACT
The Japanese health care system is characterized by two opposing elements: its remarkable achievements over five decades and its increasing difficulties in sustaining the system because of population aging and large government deficits. The achievements are produced with a relatively low ratio of expenditure to gross domestic product (GDP) (8 percent) compared with other Organisation for Economic Co-operation and Development (OECD34) member countries, where the average is 8.5 percent of GDP (WHO, 2010). This ratio is considerably lower than that of the USA, which manages to spend 15.7 percent of GDP on health care services (and a large part of the population is not even covered by health insurance). The health indexes of both infant mortality (less than 3 per 1,000 live births) and life expectancy at birth (78.4 years for males and 85.3 for females; MHLW, 2004) are among the best in the world. The health system is well equipped for the adaptation of newly developed medical technology to actual treatment, which is comparable to that used in the United States. Computer tomography (CT) scanners and magnetic resonance imaging (MRI) devices have come into far wider use in Japan than elsewhere in the world, including the United States, with 63 CT scanners per million population in Japan compared with 41 in the United States, seven in Germany and France, and four in the UK; and 28 MRI machines per million population compared with 19 in the USA, and eight, seven, and five in France, Germany, and the UK respectively (see OECD, 2008; Getzen, 2004).
