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Health-Care Reform in Japan: Controlling Costs, Improving Quality and Ensuring Equity

Author

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  • Randall S. Jones

    (OECD)

Abstract

Japan’s health-care system has provided universal access to care and contributed to the outstanding health status of the Japanese. Public spending has been kept below the OECD average through high co-payment rates and reductions in medical fees. However, with continued upward pressure on expenditure, in part due to rapid population ageing, reforms are needed to limit spending increases through greater efficiency, while improving quality. It is essential to shift long-term care out of hospitals, reform the pricing mechanism away from pay-for-visit, increase the use of generic drugs, encourage healthy ageing and promote restructuring in the hospital sector. Quality should be improved by increasing the availability of effective new drugs and medical devices. In funding spending increases, it is important to limit the share borne by employees to avoid negative effects on the labour market. Japan may need to allow more mixed billing to enhance access to some advanced medical treatments. La réforme des soins de santé au Japon : Maîtriser les dépenses, améliorer la qualité et préserver l'équité Le système de santé japonais assure l’accès universel aux soins, contribuant à l’excellent état de santé de la population du pays. Le niveau des dépenses publiques a été maintenu au-dessous de la moyenne de l’OCDE en demandant aux assurés une participation élevée aux coûts et en réduisant les tarifs médicaux. Toutefois, comme les dépenses subissent toujours des pressions à la hausse, en partie du fait du vieillissement rapide de la population, il faut procéder à des réformes pour limiter leur accroissement par le biais d’une meilleure efficacité, tout en améliorant la qualité. Il est indispensable de transférer les soins de longue durée en dehors des hôpitaux, de réformer le système de rémunération en abandonnant le paiement à l’acte, de développer l’utilisation des médicaments génériques, d’encourager un vieillissement en bonne santé et de promouvoir la restructuration du secteur hospitalier. La qualité doit être améliorée en développant l’offre de nouveaux médicaments et dispositifs médicaux efficaces. Pour financer les dépenses supplémentaires, il importe de limiter la part assumée par les salariés de manière à éviter des retombées négatives sur le marché du travail. Le Japon devra peut-être permettre encore plus la facturation groupée pour améliorer l’accès à certains traitements médicaux de pointe.

Suggested Citation

  • Randall S. Jones, 2009. "Health-Care Reform in Japan: Controlling Costs, Improving Quality and Ensuring Equity," OECD Economics Department Working Papers 739, OECD Publishing.
  • Handle: RePEc:oec:ecoaaa:739-en
    DOI: 10.1787/220005270870
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    Cited by:

    1. Rikuya Hosokawa & Toshiyuki Ojima & Tomoya Myojin & Jun Aida & Katsunori Kondo & Naoki Kondo, 2020. "Associations between Healthcare Resources and Healthy Life Expectancy: A Descriptive Study across Secondary Medical Areas in Japan," IJERPH, MDPI, vol. 17(17), pages 1-16, August.
    2. Xing, Zhang & Oyama, Tatsuo, 2016. "Measuring the impact of Japanese local public hospital reform on national medical expenditure via panel data regression," Technological Forecasting and Social Change, Elsevier, vol. 113(PB), pages 460-467.
    3. Randall S. Jones & Kohei Fukawa, 2017. "Ensuring Fiscal Sustainability in Japan in the Context of a Shrinking and Ageing Population," OECD Economics Department Working Papers 1413, OECD Publishing.
    4. Randall S. Jones & Kohei Fukawa, 2015. "Achieving Fiscal Consolidation while Promoting Social Cohesion in Japan," OECD Economics Department Working Papers 1262, OECD Publishing.

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