Japan: Maintaining equity through regulated fees

N. Ikegami

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Japan was the first non-Western country to introduce social insurance and the first to achieve universal coverage. It has been very successful in helping to bring about high health levels among its citizens at reasonable cost. Consequently, it provides a unique model for the newly industrialized countries of how to adapt modern technologies in structuring their own health care systems. Japan's financing system is organized by the government. Coverage is mandated for all citizens and is supplied by a number of insurance plans, whose variety reflects the differences in their development. The country relies mainly on the private provision of health care, delivered from physician-owned clinics and hospitals. The most prestigious facilities, however, are the public hospitals. Services are fragmented between clinics and hospitals, which compete for a share of the patients in their area. Patients can choose where to seek medical services. Providers are paid by a nationally uniform method and rate, which are decided by one central agency. Increases in payment rates are tied to the ceiling set by the government's general expenditure limitations. A uniform fee schedule has helped to control costs and to ensure equitable access. Challenges remaining for Japan's health care system are caring for an increasingly elderly population and ensuring quality of care.

Original languageEnglish
Pages (from-to)689-713
Number of pages25
JournalJournal of Health Politics, Policy and Law
Volume17
Issue number4
Publication statusPublished - 1992

Fingerprint

Fees and Charges
fee
Japan
equity
health care
Delivery of Health Care
coverage
Fee Schedules
Universal Coverage
private provision
citizen
social insurance
Cost Control
Social Security
Quality of Health Care
Public Hospitals
medical services
costs
Health Expenditures
Insurance

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Policy
  • Nursing(all)
  • Social Sciences (miscellaneous)
  • Health(social science)
  • Law
  • Health Professions(all)

Cite this

Japan : Maintaining equity through regulated fees. / Ikegami, N.

In: Journal of Health Politics, Policy and Law, Vol. 17, No. 4, 1992, p. 689-713.

Research output: Contribution to journalArticle

@article{8307bb356b2246d19260cc3bd20099ef,
title = "Japan: Maintaining equity through regulated fees",
abstract = "Japan was the first non-Western country to introduce social insurance and the first to achieve universal coverage. It has been very successful in helping to bring about high health levels among its citizens at reasonable cost. Consequently, it provides a unique model for the newly industrialized countries of how to adapt modern technologies in structuring their own health care systems. Japan's financing system is organized by the government. Coverage is mandated for all citizens and is supplied by a number of insurance plans, whose variety reflects the differences in their development. The country relies mainly on the private provision of health care, delivered from physician-owned clinics and hospitals. The most prestigious facilities, however, are the public hospitals. Services are fragmented between clinics and hospitals, which compete for a share of the patients in their area. Patients can choose where to seek medical services. Providers are paid by a nationally uniform method and rate, which are decided by one central agency. Increases in payment rates are tied to the ceiling set by the government's general expenditure limitations. A uniform fee schedule has helped to control costs and to ensure equitable access. Challenges remaining for Japan's health care system are caring for an increasingly elderly population and ensuring quality of care.",
author = "N. Ikegami",
year = "1992",
language = "English",
volume = "17",
pages = "689--713",
journal = "Journal of Health Politics, Policy and Law",
issn = "0361-6878",
publisher = "Duke University Press",
number = "4",

}

TY - JOUR

T1 - Japan

T2 - Maintaining equity through regulated fees

AU - Ikegami, N.

PY - 1992

Y1 - 1992

N2 - Japan was the first non-Western country to introduce social insurance and the first to achieve universal coverage. It has been very successful in helping to bring about high health levels among its citizens at reasonable cost. Consequently, it provides a unique model for the newly industrialized countries of how to adapt modern technologies in structuring their own health care systems. Japan's financing system is organized by the government. Coverage is mandated for all citizens and is supplied by a number of insurance plans, whose variety reflects the differences in their development. The country relies mainly on the private provision of health care, delivered from physician-owned clinics and hospitals. The most prestigious facilities, however, are the public hospitals. Services are fragmented between clinics and hospitals, which compete for a share of the patients in their area. Patients can choose where to seek medical services. Providers are paid by a nationally uniform method and rate, which are decided by one central agency. Increases in payment rates are tied to the ceiling set by the government's general expenditure limitations. A uniform fee schedule has helped to control costs and to ensure equitable access. Challenges remaining for Japan's health care system are caring for an increasingly elderly population and ensuring quality of care.

AB - Japan was the first non-Western country to introduce social insurance and the first to achieve universal coverage. It has been very successful in helping to bring about high health levels among its citizens at reasonable cost. Consequently, it provides a unique model for the newly industrialized countries of how to adapt modern technologies in structuring their own health care systems. Japan's financing system is organized by the government. Coverage is mandated for all citizens and is supplied by a number of insurance plans, whose variety reflects the differences in their development. The country relies mainly on the private provision of health care, delivered from physician-owned clinics and hospitals. The most prestigious facilities, however, are the public hospitals. Services are fragmented between clinics and hospitals, which compete for a share of the patients in their area. Patients can choose where to seek medical services. Providers are paid by a nationally uniform method and rate, which are decided by one central agency. Increases in payment rates are tied to the ceiling set by the government's general expenditure limitations. A uniform fee schedule has helped to control costs and to ensure equitable access. Challenges remaining for Japan's health care system are caring for an increasingly elderly population and ensuring quality of care.

UR - http://www.scopus.com/inward/record.url?scp=0026967508&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026967508&partnerID=8YFLogxK

M3 - Article

C2 - 1299686

AN - SCOPUS:0026967508

VL - 17

SP - 689

EP - 713

JO - Journal of Health Politics, Policy and Law

JF - Journal of Health Politics, Policy and Law

SN - 0361-6878

IS - 4

ER -