The health care system in modern Japan has long been supported by government and private companies which have offered assistance for the ill or otherwise disabled and for the old. Beginning in the 1920s, the government enacted a series of welfare programs that were based primarily on European models and that provided medical care and financial support to those in need. The insurance systems in Japan are complex and involve a mixture of public and private funding. The health care system in Japan will be examined to determine its structure, its costs, and its success at reaching the widest population.
Most postwar Japanese have relied on personal savings and the support of the family for health care, but as noted, the government and private companies do provide assistance as needed. The person who becomes ill in Japan faces several options, including a variety of religious-based and folk remedies; traditional healers such as herbalists, masseurs, and acupuncturists; and Western biomedicine, the latter of which has dominated Japanese medical care in the postwar period. Japan has public health services such as free screening examinations for particular diseases, prenatal care, and infectious disease control, and these are paid for by the national and local governments. Payment for personal medical services has been offered through a universal medical insurance system. It provides relative equality of access, with fees set by a government committee. People who do not have insurance through their employers could participate in a national health insurance program administered by the local governments. All elderly persons have been covered by government-sponsored insurance since 1973. Under these plans, patients could choose the physicians or facilities of their choice (Dolan & Worden, 1992, pp. 123-124).
A school health system had been established in Japan under national legislation as part of a tradition extending back to ...