the nineteenth century. The main components of this system are health education and health services, as well as health aspects of the school environment. The system has an especially highly developed screening process, and today the Japan Society of School Health performs mass screening for heart diseases such as congenital heart diseases, acquired heart diseases, and arrhythmias; respiratory diseases such as tuberculosis and asthma; and renal diseases such as hephritis and nephrosis. Mass screening for heart disease tries to offer accurate diagnosis and systematic control of heart disease in the school population. Screening for heart diseases includes electrocardiography (ECG) and phonocardiography (PCG) (Grunbaum & Labarthe, 1990, p. 330).
The Japanese system can thus be seen as offering health care from the cradle to the grave. It is seen as one of the most comprehensive and efficient health care systems in the world. The system has produced one of the healthiest societies in the world as well, and it has managed to accomplish this while making the financial burden on corporations relatively light - Japanese companies pay about one-fifth of what American companies pay for employee health insurance. The present system is 30 years old, and it is now facing a challenge because of the rapid growth in the number of retirees healthy enough to peddle a bicycle to the hospital but old enough to need large doses of expensive medical care. This situation will only increase - it is expected that the portion of the population 65 or older will double, from the present 12 percent to 25 percent of the population, within another 30 years. The portion of total medical costs that go for the aged population is expected to rise from 17.8 percent in 1980 to 37 percent in the year 2000 and 41 percent in 2010 (Sterngold, 1992, A1, A8).
The system supported by the health insurance plan includes more than 1,000 mental hospitals, 8,700 gener...