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Key findings on the Japanese health care system
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The quality of health care is generally very good in Japan but further improvement can be made in the management of diabetes, treatment of heart attack (AMI), and cancer control. In Japan, per capita spending on pharmaceuticals is the second highest in the OECD after the United States. Spending on pharmaceuticals could be reduced by increasing the share of the generic market.
Access latest developments on regulatory policy in Japan and its score on the 2015 Indicators of Regulatory Policy and Governance, and the 1999 and 2004 OECD Review of Regulatory Reform in Japan.
With gross government debt of 226% of GDP, Japan’s fiscal situation is in uncharted territory and puts the economy at risk. Japan needs a detailed and credible fiscal consolidation plan, including specific revenue increases and measures to control spending to restore its fiscal sustainability.
Innovation is key to boosting economic growth in the face of a rapidly ageing population. While Japan spends heavily on education and R&D, appropriate framework conditions are essential to increase the return on such investments by strengthening competition, both domestic and international, and improving resource allocation.
In 2014, Japan provided USD 9.2 billion in net ODA (preliminary data). This represented 0.19% of gross national income (GNI) and a 15.3% decrease in real terms from 2013, due to lower levels of debt relief in 2014.
This report reviews the quality of health care in Japan, and seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care. One of Japan’s foremost policy challenges is to create an economically-active ageing society. Excellent health care will be central to achieving this. A striking feature of the Japanese health system is its openness and flexibility. In general, clinics and hospitals can provide whatever services they consider appropriate, clinicians can credential themselves in any speciality and patients can access any clinician without referral. These arrangements have the advantage of accessibility and responsiveness. Such light-touch governance and abundant flexibility, however, may not best meet the health care needs of a super-ageing society. Japan needs to shift to a more structured health system, separating out more clearly different health care functions (primary care, acute care and long-term care, for example) to ensure that peoples’ needs can be met by the most appropriate service, in a coordinated manner if needed. As this differentiation occurs, the infrastructure to monitor and improve the quality of care must simultaneously deepen and become embedded at every level of governance –institutionally, regionally and nationally.
OECD Corporate Governance Working Paper No.17. This report examines the influence of institutional shareholders and their activities towards good corporate governance, the historical changes to practices within shareholder meetings and the role that institutional shareholders have played in the improvement of corporate governance within Japanese listed companies.
Specific country notes have been prepared using data from the database OECD Health Statistics 2015, July 2015 version. The notes are available in PDF format.