Dr. Christian Oberländer

The University of Tokyo, Faculty of Medicine

The Japanese Health Care System between Aging and Internationalization: Opportunities for German-Japanese Cooperation

The Japanese health care system is credited with providing the Japanese population with fairly equitable access to health care at relatively low cost. The Japanese population enjoys today the highest life expectancy in the world (82.9 years for women and 76.4 years for men in 1995). However, just like many other sectors of Japanese society, the foundations of the Japanese health care system are shaken by the two trends of population aging and internationalization. These trends force numerous difficult choices and reform decisions on Japanese health policy makers that challenge long-established arrangements. However, in addressing these problems, opportunities for cooperation between Germany and Japan also present themselves. This paper will first outline some basic features of the Japanese health care system, covering the structure of health care financing organizations, service providers, and their interaction. The special incentive structure caused by the lack of separation of medicine and pharmacy and the need for functional differentiation among clinics and hospitals in Japan will be addressed in particular. Then, recent reforms concerning the position of traditional medicine in the Japanese health care system will be briefly discussed. Finally, recent developments in the markets for medical technology and long-term care equipment will be examined with a view to opportunities for cooperation between German and Japanese companies.