Lancet Launch Symposium on Restructuring Japan's Healthcare System—Beyond the March 11 Disaster

September 1, 2011

World-renowned medical journal the Lancet has released a special series on Japan in September 2011 that commemorates the 50th anniversary of Japan’s attainment of universal healthcare coverage. The first such special series by the Lancet focusing on a single industrialized country, the series explores many facets of Japan’s health system, including its remarkable achievements in life expectancy and health status in a brief period of time, the advantages and limitations of universal healthcare coverage, its ability to maintain high quality of healthcare at low cost, achievements and challenges in the face of the world’s most rapidly aging society, and Japan’s commitment to global health and health diplomacy. The authors for this series analyze these themes while highlighting challenges for sustaining Japan’s system of universal coverage and providing recommendations for health experts inside and outside of Japan.

Lancet Special Series: “Japan: Universal Health Care at 50 Years”

English (Published in English by the Lancet)

Japanese | 日本語 (Published in Japanese by JCIE)

The Japan Center for International Exchange (JCIE) and the Lancet organized an international public symposium in Tokyo at the United Nations University on September 1, 2011, as part of the series launch. Japan managed to rebuild its health system rapidly following the devastation of World War II and achieved universal coverage of health insurance in 1961. Today, it enjoys the world’s highest life expectancy and some of the best health indicators. At the same time, Japan faces serious challenges in maintaining its high level of health services in the face of a rapidly aging society and sluggish economic conditions. The March 11 earthquake and tsunami brought to light many vulnerabilities in the healthcare system, not only in the Tohoku region but throughout the country, including limited access to healthcare service in rural areas, lack of primary care physicians, inappropriate medical governance, and challenges facing elderly communities, to name only a few.

The symposium shared findings from the Lancet Special Series on Japan and the challenges confronting Japan’s health system in the wake of the disasters in Tohoku and the implications for the future direction of Japan’s health system which should be based on the principles of equity and solidarity. In addition, the symposium also provided a forum for sharing Japan’s experience in achieving and maintaining a healthy population in the face of an aging population and changing economic conditions with other countries that are trying to strengthen their own health systems. In other words, the series and symposium presented Japan with the opportunity to play an important role in creating a healthier world by sharing our successes and our challenges with experts from around the globe.

Opening Session

Tadashi Yamamoto, President, Japan Center for International Exchange (JCIE)

Richard Horton, Editor-in-chief, Lancet, UK

Lincoln Chen, President, China Medical Board, USA
Keizo Takemi, Senior Fellow, JCIE

Session 1: What Does the Disaster Teach Us about Japan’s Health System?

Keizo Takemi

Kenji Shibuya, Professor and Chair, Department of Global Health Policy, University of Tokyo

Hidekazu Tanaka, Editor, Health and Medical News Department, Yomiuri Shimbun
Michael Reich, Taro Takemi Professor of International Health Policy and Director, Takemi Program in International Health, Harvard School of Public Health, USA

Session 2: Current Challenges Facing Japan’s Health System

Michael Reich


Medical Service Delivery
Hideki Hashimoto, Professor, Department of Health Economics and Epidemiology Research, University of Tokyo

Medical and Long-term Care for the Older
Nanako Tamiya, Professor, Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba

Sustainability of Universal Coverage
Naoki Ikegami, Professor and Chair, Department of Health Policy and Management, School of Medicine, Keio University

Harvey V. Fineberg, President, Institute of Medicine, USA
Suwit Wibulpolprasert, Senior Advisor, Ministry of Public Health, Thailand

Session 3: Reforms for the Future―Maintaining Equity, Efficiency, and Sustainability

Moderator: SHUNSUKE WATANABE, Professor, Tokyo Women’s Medical College; former Editorial Writer, Nikkei Shimbun

Naoki Ikegami

Bong-min Yang, Professor of Economics and Executive Director, Institute of Health and Environment, Seoul National University, Korea
Keiji Yamada, Governor of Kyoto Prefecture; President, National Governors’ Association
Shigeru Omi, Professor, Division of General Practice Center, Jichi Medical University

Session 4: Global Implications of Achieving Universal Healthcare Coverage Based on Human Security 

Richard Horton

Kenji Shibuya

Sudhir Anand, Professor of Economics, Oxford University, UK; Visiting Professor, Harvard Medical School, USA
Joseph Kutzin, Coordinator, Health Financing Policy, World Health Organization (WHO)
Armin Fidler, Lead Advisor for Health Policy and Strategy, Health, Nutrition and Population, Human Development Network, World Bank

Y. S. Chi, Chairman, Management Committee, Reed Elsevier plc
William SummerskillI, Executive Editor, Lancet, UK
Keizo Takemi

Co-sponsored by the Japan Center for International Exchange and the Lancet; support from the Ministry of Foreign Affairs; Ministry of Health, Labour and Welfare; Ministry of Finance; World Bank; and the Yomiuri Shimbun