OECD - OECD Reviews of Public Health: Japan

This report was prepared by Charles Baubion, Michele Cecchini, Rie Fujisawa, Emily Hewlett and Sabine Vuik, with input from Yuka Nishina, and research assistance from Chihiro Sudo. The authors also wish to thank Stefano Scarpetta, Mark Pearson, Francesca Colombo and Rabia Kahn from the OECD Directorate of Employment, Labour and Social Affairs for their comments. Thanks also go to Lucy Hulett and Liv Gudmundson for editorial input and to Isabelle Vallard, Lukasz Lech and Duniya Dedeyn for logistical assistance. The completion of this report would not have been possible without the generous support of Japanese authorities.

This report has benefited from the expertise and material received from many health officials, health professionals, patient groups and other health experts that the OECD review team interviewed during a research mission in Japan in February 2018. In particular, the team spoke with numerous officials from the Japanese Government including from the Ministry of Health, Labour and Welfare, the Cabinet Office, and the Ministry of Education. This report has also benefited from the comments of the Japanese authorities and experts who reviewed earlier drafts; the authors particular thanks go to the numerous Japanese experts who took the time to provide thoughtful and detailed feedback at the review stage.

The OECD also spoke with stakeholders including the National Institute of Public Health, National Institute of Health and Nutrition, the National Institute of Infectious Diseases, The Japanese Association of Public Health Centre Directors at Arakawa City, the Yokohama City Hall, and the Adachi City Hall. Thanks also go to the National Federation of Industrial Health Organizations, the Aichi Health Promotion Public Interest Foundation, the Tokyo Metropolitan Information Service Health Insurance Association, Uchida Yoko Health Insurance Association, Itoki Corporation, SCSK Corporation, for taking the time to meet with the OECD team.

The authors would also like to thank the academics who provided important insights into the Japanese health system and public health, including Professor Hiroya Ogata, Dr Tomonori Okamura, Professor Ryozo Nagai, and Professor Toru Takebayashi.

Particular thanks go to Professor Hideki Hashimoto, from the University of Tokyo, and Sirpa Sarlio from the Finnish Ministry of Social Affairs and Health, for the useful comments that they gave as peer reviewers for this report. Thanks also to Kaisa Lahdepuro for supporting the engagement of the Finland with this process. A draft summary of the report and of the key recommendations were discussed at the 2018 meeting of the OECD Expert Group on the Economics of Public Health. Authors would like to thank all the participants for their review and comments.

Finally, the review team is especially thankful to their key contacts in the Japanese Delegation to the OECD Hisayo Nomura and Teruhiko Kawabata and to Masayuki Azuma and Tomohiro Murakami at the Japanese Ministry of Health, Labour and Welfare, whose logistical and coordination support throughout the review process has been critically important.