Japan's Universal Health System Evaluated

Disproportionate aging population may negatively impact the country's health system

WEDNESDAY, Aug. 31 (HealthDay News) -- The disproportionate aging population in Japan and societal influences may negatively impact the country's universal health care system, according to six articles published in a Japan series online Aug. 30 in The Lancet.

In the first article of the series, Kenji Shibuya, M.D., of the University of Tokyo, and colleagues found that 23 percent of the Japanese population is aged 65 years or older, growing to 40 percent by 2050, with the population shrinking from around 127 million currently to 95 million in 2050. The universal health care system established in Japan in 1961 was never meant to handle this skewed aging population structure, which could cause problems. In a second article of the series, Naoki Ikegami, M.D., Ph.D., of the Keio University School of Medicine in Tokyo, and colleagues found that the disproportionate aging population of Japan might negatively impact the sustainability and stability of the system.

In the third article study of the series, Hideki Hashimoto, M.D., of Keio University School of Medicine in Tokyo, and colleagues found that Japan's low health care spending as a proportion of gross national product is in line with the United Kingdom but half that of the United States and lower than France and Germany, despite having a much higher proportion of citizens aged over 65 years. Three other articles in the series discuss the impacts of Japan's disproportionate aging population as well as societal affects on the country's universal health care system.

"If recent trends continue, other nations are likely to achieve lower rates of adult mortality than Japan," writes the author of an accompanying editorial. "Many explanations for this worsening relative performance are offered by [The Lancet's Japan Series], including high tobacco consumption compared with other high-income countries, a modest rise in body-mass index, and high and rising rates of suicide. Unstated is the hypothesis that although Japan has a universal health care system, the quality of the care delivered might be low."

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