A Leadership Vision for the Future of Japan's Health System

Japan Vision: Health Care 2035 Paradigm Shift in Health Care Lean Health Care: Maximizing Patient Value Life Design: Empowering Society and Support Individual Choices Global Health Leader: Lead and Contribute to Global Health Conclusion References Japan achieved universal health coverage (UHC) in 1961. This happened when Japan was still poor but beginning a period of rapid economic growth. Over the next 50 years of economic development, Japan became a wealthy country and continued to develop its health system of good health at low cost with equity. Through UHC, Japan improved its population’s health outcomes, economic growth, social stability, equity, and solidarity. Japan’s life expectancy has increased by more than 30 years and health outcomes have been topranked globally since the early 1980s. However, growth has slowed and the demographic transition is projected to lead to increases in health care and social security costs, which will place pressure on public financing and threaten the sustainability of the health and social care systems. By 2015 social security spending accounted for a third of government expenditure and this proportion is expected to grow. To ensure sustainability and prepare the health care system for current and future health care needs, we need comprehensive reform based on a forward-looking, long-term vision. The health and social care system must engage all sectors through shared vision and values, rather than maintaining the current system through basic cost increases and benefit cuts. In January 2015, I joined discussions at the World Economic Forum annual meeting in Davos, Switzerland. There, I found a surprisingly strong interest in the way Japan tackles the challenges of aging. Richard Horton, the editor-in-chief of the Lancet, once wrote, “Japan is a mirror for our future.” He identified that “the success of Japan’s health system matters not only because of its importance to Japanese citizens, but also because Japan is a barometer of Western health.” Like him, I believe that Japan can offer lessons—and hope— for the future of health in other societies.