MEDICAL-CARE IN JAPAN

The Japanese health care system presents a tantalizing puzzle. On the positive side, universal health insurance has been achieved at relatively low cost and the health indexes of infant mortality and life expectancy at birth are among the best in the world. However, the system has been criticized for lack of good management, quality control, and attention to consumers.1 In this article we will discuss the link between the positive and negative aspects of the Japanese system by describing the use of a universal fee schedule to define much of the health care system. We will then describe current efforts. © 1995, Massachusetts Medical Society. All rights reserved.