Japan

The Japanese people are among the healthiest in the world. As the world's second most industrialized nation, Japan enjoys a per capita income of $31,600, ranking as the 20th richest nation. Japan reports no poverty level, and homelessness is virtually nonexistent in this eastern Asian nation. A rating of 37.0 percent on the Gini index of inequality is indicative of Japan's status as the most equal nation in the world. Because the traditional Japanese guarantee of lifetime employment has begun to erode, the current unemployment rate stands at 4.4 percent. Only one percent of the population is considered illiterate, and 100 percent of all children are enrolled in school at the primary level and 99.5 percent at the secondary level. One hundred percent of all Japanese have access to safe drinking water and improved sanitation. The United Nations Development Programme (UNDP) ranks Japan seventh of 177 nations in overall quality-of-life issues.

With a life expectancy of 81.25 years among the population of 127,463,611, Japan is ranked sixth in the world in life expectancy.

The first welfare programs in Japan appeared in the late 19th century. Since the end of World War II and the eradication of the huge military sector, the Japanese people have enjoyed expanded benefits of good health combined with substantial government resources. Since 1994, welfare rights have been protected by the Japanese constitution. Health expenditures have remained stable over the last decade. Currently, around two percent of the overall national budget is allocated to healthcare. Some 7.9 percent of the total Gross Domestic Product (GDP) is set aside for health expenditures, an increase from 5.8 percent in 1998. The government allots $2,244 (international dollars) per capita for health costs. Over 80 percent of total health expenditures are provided by government [Page 959]at various levels. Around 90.10 percent of the 19 percent financed by the private sector involves out-of-pocket expenditures. More than 80 percent of all government health expenditures are allocated to finance social security programs. Japan has 1.98 physicians, 7.79 nurses, 0.71 dentists, and 1.21 pharmacists per 1,000 population.

Although Japan has lagged behind other heavily industrialized nations in subsidizing healthcare, a safety net for the neediest people is well established. Known as Nihongata shakai fukushi shakai, Japan's welfare system is considered unique because it is based on the notion that family, community, and employers rather than the government share the bulk of responsibility for assisting the needy. The responsibility for public healthcare is shared among the national government, prefectures, and municipalities.

With a life expectancy of 81.25 years among the population of 127,463,611, Japan is ranked sixth in the world in life expectancy. This is chiefly in response to widespread access to healthcare under a national health insurance plan that began in 1938 with a limited target population. In 1961, the public insurance policy was revised to mandate enrollment of all Japanese not otherwise ensured in a community-based healthcare plan. Since 1980, all employers require a 10 percent copayment for employees and 20 percent copayment for family members. Healthcare is also promoted through employer-provided stress-reducing facilities such as spas and leisure resorts. Like other industrialized nations, Japan has a rapidly increasing aging population. It is predicted that by 2015, one in four Japanese will be 65 or older. Modest copayments are required of individuals covered under Social Security insurance. In 1990, the government instituted the Gold Plan, which subsidizes home helps, day care, and short-term nursing home care for the elderly.

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