Health system strategies, objectives, and legislation
The Medical Care Plan is the national health strategy to establish a system to provide high quality
and appropriate medical care. It promotes a division of roles and cooperation of medical functions
in order to provide continued medical care in communities. Based on the national strategy, each
prefectural government revises their Plan every 5 years. There are at least five Prefectural Health
Care Plans based on the national plans; Health Promotion Plan, Medical Care Plan, Insured
Long-term Care Service Plan, Basic Plan to Promote Cancer Control, and the Medical
Expenditure Optimizing Plan.
The Health Insurance Act (1922) and The National Health Insurance Act (1938) established a
health insurance system that covered the entire population by 1961. The Medical Care Act 1948
and subsequent Amendments (1985 and 1992) form the basic law governing the Japanese health
care delivery system. The 1948 Act sought to ensure adequate health care, including
placement of medical facilities, personnel structure and management systems. The 1985
Amendment legislated for the creation of Prefectural Medical Care Plans, classified regional units
for implementing the plans, and regulated the maximum number of beds for each zone. In 1992
the function of medical facilities was systematized and Special Functioning Hospitals and
Regional Healthcare Support Hospitals were designated. The Community Health Act (1997)
promoted regional health care. Healthy Japan 21 (2000) supported by a new Health Promotion
Law (2002) established a national health promotion program to reduce non-communicable
diseases. The law also stipulates the National Health and Nutritional Survey and encourages both
central and local governments to monitor the prevalence of lifestyle related diseases for effective
health promotion. A range of other legislation influences health services, including the Mental
Health Act, Maternal and Child Health Act, Child Welfare Act, Labor Standards Act, School Health
Law, and the industrial Safety and Health Act.
Traditional medicine is regulated in the same way as conventional medicine and relevant laws are
applied; e.g. the Pharmaceutical Affairs Law (1960) regulates marketing approvals for all drugs
including herbal medicines.