The cornerstone of Japanese health reform over the last four decades was an advocacy initiated by the head of the Insurance Bureau of the Ministry of Health and Welfare in 1983 that stated that ever rising medical expenses would ruin the country [11]. Expansion policies in health care were switched to contraction and cost-containment policies in the mid-1980s, when a variety of measures were implemented to reduce LOS in the belief that shorter LOS would result in cost containment [12].