Lectures
What can other countries learn from how Japan delivers its healthcare?
Synopsis
How does Japan deliver so much healthcare so efficiently? The health of the Japanese population is well documented: Japan is world-leading in many areas including high rates of life expectancy, low rates of infant mortality and the fewest workdays lost through ill health. What is less well-understood is how (and how much) healthcare is delivered in Japan. Japan has had a universal health insurance system since the 1960s. The system is characterised by its egalitarian nature and direct patient access to health providers and treatments. Compared to the OECD average, Japanese patients see doctors twice as often; doctors undertake three times as many consultations; there are five times as many MRI and CT tests; inpatient stays are three times as long. Despite this high level of demand, there are currently virtually no waiting lists for any forms of treatment in Japan. Moreover, if one controls for the age of the population, Japan appears to deliver this amount of service while spending a lower proportion of its GDP on health care than the OECD average (2022: 81% of UK spend).
How does Japan deliver so much healthcare so comparatively cheaply? This talk suggests that a part of the answer might lie in the fact that, in the immediate postwar period, the private medical sector was encouraged to expand in order to reduce the need for state expenditure. Today, 70% of Japan’s 8000+ hospitals and 95% of its 100,000+ clinics are private of which combined around 80% might be defined as ‘family businesses’. The importance of the concept of continuity in Japanese family business, along with generous tax incentives for such businesses in the medical field, strict limits on the total number of medical students, a generally free market for medical practitioners and, importantly, close government control over costs all appear to have combined to make the Japanese healthcare system both competitive and efficient.
Brief Biography
Professor Roger Goodman has been the Nissan Professor of Modern Japanese Studies (since 2003) and the Warden of St Antony’s College and Pro-Vice-Chancellor at the University of Oxford (since 2017). Before taking up his current roles, he was the Head of Oxford’s Social Sciences Division between 2008-17 and the inaugural Head of the School of Interdisciplinary Area Studies (SIAS) between 2004-7. He was elected a Fellow of the UK Academy of Social Sciences in 2013 and was Chair of the Academy’s Council and President between 2015-21. In 2024, he was appointed Commander of the Order of the British Empire (CBE) for services to Social Science. Professor Goodman holds a BA in Social Anthropology and Sociology from the Durham University (1981) and a DPhil in Social Anthropology from the University of Oxford (1987). His research has been mainly on Japanese education and social policy. His most recent monograph, co authored with Jeremy Breaden, is entitled Family-Run Universities in Japan: Sources of Inbuilt Resilience in the Face of Demographic Pressure, 1992-2030 (published by Oxford University Press, 2020 and published in Japanese as 日本の私立大学はなぜ生き残るのか, 中央公論, 2021). Other monographs include Japan’s International Youth: The Emergence of a New Class of Schoolchildren (1990; published in Japanese as 帰国子女：新しい特権層の出現, 岩波書店) and Children of the Japanese State: The Changing Role of Child Protection Institutions in Contemporary Japan (2000; published in Japanese as 日本の児童養護：児童養護学への招待、明石書店). Edited books include: Ideology and Practice in Modern Japan (1992); Case Studies on Human Rights in Japan (1996); The East Asian Welfare Model (1998); Family and Social Policy in Japan (2002); Can the Japanese Change their Education System? (2002); Global Japan (2003; published in Japanese as 海外における日本人,日本の中の外国人, 昭和堂); The ‘Big Bang’ in Japanese Higher Education (2005); Ageing in Asia (2007); A Sociology of Japanese Youth (2011; published in Japanese as 若者問題の社会学：視線と射程、明石書店) and Higher Education and the State (2012). He has supervised nearly fifty doctoral theses on Japan on topics ranging from Shinto shrines to volleyball coaches, teacher unions to karaoke, hikikomori to firefighters, crying therapies to agricultural revitalisation programmes, rakugoka to SDF recruits.
Lecture Date
Monday, May 19, 2025