Japan’s Health Insurance Policy Development in the History of Empire

Takakazu Yamagishi, Nanzan University

Japan’s established universal health care system is nothing like health care in other industrialized countries, but it has historically been heavily influenced by other nations, namely “empires.” Moreover, Japan’s aspiration to become an empire impacted its development of health insurance policy. In the late nineteenth century, Japan established the foundation of its health care system by introducing ideas rooted in Britain, France, and Germany. Among them, Germany had the largest impact on Japan’s health care system. The first major health insurance program was largely affected by the legislation under Otto von Bismarck’s rule. After the 1930s, Japan started its serious efforts to become an empire by invading China and other Southeast Asian countries. Health insurance policies became a tool for the government to make better soldiers and workers to win the total. After World War II, the United States dominated the occupation authority in Japan and influenced health care legislation. In addition, the Beveridge Plan that was born in Britain impacted the discourse of the post-war health insurance reform in Japan. Eventually, Japan achieved universal health insurance in 1961. The main underlying question is how the history of empire affected the development of health insurance policy in Japan. Adopting historical institutionalism, this paper tries to see how ideas from other empires and Japan’s imperialistic aspiration changed the domestic politics and policies by looking carefully at the preceding institutional development. Moreover, this paper hopes to contribute to the theoretical argument by taking changes to international context more seriously. This paper hopes to shed a new light on the development of health insurance policy in Japan, and in other countries as well.

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 Presented in Session 160. Healthcare and Health Insurance in Domestic and Imperial Settings