Abstract - Lessons from Japan to Asia on Health & Social Policies for Ageing Society

Japan as a country of exploration and experimentation
Japan is in the middle of "Demographic Drift". From 19 century up to 1970' population under age 50 was stable around 85%, which signifies productive and reproductive age as the 2nd stage of Life had been dominant. After 2060' population over age 50 is predicted to become stable around 60% which signifies post-productive and post-reproductive age as the 3rd stage of life will become dominant. This will be the entirely new society which no human being have ever experienced. This society seems to be unthinkable and unsustainable by common sense. Many of the Asian countries follow this pass. Japan can be a experimental model for this new society. Asia can learn from success or failure of Japanese exploration.

Lessons from the failure of Japan
Japanese health care delivery system stands as the outlier of the world. Length of stay of hospital is longest and number of bed and hospital per capita is biggest of the world. This is because the differentiation of hospital and nursing home function has not been enough and homecare has been underdeveloped in comparison with the speed of the ageing which has forced patients to stay in the hospital. The reason for this failure is that the policy of the Japanese government was not strategic but reactive. Most of the effort of government on elderly care policy has been to amend this situation. Other countries can avoid the mistake by learning the lesson from the history of Japanese health & social policy.

Lessons from the success of Japan
In spite of some failure, Japanese policy has been successful in introducing appropriate system at right timing. For example workers health insurance was introduced in 1927 during the heavy industrialization and urbanization., universal health coverage in 1961 during rapid economic growth and long-term care insurance in 2000 for rapid aging. Step by step approach by Japan can be a good lesson to the countries in economic growth.

Integration of the health & social policy among different sector
Now Japan realizes the change is not only in health sector, but in life course, family structure, economy and social structure. Even in health sector health and welfare should be integrated. It is because human being is under "Survival Transition" and "Modern Times" is ending. So that whole change is interconnected historically. Japan and Asian countries are at the tip of this historical transition. We have to learn from each others and to age together in Asia.

About the Speaker - Prof Toshihiko Hasegawa

Toshihiko Hasegawa, M.D., MPH., Ph.D. is Visiting Researcher at National Institute of Science Technology and Education Policy. And retired Professor of Nippon Medical School after a long career in Japanese government including development of elderly care policy and management of Japanese national hospitals. He graduated from Harvard School of Public Health for MPH, from Osaka University Medical School for MD, and finished General Surgical Residency in Milwaukee, Wisconsin. He taught at many medical schools in Japan as visiting professor for health policy and hospital management. He did research on health policy, health sector reform, planning and evaluation of disease management program, hospital strategic management and international health. Dr. Hasegawa published many papers and books about ageing society, international health, health policy, hospital management, health care delivery system　and　safety and quality of care including the Hospital Strategic Management in 2002 that was translated in Korean, Thai, Russian and Chinese and the International Symposium on Health Transition and Health Sector Reform in Asia in 1998.