Health Care Workers in Japan

Density of medical doctors (per 10,000 population) (2012-2020): 24.8
Density of nursing and midwifery personnel (per 10,000 population) (2012-2020): 119.5
Density of dentists (per 10,000 population) (2012-2020): 8.0
Density of pharmacists (per 10,000 population) (2012-2020): 18.9

Source: World health statistics 2021: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.

Remuneration of Hospital Nurses, Ratio to Average Wage (2019): 1.1
Remuneration of Hospital Nurses, USD PPP (2019): $40,700

Source: OECD (2021), Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/ae3016b9-en.

“Of the 311,205 licensed physicians in 2014, 296,845 (95.4%) were working in medical facilities, with 194,961 (62.6%) in hospitals and 101,884 (32.7%) in clinics (Ministry of Health, Labour and Welfare, 2014c). There were 15,659 women doctors (10.0% of the total) in 1980 and 60,495 (20.4%) in 2014. Of doctors aged less than 29 years, 9165 (34.8%) were women. According to the OECD data, which is slightly different from the MHLW data, Japan has a relatively low supply of doctors (Fig. 4.5), with an estimated 2.3 per 1000 population in 2013, or the latest available year, compared with an OECD average of 3.2 (OECD, 2015). This partially reflects historical decisions to reduce the number of medical student seats and a lack of easy access to overseas-trained medical staff due to medical and institutional barriers to foreign workers in the Japanese system.”

Source: Sakamoto H, Rahman M, Nomura S, Okamoto E, Koike S, Yasunaga H et al. Japan Health System Review. Vol. 8 No. 1. New Delhi: World Health Organization, Regional Office for South-East Asia, 2018.

“In 1980, there were 248,165 practicing nurses in Japan (2.12/1000 population), but this number increased rapidly to 1,149,397 (9.06/1000 population) by 2016, a four-fold increase in almost 40 years.

“However, the nursing shortage has remained a Japanese health-care issue since 1990s, due to the increasing demand for health care that comes with rapidly ageing society. The Government estimates that there will be a shortage of 30,000–130,000 nursing personnel by 2025 under the several scenarios in the Comprehensive Reform of Social Security and Tax.”

Source: Sakamoto H, Rahman M, Nomura S, Okamoto E, Koike S, Yasunaga H et al. Japan Health System Review. Vol. 8 No. 1. New Delhi: World Health Organization, Regional Office for South-East Asia, 2018.

“As a result of fee negotiations within expenditure targets, physicians in all three countries earn lower incomes than their US counterparts. For example, in 2016 generalist physicians in the US earned an average of $218,173. In comparison, generalists in France and Germany earned $111,769 and $154,126, respectively. Similarly, specialist physicians in the US earned an average of $316,000 in 2016, compared with $153,180 in France and $181,253 in Germany.³ Japanese physicians earned, on average, $124,558 in 2016; however, this is an average of generalist and specialist incomes.”

Source: Michael K. Gusmano, Miriam Laugesen, Victor G. Rodwin, and Lawrence D. Brown. Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System. Health Affairs 2020 39:11, 1867-1874.

“The Ministry of Health, Labour, and Welfare sets prices and regulates the medical profession.²¹ Although Japan’s centralized system gives the ministry considerable power, the health budget is set by the prime minister. As one interviewee explained, the ministry’s main concern is cost control. The global budget relies on input from “the ministers and top bureaucrats of the two ministries [the Ministry of Health, Labour, and Welfare and the Ministry of the Economy and Finance]. The person in charge of the [Ministry of Health, Labour, and Welfare] budget and the [Ministry of the Economy and Finance] stays in office from two to three years, so if he points his finger up, then [the global budget] goes up. If it’s down, [the global budget] doesn’t go [any higher].”

“The second stage is taken up by the Central Social Insurance Medical Council, or Chuikyou, housed inside the ministry’s Health Insurance Bureau.¹¹ The Central Social Insurance Medical Council revises the fee schedule every two years. This council is part of the Ministry of Health, Labour, and Welfare, not independent as is the American Medical Association’s Relative Value Scale Update Committee. Increases in payments to physicians in Japan are often financed by price decreases in the pharmaceutical budget. Essentially, pharmaceutical companies pay for higher physician fees.”

Source: Michael K. Gusmano, Miriam Laugesen, Victor G. Rodwin, and Lawrence D. Brown. Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System. Health Affairs 2020 39:11, 1867-1874.

“In Japan, as is the case also in Germany and France, the bureaucracy is happy to delegate some authority to physician representatives. Conflict revolves around the extent of delegation and the budget constraint. All three nations have a stronger government purchaser or stewardship role than in the US. However, there are differences in the relationships between providers and elected officials. The close relationship between the Japan Medical Association and the Liberal Democratic Party of Japan, which has dominated Japanese politics for most of the post–World War II era, makes Japan unique, but there is still a nationally determined health budget.

“Primary care physicians dominate the Japan Medical Association and are better compensated than specialists. In most countries specialty societies engage in vigorous advocacy on economic issues, but in Japan specialists are less politically active because of their employment in hospitals and university clinical departments.^23,24 Although the Japan Medical Association can circumvent the bureaucracy via allies in the legislature during negotiations over the global budget, in Japan, as in France and Germany, fee negotiations within the context of expenditure targets or budget caps have given rise to contentious negotiations.”

Source: Michael K. Gusmano, Miriam Laugesen, Victor G. Rodwin, and Lawrence D. Brown. Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System. Health Affairs 2020 39:11, 1867-1874.

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

Page last updated Sept. 28, 2022 by Doug McVay, Editor.