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“The Constitution of Japan, created in 1946 and implemented in 1947, laid the foundation for Japan’s parliamentary system of government, which is divided into three branches: the legislative branch, the executive branch, and the judicial branch. Power is separate and checks and balances exist between the three branches.”

Source: Japan Health Policy Now. Government Structure. Health and Global Policy Institute, Tokyo, Japan. Last accessed March 25, 2025.

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“Trust in public institutions and satisfaction with public services are important yardsticks of the quality of
public governance. They reflect people’s perceptions of government competence in designing and
delivering policies and services, and expectations on the behaviour of public institutions and their
representatives. Although high trust in public institutions is not a necessary outcome of democratic
governance, trust and satisfaction with public services facilitate effective governance, as they correlate
with high rates of compliance with policies, participation in public life and social cohesion.

“Japan fares comparatively well on satisfaction with the healthcare and the judiciary system. Over
three quarters (76%) of Japanese are satisfied with the healthcare system, significantly above the OECD
average (68%). Similarly, satisfaction with the courts and legal system in Japan (67%) outperforms the
OECD average (56%). In turn, 57% and 43% of Japanese report being satisfied with the education system
and administrative services below the respective OECD averages, 67% and 63%.

“About a quarter of Japanese reported high or moderately high trust in the national government (24%) in 2021. A larger share indicated high or moderately high trust in local government (38%) and civil service (31%), than in the national government.”

Source: OECD (2023), Government at a Glance 2023: Japan, OECD Publishing, Paris.

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“Japan is the world’s third-largest economy, with a correspondingly high standard of living, level of development, safety and stability. Japan is a constitutional monarchy with a parliamentary system of government. The country is divided into 47 prefectures that span a number of small archipelagos as well as the four main islands. Japan is a highly urbanized country and is host to one of the largest metropolises in the world, Tokyo.”

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.

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“The Ministry of Health, Labour and Welfare (MHLW) is the central leading organization in the Japanese health care system. Japan’s health care system is characterized by excellent health outcomes at a relatively low cost; the system emphasizes equity, facilitated by universal insurance coverage through social insurance premiums and tax subsidies, with virtually free access to health-care facilities. The country’ population is rapidly ageing and Japan needs to transform its health care system into one that prioritize patient value, quality and efficiency of care, and integrated approaches across sectors.

“The MHLW as Japan’s leading organization, actively collaborates and cooperates with various other bodies such as the Cabinet, several other ministries and professional organizations. Traditionally, the Ministry of Finance (MOF), the Ministry of Education, Culture, Sports, Science and Technology (MEXT), and the Ministry of Agriculture, Forestry and Fisheries (MAFF) are involved in financing (in particular, the fee schedule and drug pricing), medical professional education, food security and one health, among others. Recently, the Cabinet Office and the Ministry of Economy, Trade and Industry (METI) have become more involved in health care and the medical industry. In 2013, the Central Government published the Japan Revitalization Strategy, in which health care was determined to be one of the top driving forces for revitalizing the Japanese economy (Prime Minister of Japan and His Cabinet, 2013). Under this strategy, Medical Excellence Japan (MEJ) was established under the support of the MEXT in order to promote and expand Japanese health-care services. Additionally, at the G7 Ise-shima summit in 2016, health – with a strong focus on health security – was one of the main agenda items on which the Cabinet Office, MHLW, MOF and Ministry of Foreign Affairs (MOFA) worked together closely.

“The government regulates and controls nearly all aspects of the health system at three levels: national, prefectural, and municipal, where service delivery and implementation are mainly handled by prefectural and municipal governments. Several professional organizations such as the JMA and the Japanese Nursing Association (JNA) are also actively involved in health policy processes. The manner in which the MHLW interacts with these professional organizations, including the private sector, care providers and patients, is notably complex.”

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.

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

Page last updated March 25, 2025 by Doug McVay, Editor.