An overview of the role of government in the organisation and provision of health services in Japan.

This article is illustrated with reference to health services in the Tokyo Prefecture. It seeks to describe the role of government in the organisation and provision of health services in Japan. It is based on experiences gained from a three-month placement at the Tokyo Metropolitan Government Bureau of Public Health in late 1994. Wherever possible the article identifies similarities and differences between the Japanese and Australian health care systems. Part of the analysis has been to identify areas where opportunities exist for Australian health service providers to develop further cooperation with particular sectors of the Japanese health system and also where the potential for the export of health services may exist. The health systems of Australia and Japan have points of similarity and difference. Essentially both systems operate within the context of a compulsory universal health insurance system. However, unlike Australia, the bulk of service provision in Japan is left to the private sector, while government retains the primary role of regulator. It is interesting to observe that while the Australian health care system is currently exploring options to expand the service range and level of participation of private sector services in health care delivery (within the context of universal health insurance), the Japanese health care system appears to be examining options through which further government intervention can improve service access and service efficiency. Japan presents opportunities to observe the benefits and disadvantages of predominantly private sector provision within the context of universal health insurance coverage.