Abstract
Japan is one of several East Asian countries that share an ethical system of mutual support. A review of Japan’s health care system reveals a strong egalitarian ethos often considered unique by outside observers.
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Beware of Japanese linguistic use—a memo was left after Clinton’s meeting with Yeltsin,The Asahi Shimbun, April 5, 1993; US tries to soothe Tokyo after remark by Clinton,International Herald Tribune, April 6, 1993.
Kuwabara, M. (1989).Races and Language Cultures in Southeast Asia (in Japanese), Hodaka Shoten, Tokyo.
Keeler, W. (1984).Javanese: A Cultural Approach, Ohio University, Athens.
Ohi, G. (1995). Ethical orientations and dignified death.Psychiatry & Clinical Neuroscience 49(suppl. 1), S155-S159.
Lipset, S.M. (1996).American Exceptionalism, W.W. Norton & Company, New York.
Watsuji, T. (1962).The History of Japanese Ethical Thoughts (in Japanese), Iwanami Shoten Publishers, Tokyo.
Brunt, P.A. (1971).Italian Manpower: 225 B.C.-A.D.14, Oxford, London, pp. 121–130.
Jinno, S. (1986).Ritsuryo Nation and Humble People (in Japanese), Yoshikawa Kobunkan, Tokyo.
Marmot, M.G. and Smith, G.D. (1989). Why are the Japanese living longer?British Medical Journal 299, 1547–1551.
Samson, G. (1974).A History of Japan to 1334, Tuttle, Tokyo. In addition, according to Watsuji [7], not only the fief she had inherited before marriage, but the fief which her husband had bequeathed would be also retained by her after divorce unless there was a serious fault on her side. Moreover a woman was entitled not only to become a gokenin but also to exercise the rights as a parent following the death of her husband.
Saruya, K. (1991).The History of America—Traces of Great Power (in Japanese), Chuo Sinsho (quality paperback series of Chuo Koron), SHA, Inc., Tokyo. The woman’s inferior legal status actually reflected the model in England.
Ikegami, C. (1972).History of Women’s Liberation in America (in Japanese), Aki Shobo, Tokyo.
Ohi, G. (1993). Human and policy factors accelerating the demographic transition in the post-war Japan. Presented at theWorld Bank Conference, Seoul, April 1993.
Hashimoto, M. (1955).Public Health and Organized Health Activities (in Japanese), Seishin Shobo, Tokyo.
Shimao, T. (1992). Contribution of health toward economic development.Information and Review of Tuberculosis and Respiratory Disease Research 1, 50–62.
Muramatsu, M. (1978). Estimation of induced abortions, Japan, 1975.Bulletin for the Institute of Public Health 27, 93–97.
OECD Health System (1993).OECD Health Systems—Facts and Trends 1960–61, Health Policy Studies No. 3, Head of Publications Service, OECD, Paris.
Marmor, T.R. (1992). Japan: a sobering lesson.HMQ Third Quarter 1992, 10–14.
Futagi, R. (1994).Time has come to reexamine the health policy enforcing the most strongest cost containment in the world (in Japanese), Keiso Shobo, Tokyo.
AMA may sue over medical price controls,Los Angeles Times, June 15, 1993, A25.
Iglehart, J.K. (1988). Health policy report: Japan’s medical care system.New England Journal of Medicine 319, 807–812.
Cost Finding Survey of Hospitals in Japan (1990), National Hospital Federation of Japan, Tokyo (in Japanese).
Kosaki, M. (1990). Medical cost of organ transplantation,Karadano-Kagaku (Popular Medicine)155, 64–68 (in Japanese).
Watanabe, T. (1994). Restarting primary care.Japanese Journal of Primary Care 17, 276–284 (in Japanese).
Okamoto, K. (1992).Education of the Rising Sun—An Introduction to Education in Japan (in Japanese), Sun Printing, Tokyo. He states: ‘As to the origin of the teaching style based on egalitarian ethos, we can trace back to the very beginning of the primary education: after the Meiji Restoration in 1868, boys and girls were treated equally regardless of their former class origin such as samurai or farmer. All elementary schools were of the equal nature without difference. This contributed in turn to the quick disappearance of the class system.’
Hijikata, S. (1994).Schools and Communities of Modern Times in Japan (in Japanese), University of Tokyo Press, Tokyo.
Sugiyama-Lebra, T. (1992). Self in Japanese culture. InJapanese Sense of Self, ed. by N.R. Rosenberger, Cambridge University Press, Cambridge. Regarding ‘Kokoro’ Okamoto asserts that: ‘The concrete components of the enriched “kokoro” include such diverse items as the following: respect for life of human beings and animals, ability to positively consider one’s way of life, attitude to seek truth, sensitivity to beauty and the sublime, respect for nature, sympathy and generosity, gratitude to others, autonomy and self-control, contribution to the public interests, egalitarian attitude, cooperation with others, sensitivity to morality, good habits and manners in daily life, etc.’ [26].
Lewis, C.C. (1995).Educating Hearts And Minds, Cambridge University Press, New York.
Stevenson, H.W. and Stigler, J.W. (1994).The Learning Gap, A Touchstone Book, Simon & Schuster, New York. They made an interesting observation in this respect: ‘Tracking does not exist in Asian elementary schools. Children are never separated into different classrooms according to their presumed levels of intellectual ability. The egalitarian philosophy carries over to organisation within the classroom. Children are not separated into reading groups according to their ability; there is no division of the class into groups differentiated by the rate at which they proceed through their mathematics books. No children leave the classroom for special classes, such as those designed for children diagnosed as having learning disabilities. Schools in the United States are organised to meet what are perceived to be the individual needs of each child. Within classrooms, it is assumed that individual differences among children are so great that it is necessary to divide the classroom into separate groups, each proceeding through the curriculum at a different rate. Children who have been diagnosed as having intellectual, emotional, or educational disabilities are assigned to special programs or attend special classes part of every day.’
Sekai Kokusei Zue (A Charted Survey of the World) (1994). The Tsuneta Yano Memorial Society, ed. Kokusei-sha, Tokyo (in Japanese).
Korekarano Zaisei to Kokusai-Haktou (1987). Okura Zaimu Kyokai, Tokyo (in Japanese).
Detroit’s fat cats.Time, 20 January, 1992.
The Nihon Keizai Shimbun, 1 July, 1993.
The Asahi Shimbun, 26 May, 1996.
World Development Report 1993, Investing in Health (1993), World Bank, Oxford University Press, Oxford. Regarding this issue, indeed many Japanese were appalled by the news that in 1992 the CEOs of American industry amassed $3840000 in average, while the blue collar workers had the average income of $24000 [34]. The former figure indicates six-fold increase compared to 1980 and the latter only 60%. When the US economy is lagging internationally, why are the CEOs justified to earn the income which is 160 times greater than the production workers?
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Ohi, G., Akabayashi, A. & Miyasaka, M. Japan’s egalitarian health care system: A brief historical analysis. Health Care Anal 6, 141–149 (1998). https://doi.org/10.1007/BF02678120
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DOI: https://doi.org/10.1007/BF02678120