A Critical Discussion of Arguments Against the Introduction of a Two-Tier Healthcare System in Japan

Asian Bioethics Review 9 (3):171-181 (2017)
  Copy   BIBTEX


In medical ethics, an appropriate national healthcare system that meets the requirements of justice in healthcare resource allocation is a major concern. Japan is no exception to this trend, and the pros and cons of introducing a two-tier healthcare system, which permits insured medical care services to be provided along with services not covered by social health insurance, have been the subject of debate for many years. The Supreme Court ruled in 2011 that it was valid for the government to ban mixing medical treatments and both the Ministry of Health, Labour and Welfare and Japanese Medical Association oppose the introduction of such a system. In this paper, we examine the main arguments against the introduction of a two-tier healthcare system and ideas that form their basis, which can be broadly divided into opinions based on the importance of equality and those derived from the logical conclusion that the outcomes would be detrimental. We point out issues and shortcomings of each standpoint and argue that the introduction of the system would not necessarily threaten equality and social solidarity in Japanese society, and that abuses of a self-pay tier would be controllable to a certain extent. Then, the authors—who do not actively promote the introduction of a two-tier healthcare system—conclude that the allegation that is completely devoted to one side and the theory that social healthcare is collapsing, which makes the public excessively nervous, cannot be accepted.



    Upload a copy of this work     Papers currently archived: 89,764

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Limiting Solidarity in the Netherlands: A Two-Tier System on the Way.Ruud Ter Meulen - 1995 - Journal of Medicine and Philosophy 20 (6):607-616.
Healthcare Reform in Canada: The Romanow Report.Alister Browne - 2004 - Cambridge Quarterly of Healthcare Ethics 13 (3):221-225.
Just Healthcare? The Moral Failure of Single-Tier Basic Healthcare.John Meadowcroft - 2015 - Journal of Medicine and Philosophy 40 (2):152-168.
The Ethics of Aggressive Discharge Planning.Alister Browne - 2010 - Cambridge Quarterly of Healthcare Ethics 19 (1):75.


Added to PP

24 (#557,108)

6 months
2 (#652,396)

Historical graph of downloads
How can I increase my downloads?

References found in this work

Principles of biomedical ethics.Tom L. Beauchamp - 1979 - New York: Oxford University Press. Edited by James F. Childress.
On Inequality: Princeton University Press.Harry G. Frankfurt - 2015 - Princeton, N.J.: Princeton University Press.
Is There a Right to Health Care and, If So, What Does It Encompass?Norman Daniels - 2009 - In Helga Kuhse & Peter Singer (eds.), A Companion to Bioethics. Oxford, UK: Wiley‐Blackwell. pp. 362–372.

Add more references