Japan’s health care system supports the world’s longest lives

Oleg Borodin

By Shiv Sudhakar

See more of our trusted coverage when you search.Prefer Newsweek on Googleto see more of our trusted coverage when you search.

Japan’s aging population relies heavily on the nation’s health care system. Experts point to the physician-led governance, mandatory long-term care insurance and community-based integrated care as key elements of a system designed to support longevity, alongside various social programs, but the system will see increased strain in the coming decades.

The World Economic Forum estimates that nearly 30 percent of Japan’s population is age 65 or older, making it the world’s oldest population. The 14,125-island nation is home to nearly 100,000 citizens aged 100 or older, the country’s health ministry reported in 2025.

Experts say the reasons for such longevity are nuanced—dietary patterns, public health measures, education, social conditions and health-related behaviors—all of which are intertwined with having a supportive health care system.

Read More on Health Care

“Japan’s health care system has been a relative success,” Dr. Naoki Ikegami, emeritus professor at Keio University in Tokyo, told Newsweek.

Japan operates under a universal health coverage system, which was established in 1961. By law, participation is mandatory for everyone living in the country—including foreign nationals.

Anyone who lives in the country for at least three months is required to have insurance, either through Employees’ Health Insurance for salaried employees or the National Health Insurance system for those who are self-employed, unemployed, retired or anyone who permanently lives in Japan for three months or more, according to The Commonwealth Fund.

Copays vary depending on level of care, but patients are generally protected from high insurance costs.

“Costs have been controlled by the national government, which sets the fees...for virtually all health care services and pharmaceuticals,” Ikegami said.

“As the population has aged, Japan has developed one of the world’s most structured post-acute and long-term care systems, with rehabilitation hospitals, long-term care hospitals, nursing homes and home-care services operating within interconnected care pathways,” Meilin Möllenkamp, head of health care analysis at Statista, told Newsweek.

But the health care system faces significant challenges as the population ages, which may rise to over 40 percent for those 65 and older by 2060.

“Workforce shortages, particularly among nurses, caregivers and rehabilitation professionals, remain a defining operational challenge for aging-care systems such as Japan’s,” Möllenkamp said. “These pressures are often more pronounced in rural and highly aged prefectures, where health care systems face high and increasing levels of demand alongside constrained workforce availability.”

The financial sustainability of hospitals is also a concern as hospitals increasingly have limited ability to pass rising labor, energy and supply costs on to payers, Kazunari Onishi, associate professor in the graduate school of public health at St. Luke’s International University, told Newsweek.

“Strengthening preventive care, promoting healthy aging and improving the efficiency of health care delivery will be increasingly important to maintain both population health and the sustainability of the health care system,” Onishi said. “The challenge will be not only helping people live longer but also helping them remain healthy and independent for longer periods of life.”

View 0 Comments

Request Reprint & Licensing

Submit Correction

View Editorial & AI Guidelines