The Partial Amendments to the Health Insurance Act that were passed by the Diet on June 14, 2006, decided the direction of subsequent health care system reforms in Japan. The amendments were made within a context of steeply rising medical expenditure for the elderly, and consisted mainly of measures to curve the medical expenditure by increasing the size of co-payments by the elderly, and by preventing lifestyle-related diseases.

Japan has undertaken the first major revision of its Long-term Care Insurance System (LTCI). LTCI is a national insurance program instituted in April 2000. This insurance program was enacted in response to an emerging awareness in Japan that satisfactory service delivery for older people requires the commitment of not only their families but also their community and the public sector.

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