Abstract
This contribution focuses on the meaning and challenges of realizing the right to health in Japan, based on the author’s experience with monitoring the right to health in Japan. The first section summarizes the outcome of monitoring the right to health in Japan, which includes the country’s legal commitments to the right to health, domestic laws, public health financing, and the state of people’s health. The second section explores the significance of this right in Japan, the policy approach to human rights, and the right to health as a guiding principle of relevant policies. It is suggested that a number of guideposts commonly accepted with respect to the right to health, in particular the notions of “availability,” “accessibility,” “acceptability,” and “quality” (“AAAQ”) as well as the notions of “accountability” and “participation” are important in Japan. The last section will focus on the challenges for Japan to implement the right to health, by creating a system to monitor human rights and using and developing human rights indicators at a national level.
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Notes
- 1.
- 2.
Japan has not ratified the Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families.
- 3.
Cf. the Shiomi case, Sup. Ct. Mar. 2, 1988 Hanrei Jihyo [Case Law Reports] No. 1363, p. 68.
- 4.
Tokyo District Ct. Apr. 23, 1997 Hanrei Jiho [Case Law Reports] No. 1651, p. 39. For a very similar approach before the Dutch courts see the Chapter on the Netherlands in this same volume.
- 5.
Inoue 2001 pp. 4–5.
- 6.
According to the latest data from 2012, Japan’s GDP was US$ 5,963.969 billion, making it third behind the US and China. This report uses data from 2009, when all of the related data came out, to allow comparison of the GDP and medical expenditures.
- 7.
WHO Western Pacific Region 2011.
- 8.
Ibid.
- 9.
Ibid.
- 10.
Ibid.
- 11.
Ibid.
- 12.
OECD 2013. This chapter uses statistical data from the WHO with regard to Japan’s health insurance financing, but the OECD and WHO have different statistical data for the year 2009, so specific numbers have been omitted. According to data from the OECD, the OECD average for national healthcare expenditures per capita was US$ 3,233 versus Japanese healthcare expenditures per capita of US$ 2,878. The OECD average for national healthcare expenditures as a share of GDP was 9.6 versus 8.5 % for Japan. The OECD average rate of increase in national healthcare expenditures was 4.0 versus 2.4 % for Japan.
- 13.
Op. cit. WHO.
- 14.
Op. cit. OECD.
- 15.
Op. cit. WHO.
- 16.
Ibid.
- 17.
Ibid.
- 18.
Op. cit. OECD. According to data from the OECD, there were 9.5 nurses (per 1,000 of population) in 2009.
- 19.
Op. cit. WHO. According to data from the OECD, there were 32.5 midwives per 100,000 females of population in 2009 compared to an OECD average of 69.8 midwives.
- 20.
Ibid.
- 21.
Ibid.
- 22.
Op. cit. OECD. The OECD average is 4.4.
- 23.
Op. cit. WHO.
- 24.
Op. cit. OECD. The OECD average is 6.7 %.
- 25.
Ibid. The OECD average is 117.
- 26.
Ibid.
- 27.
Ibid. Respective OECD averages are 208, 124, 52, 20, 20.1, and 22.4.
- 28.
Ministry of Health, Labor and Welfare 2013.
- 29.
Op. cit. OECD. Respective OECD averages are 6.5 and 16.9 %.
- 30.
Ibid. Respective OECD averages are 260.9, 71.6, and 70.5.
- 31.
Ibid. The respective OECD average is 0.16 % and 14.0.
- 32.
Hunt 2009 p. 21.
- 33.
UN CESCR 2000, para 12.
- 34.
A Health Insurance Certificate that is valid for several months as opposed to a normal Health Insurance Certificate, which is valid for 1 year (except in special circumstances).
- 35.
Ministry of Health, Labor and Welfare 2011.
- 36.
Japanese Medical and Dental Practitioners for the Improvement of Medical Care (Hodanren) 2010.
- 37.
Ministry of Health, Labor and Welfare 2010.
- 38.
UN CESCR 2001, para 49.
- 39.
Ibid.
- 40.
“MSV” is an abbreviation of “millisievert”. It is a unit of dose equivalence.
- 41.
Independent Commission to Investigate the TEPCO Fukushima Nuclear Accident (2012) Commission Report of the National Diet’s ICIFNA. (English version): http://warp.da.ndl.go.jp/info:ndljp/pid/3856371/naiic.go.jp/en/. Accessed 17 January 2014. The Independent Commission to Investigate the TEPCO Fukushima Nuclear Accident was an independent investigative body under the auspices of the National Diet. Based on the Act for the Independent Commission to Investigate the TEPCO Fukushima Nuclear Accident (enacted Oct. 30, 2011), the commission sought to explore the causes of the accident at TEPCO’s Fukushima Daiichi Nuclear Power Plant and offer suggestions.
- 42.
UN CESCR 2013, para 25.
- 43.
Ibid.
- 44.
UN General Assembly 2013.
- 45.
Ibid.
- 46.
Ibid, para 8.
- 47.
OHCHR 2012.
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Munesue, T. (2014). The Right to Health in Japan: Its Implications and Challenges. In: Toebes, B., Ferguson, R., Markovic, M., Nnamuchi, O. (eds) The Right to Health. T.M.C. Asser Press, The Hague. https://doi.org/10.1007/978-94-6265-014-5_4
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