War and Health Insurance Policy in Japan and the United States

World War II forced extensive and comprehensive social and political changes on nations across the globe. This comparative examination of health insurance in the United States and Japan during and after the war explores how WWII shaped the health care systems of both countries.Takakazu Yamagishi discusses the effect of total war on the development of health insurance in both countries and compares the two using four measures: political structure, the power of interest groups, the existing political culture, and policy feedback. During the war, the U.S. and Japanese governments realized that healthy soldiers, workers, mothers, and children were vital to national survival. While both countries adopted new, expansive national insurance policies as part of their WWII mobilization efforts, they approached doing so in different manners and achieved near opposite results. In the U.S., private insurance became the predominant means of insuring people, save for a few government-run programs. Japan, meanwhile, created a near-universal public insurance system. After the war, the nations further consolidated their respective insurance policy. Yamagishi argues that these disparate outcomes were the result of each nation's war experience. He looks closely at postwar Japan and investigates how struggles between the American occupation authority and U.S. domestic forces, such as the American Medical Association, actually helped solidify the country's existing health insurance system.Original and tightly argued, this volume makes a strong case for treating total war as a central factor in understanding how the health insurance systems of the two nations grew while bearing in mind the dual nature of government intervention -- however slight -- in health care. Those interested in debates about health care in industrialized countries and scholars of comparative political development especially will appreciate and learn from Yamagishi's study.