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Pandemic influenza A(H1N1) vaccination in Japan has been run as a governmental project. In order to secure a sufficient amount of pH1N1 vaccine, the government enacted a new law of governmental compensation for death or health damages caused by pH1N1 vaccines and announced to issue exceptional authorization of production and distribution for two pH1N1 vaccines produced by international manufacturers.
The Japan Obstetric Compensation System for Cerebral Palsy was established in January 2009 with collaboration of the government and obstetricians. It aims to help children having delivery-related disabilities and their parents to promote urgent settlements of disputes in relation to delivery, and to improve the quality of maternity care. The system is essentially based on a private insurance scheme and operated by an independent body in cooperation with private insurance companies.
The government revised its strategy for developing ICT that gives priority to the health care sector. The strategy includes conversion to e-billing in public health insurances, development of personalized health information systems and promotion of remote health care, electronic medical records, and comprehensive information systems for health care.
The Democratic Party of Japan, taking office by its landscape victory at the 2009 Lower House election, has declared that it will stop the collapse of the medical system and take the anxiety on it prevailing in Japanese society. Specific measures include: to increase health care expenditure and human resources, to develop measures against major health problems, and to abolish the Health Insurance for the Old-Old.
The Government reviewed its 2004 vision for reforming mental health and welfare services. The vision has tried to transform hospital-centred mental health care into community-based care for people with mental disorders by developing community services and reducing psychiatric hospital beds. The review recognized little change in the number of hospitalized patients and proposed new policy initiatives.
After the formal establishment of the Japan Health Insurance Association in 2008, the Government published a new rule for setting premium rates for the insured at local branches. The current single countrywide rate will be replaced by different rates varying with local health expenditures, demographic structures and incomes. After discussions with local representatives of the JHIA, the Government decided to introduce a measure to mitigate drastic increases in the financial burden of the insured.
In April 2008, the Government implemented a new insurance scheme for the elderly aged 75 and older, named 'Health Insurance for the Old-Old'. It established new insurance bodies and intended to ensure funding health care for the elderly by clarifying responsibilities. Despite the apparent necessity of handling increasing health expenditures, the policy received strong objections by the opposition parties, media and the elderly when implemented.
The Government has been promoting end-of-life care at home or at nursing homes, rather than at hospitals, which is expected to increase patients' choices of places to get care. In 2006, a special fee schedule for clinics registered for providing planned home care was introduced, which highly values care in communities. In addition, in 2007, the Government issued a guideline on processes of decision-making in end-of-life care, and fosters awareness of choices where to die.
In 2006, the Government declared to decrease the number of long-term care beds in hospitals by 2012 to promote community care and to mitigate the increase in hospital care costs. To achieve the goal, Government introduced differentiated payments to hospital long-term beds according to medical need, and facilitated conversion of those beds into nursing home or community-based services through subsidies and deregulations. In addition, prefectures made plans on reorganization of long-term care.
To develop collaboration between acute and rehabilitative hospitals, the Government has introduced additional payments to hospitals that have established formal collaboration structures through joint clinical pathways for treatment of hip replacement and stroke. Hospitals have tried to establish collaboration in various ways and developed professional networks, better collaboration, and more simultaneous diffusion of knowledge.