‘Getting Health Reform Right; A Guide to Improving Performance and Equity’: A monumental work.


Health Reform is without doubt a great issue in any nation of the world.  In Japan and the United States, too, it is counted as one of the most pressing challenges in national political agendas.

In each country, there exist complicated elements ? social, political, economical, cultural ? unique  to each society and country, but on the other hand, medicine and health care technologies are developing faster in speed.  There is no such health system which fits to every society and country.  Developed nations are struggling on how to reform existing system, which is one of the greatest challenges for policy makers of today.   In the world where information spread with no time, the gap between expectation and perception of the society and actual reality of the health care as they see receive continues to widen.

Large numbers of books on health care system are available including those which illustrate the reform carried out in many countries.  Any universal model does not exist, so each ‘leaders/experts’ must learn as much as possible and speak from better perspective, not only from the value of one’s position.  As I often point out in this web-site and elsewhere (Ref.1, 2), it seems that too many leaders/experts in Japan speak only from their limited personal experiences or positions, thus tend to be less objective and not much perspectives, visions for a bigger picture or longer time frame.

This is one of weak points of ‘Tate shakai (Hierarchical society)’ of Japan where the great majority of people pursue their careers in a linear style (i.e. within the same organization and often seniority-based) within Japan.

Several days ago, ‘How to Realize Health Care Reform’was published from Nihon Keizai Shinbun sha.  This is the translation of ‘Getting Health Reform Right; A Guide to Improving Performance and Equity‘(2nd edition, 2008) by Professors of Harvard School of Public Health, Drs Marc Roberts, William Hsiao, Peter Berman, and Michael Reich.  Japanese students who were taught by the authors translated it.  Please search for this book at Amazon.

What makes this book unique from other books of the same theme is that the authors have rich experiences in many countries, understand the difference of social backgrounds of each country; they write not only about policies but also analyses of five ‘Controllers’, i.e. ‘Finance, Expense, Organization, Rules, Actions’, and discuss ethical, political aspects (of the policy) as well as the processes that explain how reform is possible.  The content is very rich and outstanding

The book also provides the analysis of issues and situations pertinent to Japan, how to make reform possible, how policies being developed and advanced on what basis…   Everything is so well thought-out; they encourage us to see the health policy from overall perspectives, stimulate our practical thinking.

I would sincerely like to express my deep appreciation and respect to the four Professors of Harvard University who had written such a wonderful book as well as those who planned and carried out the publication of its Japanese translation.  It was my pleasure and honor to be asked to write a ‘recommendation’in Japanese ) in this book.

This is a book that I recommend strongly to anyone who cares about health policy.  The price seems a bit high (4,500 yen), but is well worth it.