Good afternoon, ladies and gentlemen.
I am Yoshitake Yokokura, President of the Japan Medical Association and the past president of theWorld Medical Association. I hope that this message will serve as an opportunity for young doctors
to become more interested in Universal Health Coverage (UHC) and contribute to the promotion
through UHC Youth Network.
The promotion of UHC became the global agenda as in December 2017, the UN General Assembly
adopted a resolution that proclaims 12th December as International UHC Day, and Prime Minister
Abe announced support with leaders in the global health field at the UHC Forum 2017 held in Tokyoon the 13th and 14th of the same month.
This movement is growing at a global level as in June this year, the first joint meeting of healthministers and finance ministers was held at the G20 Osaka Summit to gain a common understandingon the strengthening of UHC finance in developing countries. The UN High Level Meeting on UHC
is being held for the first time in September.
I heard that the theme of this year's International UHC Day is “KEEP THE PROMISE”. Everyone,
no matter where they live, should be able to receive the high quality medical services they needwithout facing financial difficulties, and the message aims to covey the implementation of “Healthfor all” to the world leaders.
Doctors must return to the origin of medical care, build a healthy and long-lived society and continue
to support it in this changing era of aging society. Regardless of the difference in the speed, this is amajor issue that each country should deal with in future.
The existence of the national health insurance system as UHC is indispensable behind the backgroundof raising the Japanese healthy life expectancy to the top level in the world. I am convinced that thenational health insurance system is a model that leads to an aging society that the world has neverexperienced to a safe society.
Japan has developed rapidly after the Second World War. The reason why we were able to achieve
this is because we had the national health insurance system that allows us to work in peace. The senseof security that you can receive medical care when you get sick has driven our growth.
The medical system based on the national health insurance system in Japan is highly regarded by theLancet, which is well known in the medical field, and regarded as a world model of UHC by theWorld Bank. This is based on Japan's experience with the national health insurance system over thepast 50 years, and we have high expectations of Japan's leadership in this field.

The Japan Medical Association will continue to contribute to the well-being of people all over theworld by disseminating this excellent medical system to the world.
The medical system in Japan began in 1927 with worker insurance, which was joined by employeesof large corporations. From around 1940, during the wartime system, medical insurance in somemunicipalities began and the number of those insured also increased. However, due to the confusion
after the end of the war in 1945, the medical system has fallen into a devastating situation.
In December 1956, the Ministry of Health and Welfare resubmitted the amendment to the Health
Insurance Act. The amendment was intended to control medical costs by strengthening bureaucratic
control over the entire health care system and putting stricter limits on the practice of doctors.
In April 1961, health insurance societies were established in all municipalities, the citizens wereobliged to join them and the national health insurance system was achieved. A medical aid system
was applied to those who could not join due to economic reasons, and UHC was achieved in which
all citizens join public medical insurance.
At the end of the 20th century, with the progress of aging population, the need for elder care increased,such as an increase in the number of elderly people requiring nursing care and a prolongation ofnursing care period. Therefore, the Long-term Care Insurance Act was enacted in December 1997
under the Japan Medical Association's claim that elder care should be supported by society as a whole
as it is part of medical care. The nursing-care insurance system has started in April 2000.
In future, social security expenses are expected to increase in the medical and nursing care fields as
the population ages. In the context of fiscal austerity, pressure is expected to narrow insurance
coverage in the name of growth strategies and deregulation.
In Japan, free access to outpatients contributes to early detection and treatment of diseases. By first
visiting the “family doctor” who plays the central role in this, we can expect medical expenses to be
optimised through appropriate patient’s behaviour, correction of duplicate medication, prevention ofmultiple medication, etc.
There is an opinion that "medical care is consumption", but social security and the economy are in aninteractive relationship. Economic growth supports the financial base of social security, while thedevelopment of social security supports the basics of the Japanese economy through production
inducement effects and employment inducement effects.
Improving the level of public health through the expansion of medical care contributes to economic
growth and social stability. This is clear from the fact that, as I previously mentioned, after achieving
the national health insurance system in 1961, Japan has the highest life expectancy in the world andachieved dramatic economic growth. Furthermore, it is necessary to enhance social security when thepublic's anxiety increases so that citizens can retire with peace of mind. Reassuring many citizens

who are worried about their retirement is also a starting point for regaining economic growth.
In addition, it has been pointed out that people are worried about future social security and that is afactor of slumping personal consumption. Enhancing social security through increase in public
spending due to an increase in social security resources, the promotion of innovation through taxation,
subsidies, and the use of public and private funds will lead to economic growth by creating demandand expanding employment opportunities. And I believe that it is necessary to eliminate the publicanxiety by realising a virtuous cycle in which economic growth increases wages and further enhances
social security.
The role of doctors is to protect the health of the people, and a group consisting of these doctors is
the Medical Association. Under the slogan of the Japan Medical Association Charter, the Japan
Medical Association is striving to realise the medical supply system that is truly required by thepeople by claiming to protect the health of the people and national health care and with a highphilosophy.
Professor Hirofumi Uzawa, a Japanese economist who taught at the University of Chicago's
Faculty of Economics in the 1960s, called a social device that helps all people to have a good lifeand maintain an attractive society as "social common capital". As with the natural environment,roads, water supply, electricity, education, etc., medical care is placed as one of them.
I think the essence of medical care, in other words, what medical care should be is shown here. I
will promote UHC under the ideal that medical care will be the “social common capital of the entireworld”.
Last but not least, looking ahead to future medical care, it is very important to train young doctors tomeet the needs of the times and to create an environment that will produce the results. To that end, I
would like to firmly support the activities of the World Medical Association Junior Doctors Network.