February 20182017 Survey on Healthcare in Japan
1．Summary
The Health and Global Policy Institute has been undertaking regular surveys of public opinion on healthcare issues since 2006 in order to gain a better understanding of
public perceptions and a better awareness of the health services and health care policies that the public desires. Continuing on from previous surveys, the 2017 survey
included questions on the level of satisfaction that the public feels with the current healthcare system. The survey inquired also about the public’s perception of annual
upward trends in medical costs, and how they are reacting to this. Moreover, the survey included questions on issues that have been garnering attention recently, suchas measures to prevent passive smoking, the self-medication tax deduction system, dementia, end-of-life expectations, and degrees of trust in various sources of medicalinformation.
(1) Survey highlights

 Respondents were divided on their overall degree of satisfaction with the healthcare system.
 In particular, there was low satisfaction with the degree of public participation in shaping the healthcare system, and the fairness of the decision-making processes in thesystem.

 Regarding passive smoking, about half of respondents backed a full ban on smoking in eating and drinking establishments, irrespective of the establishment’s floor space.
 66% of respondents believed that e-cigarettes should be targeted as soon as possible in preventive measures against passive smoking.
 About 90% of respondents were unaware of the self-medication tax deduction system.
 Over 50% of respondents approve of remote doctor oversight for death pronouncements.
(2) Healthcare policy based on survey results (future discussion points)

 Although efforts have been made to promote participation among the public in medical institution decision making, further measures to encourage more active participationand improved process transparency could be future issues.

 Measures against passive smoking affect human life as public health policies. The realization of highly effective passive smoking countermeasures may also be a future issue.

■ Overview of survey
 An internet-based public opinion survey was administered to 1,000
males and females over 20 years of age throughout Japan, during

2017 Survey on Healthcare in Japan – Respondents

Figure 1

November 2017. The breakdown of respondent demographics isshown in Figure 1. The survey was only administered to those whogave informed consent after having read an explanation of thesurvey’s objectives. The questionnaires were self-administered, and aserial number was given to each respondent to ensure anonymity.

• Survey period: November 2017
• Survey type: Internet survey• Respondents: 1,000 nationally representative males and females aged 20 and above, selectedfrom the monitor panel of the research firm that conducted the survey• Number of valid responses: 1,000• Breakdown of respondent demographics
Area The conduction of a survey on the internet introduces a fixedsampling bias in that it selects only for respondents who can use theinternet, and hence have a certain level of education, as internet
literacy is generally correlated with education level.1 It is important toAge group• Hokkaido - Tohoku• Kanto• Chubu• Kinki• Chugoku – Shikoku• Kyushu - Okinawa

11.7%
33.8%
16.9%
17.6%
8.8%
11.2%

Sex

• 20’s• 30’s• 40’s• 50’s• 60’s• 70 and above

take this limitation into account when interpreting the results of this

11.4%
14.9%
17.5%
15.3%
17.6%
23.3%

• Male• Female

48.5%
51.5%

Source: Specified non-profit corporation Health and Global Policy Institute –2017 Survey on Healthcare in Japansurvey.

■ Survey results
１．Passive smoking
About half of respondents support a total ban on smoking in eating andPassive smoking

drinking establishments, irrespective of the establishment’s floor space.
 On the question of whether a complete or partial ban on smoking
should be introduced for drinking and eating establishments
depending on their floor space, 49.9% of respondents selected theFigure 2

Question: “This is a question regarding preventive measures against passive smoking in eating and drinking
establishments. What do you think of the proposition to impose a complete or partial ban on smoking to drinking andeating establishments depending on their floor space?”（November 2017; n=1,000）

I don'tknow
10.3%

answer, “a total ban should be applied irrespective of establishment

floor space.” 6.3% chose “smoking should be tolerated, irrespectiveof establishment floor space,” and 33.5% that “the matter ofwhether to impose a complete or partial ban on smoking should bedecided based on the establishment’s floor space” (Figure 2).

The matter of whether toimpose a complete orpartial ban on smoking
should be decided basedon the establishment’s
floor space
33.5%

Smoking should betolerated irrespective of
establishment floor space
6.3%

A total ban should
be appliedirrespective of
establishment
floor space
49.9%

Source: Specified non-profit corporation Health and Global Policy Institute –2017 Survey on Healthcare in Japan

Commentary
Currently in Japan, there is much debate on using floor space to apply complete or partial bans on smoking in eating and drinking establishments. However, about halfof the respondents of this survey appear to agree with a complete ban on smoking in such establishments, irrespective of floor space.
1) Smith MA, Leigh B. Virtual subjects: using the Internet as an alternative source of subjects and research environment. Behav Res Meth Instrum Comput.
1997;29:496–505.

Survey results（Excerpts）
２．Degree of satisfaction with medical care and the healthcare system
Respondents were divided on “Overall degree of satisfaction with the healthcare system”
 Less than half (47.0%) of respondents were either very satisfied or somewhat satisfied overall with the healthcare system.
 Comparatively higher levels of satisfaction (including “somehow satisfied”) were seen related to “accessibility to medical institutions” (53.7%), the “quality of technology
in diagnosis and treatment” (52.9%), and “medical safety” (48.3%) (Figure 3).
 The lowest levels of satisfaction were seen for “public participation in shaping the system (whether the voices of the citizens are accounted for)” (21.0%) and “fairness ofthe decision-making process (transparency of the system-building process)” (21.8%) (Figure 3).

Commentary•

Free access to healthcare facilities, a characteristic featureof medical treatment in Japan, received the highest level ofOverall degree of satisfaction

4.0%

Quality of technology in diagnosis and treatment

5.9%

Medical safety

4.4%

Availability of information about medical institutions and treatments

3.6%

On the other hand, remarkably low levels of satisfaction

Incorporation of patient's opinion into courses of treatment

3.5%

Individual out-of-pocket costs

4.5%

with the “public participation in shaping the system” andFairness in the healthcare system*1

7.0%
2.9%

satisfaction.
•Degree of satisfaction with medical care and the healthcare system

the “fairness of the decision-making process” suggest that

Equality of healthcare cost burden sharing among generations
Comprehensibility of information and procedures in the healthcare system
Public participation in shaping the system

citizen opportunities to participate in the policy decision-

Fairness of the decision-making process

1.9%
1.9%
2.3%
3.1%

Quality of service for patients*2

making process are insufficient, and a substantial number
are dissatisfied with the transparency of the system.
•

Henceforward, it is important to further involve the public in
the decision-making process and improve transparency.

Figure 3（November 2017; n=1,000）

0%Very satisfied

Somewhat satisfied

47.0%
43.9%
36.6%

28.9%

5.8%

33.6%

8.1%

18.2%

34.2%

19.1%

36.5%

19.5%

36.1%

30.9%

20.3%

11.4%

15.5%

15.0%

17.7%

16.3%

20.8%

16.0%

20.7%21.8%

19.8%
37.6%
23.8%
50%

Very dissastisfied

22.3%
13.4%

44.3%
40%

16.1%
16.7%

38.5%

30%

14.5%

9.1%

26.3%

22.8%

20%

13.3%

6.8%

32.8%
35.7%

36.2%

Somewhat dissatisfied*1 Unrelated to economic equality, all citizens of Japan may receive the same medicaltreatment*2 Unrelated to the type of services (Health personnel’s conduct, health facility environment,
waiting time etc.)

29.8%

28.1%

10%

11.2%

25.8%

37.8%

9.4%

Accessibility to medical institutions

28.5%

43.0％

60%

70%

15.0%8.7%

13.8%

80%

90%

100%

I don't know

Source: Specified non-profit corporation Health and Global Policy Institute –2017 Survey on Healthcare in Japan

３．Self-medication tax deduction system
Figure 4

Self-medication tax deduction system

About 90% were unaware of the self-medication tax deduction
systemQuestion: “Are you aware of the ‘Self-medication tax deduction system’?”（November 2017; n=1,000）

 11.1% of respondents were knowledgeable about the details of

I am knowledgeable about its
details
11.1%

the self-medication tax deduction system, while 33.7% were
aware of the term but not its exact meaning, and 55.2% were

unaware (Figure 4).
I am aware ofthe term but notits exact
meaning
33.7%

I am unawareof it
55.2%

 62.5% of respondents either “Want to actively make use of it(the system)” or “Want to make use of it to an extent” (Figure 5).

Source: Specified non-profit corporation Health and Global Policy Institute –2017 Survey on Healthcare in Japan

Commentary•

The self-medication tax deduction system has been in place

Figure 5

Self-medication tax deduction systemsince January 2017. Yet, the results of this survey suggestthat the number of people who are familiar with the detailsof it is still small.
•Question: “Do you want to make use of the ‘Self-medication tax deduction system’?”（November 2017; n=1,000）

However, after respondents were given an explanation ofI do not wantto make use of it at all
12.2%
I want toactively
make use of it
20.0%

the system and questioned on whether they would makeuse of it, over 60% said they would.
•Incidentally, a similar proportion of over 60% wanted tomake use of the system across all age groups. In light of this,
it is necessary that more effort be made to raise awarenessabout the existence of this system

I do not reallywant to makeuse of it
25.3%
I want to make use of it
to an extent
42.5%
Source: Specified non-profit corporation Health and Global Policy Institute –2017 Survey on Healthcare in Japan

Health and Global Policy Institute Tel: 03-4243-7156 Fax: 03-4243-7378 E-mail: info@hgpi.org
The full report of the survey can be accessed on our website（https://www.hgpi.org/)