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[Comment] Japan’s vision for health care in 2035

Over the past half century Japan has made remarkable achievements in good population health at low cost, with increased equity.1 However, a demographic shift towards rapid ageing, the growth of non-communicable diseases (NCDs), and advances in medical technology have led to great changes in health-care needs. In the Lancet 2011 Series on Japan: Universal Health Care at 50 Years, three major challenges to Japan’s health system were identified: sustainability, governance, and responsiveness.2 In that Series, several reforms were proposed to assure the sustainability and equity of Japan’s health accomplishments: implementation of human-security, value-based reforms; redefinition of the roles of central and local governments; improvements in the quality of health care; and a commitment to global health.