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18 Bodenheimer, Thomas S., and Kevin Grumbach (1998) Understanding Health Policy: A Clinical Approach, 2nd ed. Appleton & Lange.

19 The Present State of Managed Care and the Feasibility of its Application to Japan Toshitada Kameda, M. D. Abstract As we approach the 21st century, all advanced nations are striving to build a healthcare system capable of providing high-quality healthcare to every citizen. Particularly, the healthcare system of the United States continues to challenge essential issues with their original approaches, while also facing the problems of a considerable number of uninsured citizens and higher healthcare costs than any of the other countries. Since 1980, managed care in the United States has been expanding at a pace rapid enough to bring about radical changed to the various healthcare systems, but it seems vague due to its variety and variation. It was born and developed in a private-insurance-centered system unique to the United States. It does not seem to easily apply to other healthcare systems in other countries, for example, in the social-insurance-centered healthcare system of Japan. However, from the standpoint of a provider, an insurer, a consumer and a payer, we have found the possibility of effectively applying the concept and method of managed care in various configurations and forms while preserving the advantages of the Japanese healthcare system. In this article, I will introduce the efforts of providers, insurers and consumers in Japanese-style managed care, look at each element of the managed care system of the United States, and examine the feasibility of adapting it more broadly to the Japanese healthcare system. Keywords:Managed care, Quality of care, Disease management, Japanese-style managed care Chairman of the Board, Kameda Medical Center

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