This paper aims to discuss the focus on physical activities in health promotion policies in the past two decades in Japan. In the mid-2000's, the Japanese government decided to make medical insurance programs and the public nursing care system more prevention-oriented. They intended not only to reduce the expenses for medical and nursing care, but to assign incentives or penalties to insurers according to their efforts for reducing health-related risks such as the effectual implementation of health checkups and health guidance. The insured persons, as well, began to receive incentives from their health insurance organization or health programs based on their efforts to lead a healthy lifestyle.