Reconsideration of the Health Insurance Law of 1922

Abstract

This paper focuses on Japan’s first public health insurance legislation, passed in 1922 and implemented in 1926 （although provisions on insurance benefits and cost sharing went into effect in 1927）. In the plenary session of the 142nd Biannual Conference “The Pandemic and the Future of Social Policy,” I suggested that the Spanish influenza pandemic of a century ago, combined with a simultaneous rise in tuberculosis mortality, may have triggered a change in attitudes toward “health” and led to the Health Insurance Law’s enactment. The conference chairperson’s report was positive in that it “suggests that the pandemic penetrated into the ‘deep psyche’ of society and had the effect of changing people’s thinking and behavior on an unconscious level,” but it was empirically insufficient in that it lacked examination of the health insurance law itself. Therefore, we will reconsider the significance of the Health Insurance Act of 1922 and studies that have explained its passage as a concession by capitalists to the growth of the working class. This is an attempt at empirical research into social policy history.