Japan has a very unique healthcare crises based on it's aging population. The median age in Japan is over 9 years older than the United States and the population is continuing to get older. This crises would be very hard to deal with in any health care system, and it compounded by other pressures of taking care of an older population. Pensions programs are being stressed as the relative number of young workers are decreasing. Additionally the older population is likely to prefer economic policy that reduces inflation (to make pensions stretch further), making the working generations fight harder in international trade.

Japan's healthcare system doing so well given current stresses is a testimony to it's strength.