We use newly released data on Japanese hospitals to explore patients’ perceptions of hospital quality, the implications of these assessments for the structure of demand for hospital care, and the role of the availability and quality of hospital care in influencing access. We find that the primary influences on hospital choice for Japanese patients are interpersonal aspects of care, that Japanese hospital markets are not segmented, and that availability has no influence on access. These results are interpreted in light of institutional differences between the Japanese and American health care systems.

In comparison with the postwar decades from 1945 to 1990, East Asian prospects for peaceful stability and economic growth have never been better. The Cold War confrontation between the Soviet Union and the United States has ended. The arms race that flooded the Pacific region with Soviet and U.S. nuclear weapons systems has been replaced by a gradual phasing out of tactical and intermediate missiles. The navies of the two superpowers are diminishing, albeit involuntary on Russia’s part. Moscow’s alliances with Pyongyang and Hanoi now exist only on paper. Washington’s bases in the Philippines were closed by mutual agreement.