1. The Social Security System in the Prewar Days

• Japan's social security systems now provide public relief from risks which are beyond the scope of an individual's resources. In so doing, they contribute to the stability and development of the society and economy. However, it has not been such a long time since this system of public relief was established in a unified manner. It has been since 1874, after a centralized government had been established in Japan, when the Social Relief Regulations was enacted which provided rice to extremely poor people without family who could not engage in productive activities because they were too old, too young, sick or disabled. However, this was a system which assumed a spirit of mutual aid among blood relatives and neighbors, offering limited relief to people who would not receive such help. Later, a large number of people became needy during the prolonged depression which followed World War I, and in 1929, the Relief Law was enacted which clearly defined public relief obligations and expanded the range of beneficiaries.

• Japan's modern public health administration grew out of the introduction of the West-ern medicine and the measures against epidemics of acute communicable diseases, followed by measures against tuberculosis and high infant mortality. The main emphasis was placed on the concept of "social defense" for upholding the overarching national goals of increasing industrial production, national wealth and military power. For example, the Tuberculosis Prevention Law, which was established in 1919, was enacted out of a recognition that the prevalence of tuberculosis patients was sapping national strength. The establishment of the Ministry of Health and Welfare in 1938 was grounded on the decline in the physical strength of the Japanese people due to increased tuberculosis patients, and the consequent need for the establishment of an administrative system to deal with these problems.

• As the capitalist society developed in Japan in the 20th century, labor movement intensified, and the time was ripe for the introduction of a social insurance system. The essential programs of a social insurance system were established during this period, with the Health Insurance, a scheme of medical care insurance for employed people being established in 1922, a National Health Insurance system for the self-employed and farmers in 1938, and a pension program for workers in 1941. (In 1945, the medical insurance system covered about 60% of the whole nation.) The system received a devastating shock in World War II, placing it on the verge of total collapse. However, after the war, the recovering economy redirected the system toward universal medical care insurance and pension systems.

• Thus, this period saw the tentative establishment of a system of assistance to the needy, public health administration and social insurance. However, the system was characterized primarily by "charity" and "benevolence" which contribute to increased production, national wealth and military power, and it lacked the modern concept of "social security" which was introduced after the war.