directive issued in February 1946 setting out occupation goals in the area of social policy
called for the creation of a single government agency to administer a range of expanded
government programs in areas such as pensions, unemployment insurance, and public
assistance (Milly 1999: 103). Reflecting the influence of New Deal thinking, many of
these SCAP proposals came directly from the 1945 platform of the American Public
Welfare Association (Tatara 1982: 321).
On the issue of health insurance, for example, the Labor Advisory Committee
praised Japan’s comprehensive if fragmented system of social insurance and compared it
favorably to other western nations, especially “the broad coverage of the National Health
Insurance program…in providing health security for farmers and self-employed persons”
(SCAP PHW 1946d: 5). However, the Labor Advisory Committee report also concluded
that “a comprehensive reform of social insurance can and should be undertaken” (ibid: 1).
In particular, the interim report dated 5 April 1946 noted that with separate programs for
government employees, industrial wage earners, farmers, and the self-employed, PHW
should consider “the feasibility of consolidating some or all of these programs into a
unified, comprehensive social insurance system” (SCAP PHW 1946a: 2). Such a
comprehensive reform would likely resemble the kind of universal national health system
emerging in postwar Britain at the time. In fact, when addressing the matter of doctors’
compensation in its final report of May 1946, the committee noted that, “consideration
should be given to a compensation scheme patterned on the British model” (SCAP PHW
1946d: 15). That is, the committee recommended that doctors receive compensation
based on the number of patients seen, as envisioned in the National Health Service Bill
under review at the time in the British House of Commons.
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Convention