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As a Japanese clinician working under universal health coverage in Japan, I feel great discomfort with regard to Prime Minister Fumio Kishida's Comment.1 There is currently an overwhelming shortage of health-care workers in Japan, and hospitals are largely unable to provide necessary health care to the general public.2 In addition, after April 1, 2024, it will be illegal for clinicians to work more than 960 h of overtime per year (and no more than 100 h of overtime per month),3 and no adequate funding has been provided to account for the impending shortage. This shortage is similar to that of the National Health Service in the UK.4 Furthermore, in Japan, the construction of a large facility to house people infected with COVID-19 was not completed before the pandemic's peak, and the project was subsequently closed when it became irrelevant. This expenditure demonstrates the incredibly inefficient management of health-care funds that currently takes place. Moreover, the Japanese clinics that provide primary care are private, not public. Although 80% of medical facilities are private, the Government sets the medical fees, meaning there is no price competition, and clinicians are forced to work for lower wages than in most other G7 countries. A US politician aptly described the situation as follows: “The Japanese medical system is maintained by the saintly self-sacrifice of medical workers.”5

rivate, the Government sets the medical fees, meaning there is no price competition, and clinicians are forced to work for lower wages than in most other G7 countries. A US politician aptly described the situation as follows: “The Japanese medical system is maintained by the saintly self-sacrifice of medical workers.”5 Lastly, the Japanese Government advocates a 100 days mission (ie, a plan to reduce the impact of future pandemics by making diagnostics, therapeutics, and vaccines available within 100 days), but as of 2023, there is still no COVID-19 vaccine produced in Japan. Meanwhile, the USA, EU, China, and Russia completed their own clinical trials for COVID-19 vaccines by the end of 2020. For these reasons, I believe that Kishida's “Japan's vision” is too far removed from the reality of the current situation.1 This online publication has been corrected. The corrected version first appeared at thelancet.com on April 20, 2023 This online publication has been corrected. The corrected version first appeared at thelancet.com on April 20, 2023