Commonwealth Fund–supported research published in Health Affairs (May 2012) by Naoki Ikegami, M.D., Ph.D., and Gerard Anderson, Ph.D., focuses on how Japan has been able to contain health care spending as a share of gross domestic product to about half the level seen in the United States. Japan, which has universal insurance coverage, has been able to maintain access to care and avoid rationing, while still taking advantage of the latest medical technology, in part by applying a standardized fee schedule for nearly all health care goods and services.