PurposeThe purpose of this paper is to examine the health sector reform toward 2040 of Japan as a super-aged society.Design/methodology/approachThis paper discusses the current healthcare policies adopted in Japan and projects the challenges in future as a super-aged society.FindingsThrough Japanese experiences, it is considered that Community-based Integrated Care System is useful, which takes into account the perspective of health care users. Being a super-aged society, it is essential for Japan to have more consensus by further removing obstacles, and paying attention to the change of paradigm and the purpose of care.Originality/valueBased on the case of Japan, this paper serves as a reference for other East Asian countries, which would sooner or later encounter the similar situation of becoming super-aged societies in the 21st century.