This article discusses two healthcare policies or systems “Primary Health Care (PHC)” and “Universal Health Coverage (UHC),” and also the issues surrounding the policy/system implementation. PHC is a term adopted in the Declaration of Alma Ata (1978), and UHC in the 2030 Agenda for Sustainable Development (2015). The objective of the two international instruments is to make health care available to everyone without financial concern. Partly due to the idealistic nature of PHC and UHC, implementation of each of the two has been and would be difficult for certain countries. Today, the 2030 Agenda for Sustainable Development demands that countries and organizations cooperate in UHC implementation. Some countries have expressed their willingness to cooperate in the implementation abroad, and Japan is one of them. This article examines the case of Japan as a UHC implementation cooperator. The problem is Japan’s competency. The country may not be competent enough to contribute as much as it hopes to, because it has yet to discover the resolution to its own domestic health-related issues such as population ageing and non-communicable disease prevalence that are related to UHC. Japan’s possible incompetency arises from the problems in its healthcare insurance and delivery systems.