求翻译：医疗保险的运营由国家公共机关负责。考虑到医疗保险的特殊性质，日本的医疗保险的运营，采取由国家和地方政府或者具有类似资格的机构负责的方式。是什么意思？

4. Medical insurance operations by the national public authorities responsible for. Taking into account the special nature of the medical insurance, medical insurance carriers to take responsibility by state and local governments or agencies with similar qualifications.

4.health insurance business by the national public authorities are responsible for. Taking into account the special nature of the medical insurance, medical insurance in Japan to be taken by the state and local governments or institutions with similar qualifications in responsible ways.

4. medical insurance operation is responsible by National Public institution.Considered medical insurance special nature, Japan's medical insurance operation, adopts or has the similar qualifications organization responsible way by the country and the local authority.

4. medical insurance operations by national public authorities are responsible for. Taking into account the special nature of health insurance, Japan medical insurance operations, taken by national and local governments or bodies responsible way with similar qualifications.

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