A Comparative Look at the Japanese Healthcare System

A Comparative Look at the Japanese Healthcare Systems The Japanese health care system is one of the most efficient in the world. In fact, it is so efficient that the people of Japan have the highest life expectancy rate of any other country in the world (The Economist, 2011). Life expectancy at birth was 83 years in 2009 ; 79. 6 for males and 86. 4 years for females (Wikipedia, 2012). The Japanese government has been able to accomplish this through strict regulations and policies.

Although this system has worked for the people of Japan since its institution in 1961, heir healthcare system is now facing financial ruins if changes are not implemented in the near future. It is my intent to explore why the Japanese health system has been able to function in a cost effective way and how it affects health outcomes. Japan has a universal health system called kaihoken (The Economist, 2011). Citizens are required to get insurance. Most people get it through their employers and are responsible for paying10%, 20%, or 30% of their healthcare costs depending on their family size and income.

The government covers the difference (Wikipedia, 2012). If a itizen cannot get coverage through an employer then they have the option of participating in a national health insurance program that is managed by the local government (Wikipedia, 2012). Japanese citizens are free to go to any physician or healthcare facility that they want and cannot be denied treatment (Wikipedia, 2012). Because of this freedom, Japanese citizens visit the doctor four times more than the average American does in a year (Wikipedia, 2012). Japan has strict regulations on the healthcare system that allows them to keep their costs down.

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Japan has about the owest per capita health care costs among the advanced nations of the world, at around $2,873 (Arnquist, 2009). They are able to do this for many reasons. The first being they set a fixed price for services and medications with physicians every two years. This way there is no question about what their compensation will be (Harden, 2009). Also, administrative costs are four times lower than they are in the United States, partly because insurance companies cannot set rates for treatment or deny claims. It is against the law for them to make profits or advertise to attract low-risk, igh-profit clients (Harden, 2009).

The downside to all of this is physicians in Japan are overworked and underpaid, making an average of about $125,000 by the time they are midway into their careers (The Economist, 2011). There is evidence that physicians and hospitals compensate for minimal reimbursement rates by providing more services. This is acceptable because the fee-for-service system does not limit the supply ot care comprehensively. Japan's physicians oversee almost three times as many consultations a year as their colleagues in other developed countries do. There s also a shortage of physicians within Japan, especially those who practice specialty medicine.

In Japan, physicians who practice primary care makes more money than their colleagues who practice highly specialized care (Arnquist, 2009). This is the complete opposite from American doctors. Some other issues that the Japanese healthcare system faces are an aging population and an overutilization of services. As stated earlier, Japan has the highest life expectancy rate in the world. This also means that the government will have to take care of more of their citizens' medical eeds for an extended period of time. It is estimated that by 2050 two-fifths of the population will be over the age of 65 (The Economist, 2011).

With an aging population and low birth rates, this puts a substantial strain on government spending. Another problem that Japan faces is an overutilization of services. By this I mean citizens are much more likely to go see a physician for minor illnesses because there are no restrictions on which they can see at any time, without proof of medical necessity and with full insurance coverage (Henke et. al. , 2009). Since everyone has access to edical care, long wait times in physician offices and overcrowding in emergency rooms are commonplace.

A report has shown that more than 14,000 emergency patients were rejected at least three times by hospitals in Japan before getting treatment (Wikipedia, 2012). The average length of a hospital stay is two to three times as long in Japan as in other developed countries (Henke et. al. , 2009). In contrast, the U. S. has a lower life expectancy than Japan at 78. 7 years (CDC, 2010). This is in large part to our high obesity rates and unhealthy lifestyles. The older population, those persons aged 65 years and older, makes up about 12. % of the U. S. population (AOA, 2013).

Both Japan and the U. S. have seen declines in their birthrates. But unlike Japan, Americans are less likely to seek medical care for minor ailments such as the Japanese. This is due to the fact that a large number of Americans have little to none insurance coverage. Those that do have coverage often have copays. Another vast difference between the two healthcare systems is the insurance regulations that many Americans encounter. It is not an uncommon practice for insurance companies to deny patients claims and not cover certain medical treatment.

The patients are then forced to appeal the claim, pay out of pocket, or simply do without the treatment that they needed. One would think that because the Japanese have so much access to health services that their health outcomes would be above average. This is not always the case. The physician shortage means long wait times and shorter consultations. Those that have complicated medical cases often do not get the proper amount of medical attention (The Economist, 2011). The Japanese are only a quarter as likely as Americans to suffer a heart attack, but twice as likely to die if they do (The Economist, 2011).

An oversaturation of hospitals also affects health outcomes. Research has shown that health outcomes are better when the centers and physicians responsible for procedures perform large quantities of them. Because Japan has so many hospitals, very few are able to achieve this (Henke et. al. , 2009). The small scale of most Japanese hospitals also means that they are inadequately equipped with intensive- care and other specialized units. Very few Japanese hospitals have oncology units. Theretore, a number ot ditterent departments in each hospi tal deliver care tor cancer Henke et. l. , 2009). In the U. S. physicians and nurse are required are certain number of Continuing Education hours every few years in order to renew their license. This helps them stay current with medical practices and sharpens their skills. In Japan, once a doctor or nurse is licensed, they are no longer required to further their education. There is no central agency oversees the quality of these physicians' training nor are there criteria for board certification in specialties (Henke et. al. , 2009). Despite some flaws, the Japanese healthcare system is able to do many hings well.

For one, the Japanese system is quite proficient in chronic care, particularly due to the fact that it has so many older people. Along with appropriate medical care, Japan also provides long-term care to all older people who need it through a public insurance system that started in 2000 (Henke et. al. , 2009). In Japan, a person's income does not influence the quantity and quality of medical care that they receive. Premiums and out-of-pocket costs are minor concerns for most people, and those whom have a low-income and the elderly receive subsidies to afford care Arnquist, 2009).

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