In the American health care debate, some reformers point to other countries’ medical models for guidance. Along with the United Kingdom, France and Germany, some say Japan’s medical health insurance system looks like a good model to copy.
The United States: Health care is about 15 percent of gross domestic product (GDP). Employer-purchased insurance is the norm. Some people buy individualized plans. Public programs are in place for the very poor. Federally-funded Medicare covers people over 65 and some people with disabilities. Estimates put the number of uninsured Americans at around 47 million. Last night, the U.S. Senate agreed to debate health care reform.
Japan: Japan’s system comprises about 8 percent of GDP and coverage is said to be universal. Japanese pay about half as much as Americans for care. The government sets prices for health services and prescription drugs, limits doctor fees and bans insurance companies from making large profits and denying claims.
Insurance is compulsory. Employers purchase insurance for their workers, or one buys into a public plan. People can pick their own primary care physicians and specialists. This, plus healthier eating habits and lower crime rates have allowed Japanese to have a life expectancy of 82.5 years.
But as with most things, there are tradeoffs. Doctors in hospitals are underpaid compared to their
counterparts working in private clinics. There is a shortage of obstetricians, anesthesiologists and emergency room specialists. Japanese experts attribute this to low pay, long hours and high stress.
As Japan’s population continues to age, the model looks unsustainable. Projections put the number of Japanese 65 or older at 40 percent by 2050.
The Japanese Medical System
By About Japan editors
October 29, 2009
Health Care in Japan: Low-cost For Now
By Blaine Harden and contribution by Akiko Yamamoto
September 7, 2009
American Medical Student Association
Overview of the U.S. Health Care System
By Kao-Ping Chua
February 10, 2006
The original is an Adobe PDF file, this is the HTML converted by Google.
The Sydney Morning Herald
The Granny state – Japan’s life expectancy boom
By Justin McCurry
July 10, 2004
A video from PBS about the Japanese health care system. (3:08)