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Japanese health care — a non-issue

Along with the U.S.’s ailing economy, health care is foremost on the minds of Americans this election season. NPR has been running a series of reports on health care in “wealthy nations” around the world, showing that universal health care is indeed possible and does not lead to rampant socialism. Back in April, T.R. Reid reported on the Japanese system:

Everyone in Japan is required to get a health insurance policy, either at work or through a community-based insurer. The government picks up the tab for those who are too poor.

It’s a model of social insurance that is used in many wealthy countries. But it’s definitely not “socialized medicine.” Eighty percent of Japan’s hospitals are privately owned — more than in the United States — and almost every doctor’s office is a private business.

And while American hand-wringing over the cost and bureaucracy of health care was shamefully brought to light in the 2007 documentary, Sicko, in an interview with Prof. Saito Hidero, President of Nagoya Central Hospital, Reid learned that such situations are completely foreign to Japan:

Reid: In Japan, how many people go bankrupt from medical costs?
Saito: I don’t know…

(Reid: Just the question seemed bizarre to him. He checked to make sure he understood me correctly.)

Saito: 医療費が払えなくて破産する人って… We never heard of it. Almost never heard of it.

Health Care for All series at NPR

19 comments - What do you think? Posted by Pamela - July 7, 2008 at 6:06 am

Categories: General Japan Tags: health care, npr

Dave

I thought the biggest problem was that Japanese doctors/dentists make almost no money? To the insured, it’s easy street, but for the people on the other side of the table, they’re barely making a living wage. Does anyone know if that’s true?
http://pamutron.1up.com Pamela

hmm, looks like the link to the story is broken, here it is again:

http://www.npr.org/templates/story/story.php?storyId=89626309

and you’re right that the doctors/health care workers don’t seem to be compensated sufficiently:

[Dr.] Kono [Hitoshi] says he’s getting paid peanuts for all his hard work.

If somebody comes in with a cut less than 6 square inches, Kono gets 450 yen, or about $4.30, to sew it up.

“It’s extremely cheap,” he says.

Kono is forced to look for other ways to make a yen. He has four vending machines in the waiting room. In a part of Tokyo with free street parking, he charges $4 an hour to park at his clinic
Bill

Hi,
I lived in Japan for a long time. I did have the experience on many occasions to visit the doctor and hospital for check ups and emergency situations. One of my children was born there. There is a lot to admire about their system (mainly efficiency ..aren’t most Japanese systems efficient?) but honestly it is far from the quality that we get here in the US. Their medicines are not very effective, the doctors tend to provide excessive medical treatment and there is a well known back door agreement between the doctors and drug companies.I also don’t believe that Michael Moore and NPR are the most objective sources to go by.
Bill
http://rg one

kind of incomplete.

This does not take into account the fact that americans stuff their faces with unhealthy food and most are insanely over weight because of it. I have a feeling that the expectancy in japan will fall in the near future. People are not eating the foods they did in the past, much more fried and fast food than before.

As far as the cost……. you get what you pay for.
Level3

Jesus, just about every paragraph in the story leaves out critical facts.

No mention of the 30% co-payment.

No mention that you still have to keep paying your premiums even if you lose your job and “get to keep” your insurance.

100% insured? HAH! No mention that so many young part-timers just can’t pay the premiums any more, and are kicked out of the system.

No mention that many people are too poor to keep up the payments AND cough up 30% of the bill to see a doctor. Ironic. At low income levels, we can’t afford to see a doctor, because we have to pay for insurance.

People don’t go bankrupt for life-saving treatments like in the USA? Yeah, true. Cause in Japan, they’re DEAD! The country that only recently approved organ donation, and just started covering heart transplants 2 years ago.
The super rich can afford to go to (guess where? AMERICA!) to get top-notch medical treatment.

Bragging about Japanese visiting the doctor 3 times as much as Americans? That’s because the doctors here drag everything out to 3 visits, just so they can get more money out of you. Dentist in the USA for a filling? One visit. Done.
Japan? 1 visit to confirm it’s a cavity. Another to actually do a temporary filing, and a third to put in the permanent filling, which will fall out in couple years.

Add in all the pensioners who only have to pay 10% of the bill visiting the doctor every other day cause they’re lonely.

No apppointments necessaary? HAH!
Yeah, no appointments necessary a thte hospital, but please show up only Mon-Fri between 8AM and 11:30AM to get a number in the waiting room. Sick on a weekend? Get hit by a car at 2AM? Good luck…

So many blatant omissions.

But the most important to me is this:
In the USA, I have never ever had a doctor just shrug his shoulders and say “I don’t know what’s wrong.” THAT is a totally alien concept to me in Japan. Worse, you still have to pay 30% for the “diagnosis”.

LOD

I can’t agree with you more. While American system may have flaws, Japanese system is not superior. At all.
http://pamutron.1up.com Pamela

I agree that the level of care itself and the technology involved is at a much higher standard in the US, and that the idea that more visits = more care is dubious at best, but I’m not sure that Reid was “blatantly omitting” details. I think the point of the series is to showcase what’s good in different systems around the world, so that the US could learn from them. Japan’s is certainly far from perfect, but that doesn’t mean that there isn’t anything worth learning or at least considering.

Kevin

The quality of health care in the US is definitely much better, but that’s only if you can afford it. Especially in areas like Seattle where temp work is pretty much all that’s available, it’s almost impossible to get medical coverage. You’ll end up paying around $200 for any appointment, and the medicine will always run you about $100. If you felt so inclined, you could join Cobra (no, not GI Joe), but that will run you about $200-$300 a month. I think that gives you emergency medical coverage, but doesn’t cover minor check-ups. There’s a reason why old people take buses to Canada to get medicine.
I can’t even imagine what would happen if you were to get seriously sick while uninsured while in the US. While the Japanese system needs improvement, the US system is FAR from being the ideal.

ZoneDaiatlas

That’s funny because people from Canada come to the US for the healthcare service where it’s not rationed by the Government and quality of care is superior to what you get in Canada and other countries that have Universal heathcare services.

My ex girlfriend works at Northwestern Memorial Hospital in Chicago and they had a patient from Canada and this patient told her that there was a 5 months waiting list to see a doctor to have her gallbladder removed. This is the type of healthcare the politians want to force down our thraost in the US. NOPE! I don’t want the Govt running the healthcare service in this country…
Kevin

Your comment doesn’t counter mine, it just proves that each system has strengths and weaknesses. The US system essentially provides unlimited access to any service at any time – the free market system makes sure that those with money can get the service they need. The biggest drawback is, of course, price. Designer medications cost money, and if you’re going to want treatment, you’re going to pay for it. I already mentioned in my previous post how much something like that costs; it’s expensive.
However, in Japan, and Canada for that matter, health care is much cheaper. I only pay 30% of the total bill and my company pays the rest. That includes medicine as well – most medical bills are about $15. This is why elderly people head to the US; a limited budget means you can only afford a limited amount of prescription medication.
People generally say they like the US system of health care until suddenly they lose their job and have to pay everything out of their own pocket. That’s when you’re SOL.
Kevin

That should say, “head to Canada”

Random

Seriously, a medical system in which pregnant women die because they can’t find a hospital can’t be seen as superior.

re:random

http://edition.cnn.com/2008/US/07/01/waiting.room.death/index.html?iref=newssearch

Joe

Makes me glad I live in the UK where we have the NHS (National Health Servce)

Free for all! like it should be.

ZoneDaiatlas

National Health Service? Free? Is this the same Universal Healthcare where the Government rations healthcare, long waits to see a Doctor and the quality of care isn’t very good? That free healthcare service? The Heathcare service in the US isn’t perfect but I will take that over Universalwhat you people get and by the way nothing is free when you have high inflations and taxes to pay for your so called free healthcare.

Brian

Doctors are grossly overpaid in America, but they are grossly underpaid in Japan. Another issue is that doctors in japan are all paid the same, no matter their position — family doctor, anesthesiologist, or brain surgeon — much like schools in America. And we all see how well schools in America are doing.

As Americans, we are going to face an important decision in the future on whether or not we want the best health care in the world for those who can afford it, or provide mediocre health care to all. Quality and technology will always go to where the money is. The money is not in Japan, it’s in America. If the American market becomes hostile to profits in the medical industry, a new country will overtake America in medical finesse.

stereo

>Another issue is that doctors in japan are all paid the same, no matter their position.

Oh my. Brian, do you believe that BS?

In a hospital in Japan, each doctor is paid differently according to his/her position in hospital hierarchy.

If a doctor opens his/her own clinic as a sole proprietor, the payment from social insurance is based on the amount of work, or POINTS he/she fulfills. Seeing a cold patient is so and so points, injection of so and so drug is so and so points, subscribing so and so drug is so and so points, and so no. Any doctor is paid from social insurance same amount of money for each point he/she accumulates. But since the amount of points a doctor accumulates differs form another, each doctor is paid quite differently.

Are they underpaid?
Ministry of Welfare and Labor has statistics.
http://www.mhlw.go.jp/shingi/2007/10/dl/s1031-3k.pdf
http://www.mhlw.go.jp/shingi/2007/10/s1031-3.html
It says average monthly salary of a doctor at a national hospital is 1,110,901 yen, whereas that of a doctor at a private hospital is 1,336,171 yen. Multiply that by 12 and divide by 107 to convert into US dollars. They are paid 120,000 USD to 150,000 USD a year on average. Do you think they are underpaid?
Dave J

Interesting story – I agree we have major problems with the health care situation in the U.S. that need to be resolved, however the article and so called facts presented in Mr. Reid’s article are outright false.

I have lived in Japan over 10 years and I have had the need to visit hospitals (myself and my children). In one case my son was very sick and we decided to take him to the emergency room. The first and second hospital we visited did not have a doctor available. After several hours and 2 taxi rides, the third hospital was able to see him.

Yes you can go to a hospital or clinic and be seen that day, but as already stated, be prepared to spend 4 ~ 6 hours minimum waiting. Go in the morning, pick a number at the right machine, wait until your number is called, see the doctor.

The statement that all Japanese must have health insurance is false. I know several Japanese friends who do not have health insurance.

As previously stated if you are layed off of course you keep your insurance (but you pay for it).

Doctors in the United States are not overpaid!!! These guys make life and death decisions daily. The average salary for an emergency room physician is $210,830. This, in a society where we pay guys to hit a ball > $5,000,000 per year or actors and actresses much more. In my opinion the doctors are underpaid – especially considering their exposure to lawsuits.

The biggest problems in the US are litigation and insurance companies, which drive up the costs to unreasonable levels

The biggest problems in Japan are the decline of Japanese going into the profession, the unwillingness to accept or allow foreigners to practice, and the difficulty of getting governmental approvals for treatments/drugs that have been in use in other countries for up to a decade.

Both systems are messed up. If I had my choice for an elective procedure (where I could travel) I would still go to the US.

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Japanese health care — a non-issue

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