japan healthcare system

1

Running Head: Japan Healthcare System

Healthcare System of Japan vs. U.S. Healthcare System

HCS 400

Karyssaann Costagliola

Professor Durant

November 19, 2014

2 Japan Healthcare System

Abstract

The healthcare system is an important and ever changing subject all over the world. Japan has

one of the best health care systems that some aspects are highly sought after by Americans.

Japan is able to provide health care across the board to everyone at a lower cost than that of the

United States.


The healthcare system of Japan is one that is able to give equal benefits to all its citizens

while still maintaining costs and keeping them low. It is said that, “they hold the belief that if

equity and universality of access are goals, then cross-subsidization of payments must occur

between people of different economic means, and government must regulate this process”

(Ikegami 2014). The U.S. healthcare system is ranked second in costs for health care spending

and rising costs and inability for some to get insurance makes it difficult for some Americans to

obtain insurance. It is noted that the people of Japan are one of the healthiest and have record

rates of living longer than most developed nations.

Japan has designed a healthcare system that makes any and all medical services available

to all its citizens by way of having employer-purchased insurance which controls expenditures.

This way of healthcare has made them one of the healthiest nations and a nation that is keeping

the cost of healthcare down unlike that of the United States. Since 1961 they had in place the

universal healthcare system that is still being used today. In U.S. after many changes the ACA

what we know today’s healthcare as was enacted in 2010. The two health systems are strong in

their own respect and have come a long way since being introduced to each country. Japan looks

at healthcare insurance being a right that all citizens’ even temporary citizens should get. Japan

pays for this health insurance through payroll deductions, tax dollars, and the copayments made

by patients during office visits.

As compared to Japan’s outlook on healthcare the U.S. has a view that it is more of a

privilege to have insurance and it should come with a cost. In the U.S. we do not have the

healthiest people and not everyone is focused on an overall better health. It is proven through

life expectancy rates compared to Japan. In the U.S. the life expectancy rate is 80.6 and Japan

has a life expectancy rate of 86.4 as of 2011. The infant mortality rate for Japan is 2% and the


U.S. holding at 6.2%. The factors of mortality rate in infants are due to way of living and

treatment between the two countries. In the United States there is more lapse in care for

pregnant mothers’ because of their own doing or the way they are treated within the household.

In Japan there is a lot of care and food choices are much better in the homes of Japan. The

length of stay in Japan averages at 52.1 days with the U.S. being considerably lower at 4.6 days.

Although it seems way better in the U.S. the cost of both of those stays for one patient with the

same condition the U.S. is much higher in cost than that of Japan. One of the reasons for the

length of stay in Japan is partially due to the population mainly being elderly and not having a

nursing home it leads to longer stays in hospitals. Some other differences between the two

systems are the cost for appointments. In Japan most visits to doctors cost what it would for a

co-pay here in the United States. The average cost for healthcare for a family is $280 monthly

compared to anywhere from $300 or more for a family in the United States possibly even just for

a single person depending on the coverage level. Another big difference in the two is the costs

for tests. Here in the U.S. tests can range from $500-$2,000 just for a simple MRI. In Japan

these same tests and quality machines can cost as little as $100. The United States is one of the

top states in spending costs for healthcare per capita, but yet see little efficacy for that money

spent.

Each system has its’ strengths in the way it is run and the delivery of healthcare.

A strength that is known for the United States is it offers top quality care to people who can pay

for it or have insurance that will. Secondly, the U.S. is also known for it is at the top as far as

clinical research and in technological advancements and breakthroughs in treatment of many

different types of diseases. The U.S. also has a lot of specialty doctors and medical providers’

throughout the country. Japan also has its’ share of strengths that make it so functional like it is.


One of the strengths is the universal coverage that it gives to the people of Japan. The next

strength that Japan has is that all costs are controlled by a national fee schedule imposed by the

government that has limits on all expenditure increases. The patients and insured of Japan have

the ability to choose their provider or specialist that they wish to see with no question or wait to

be seen. For Japan all medical providers are paid the same for the same treatment across the

board preventing unnecessary inflation for certain doctors. Lastly, a strength of Japan is dental is

also included along with prescription coverage.

With strengths comes weakness and these two systems have a few that limit the

care that is given. In the U.S. the weaknesses that are seen are that even though the

implementation has occurred with the ACA over 37 million people are still uninsured and might

remain this way due to the flaws in the ACA. The costs of healthcare are the highest per capita

and are continuing to steadily rise. The healthcare outcomes in the United States are poor

compared to other developed countries showing how the U.S. is 20th in infant mortality rate, 29th

for premature or low birth weight infants, and 6th in life expectancy. In the United States people

are still being denied based off preexisting conditions or they are still finding the “Affordable”

Care Act unaffordable. There are also shift costs where hospitals are charging more to one

insurance than another to try and cover lost money from the uninsured or underinsured patients.

The United States have a somewhat steady rate of providers, but they are not evenly placed or

available in places that really need them. Japan has its’ share of weakness that could be

improved upon. The universal healthcare coverage does not cover preventative health exams. It

also has the financial incentives that cause overuse of labs tests, high-tech equipment, and

prescription drugs which Japan is one of the highest users of prescription drugs costs. There is

an issue of long hospital stays due to lack of nursing homes for their elderly population. The


medical services that are given are fragmented and often duplicated causing unnecessary costs to

their health system which also causes excess capacity problems.

If Japan would make some adjustments to availability of nursing homes especially with the

rising numbers of elderly it can only benefit them. It has the entire basis to a great system and to

focus more on cutting unnecessary spending even though it isn’t at a really high cost to the

consumer it can benefit the country greatly. In turn if the U.S. healthcare system would adapt

some of these practices and realize that giving everyone better opportunity for healthcare that is

actually affordable it can benefit them in the long run. If you have a healthier population rather

than one that consists of a lot of sick people due to inability to have insurance it would lower

costs and make the healthcare system function better as a whole.


References

Ikegami, N (1991). Japan’s Universal and Affordable Health Care. Retrieved from

http://www.nyu.edu/projects/rodwin/lessons.html

The Economist Newspaper (2011, September 10). Not all smiles. Retrieved from

www.economist.com/node/21528660

Commonwealth Fund (2013, November 14). International Profiles of Health Care Systems.

Retrieved from http://www.commonwealthfund.org

Wanjek, C (2009, July 28). Healthcare Systems: U.S. vs Japan. Retrieved from

http://livescience .com/7830-healthcare-systems-japan.html

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