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Japanese medical care system

 2016/02/15 Japanese Culture   18 Views

Contents

Contents

1.Japanese medical care system

2.Costs for patients

3,Qualiteis of medical system in Japan

4.Do low risk patients flood the system?

5.summary

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Japanese medical care system provides healthcare services, including screening examinations, prenatal care and infectious disease control, with the patient accepting responsibility for 30% of these costs while the government pays the remaining 70%. I will show you about Japanese medical care system.

Japanese medical care system

Since 1961 Japan has provided universal health coverage, which allows virtually all access to preventive, curative and rehabilitative services at an affordable cost.

All residents of Japan are required by the law to have health insurance coverage. People without insurance through employers can participate in a nationalhealth insurance program administered by local governments. Patients are free to select physicians or facilities of their choice and cannot be denied coverage. Hospitals, by law, must be run as non-profit and be managed by physicians. For-profit corporations are not allowed to own or operate hospitals. Clinics must be owned and operated by physicians.

Medical fees are strictly regulated by the government to keep them affordable. Depending on the family income and the age of the insured, patients are responsible for paying 10%, 20% or 30% of medical fees with the government paying the remaining fee.

Uninsured patients are responsible for paying 100% of their medical fees, but fees are waived for low-income households receiving government subsidy. Fees are also waived for homeless people when they are brought to the hospital by ambulance.

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Costs for patients

In 2008, Japan spent about 8.5% of the nation’s gross domestic product(GDP), or US$2,873 per capita, on health, ranking 20th among Organisation for Economic Co-operation and Development (OECD) countries. That amount was less than the average of 9.6% across OECD countries in 2009, and about half as much as that in the United States. In 2013 expenditure was $479 billion, 10.3% of GDP – about the midpoint of OECD countries.

The government has well controlled cost over decades by using the nationally uniform fee schedule for reimbursement. The government is also able to reduce fees when the economy stagnates.

Fees for all health care services are set every two years by negotiations between the health ministry and physicians. The negotiations determine the fee for every medical procedure and medication, and fees are identical across the country.

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Qualiteis of medical system in Japan

Japan is the home to some of the world’s most famous and accomplished doctors. Japanese outcomes for high level medical treatment is generally competitive with that of the US. A comparison of two reports in the New England Journal of Medicine by MacDonald et al.and Sakuramoto et al. suggest that outcomes for gastro-esophageal cancer is better in Japan than the US in both patients treated with surgery alone and surgery followed by chemotherapy. Japan excels in the five-year survival rates of colon cancer, lung cancer, pancreatic cancer and liver cancer based on the comparison of a report by the American Association of Oncology and another report by the Japan Foundation for the Promotion of Cancer research.The same comparison shows that the US excels in the five-year survival of rectal cancer, breast cancer, prostate cancer and malignant lymphoma. Surgical outcomes tend to be better in Japan for most cancers while overall survival tend to be longer in the US due to the more aggressive use of chemotherapy in late stage cancers. A comparison of the data from United States Renal Data System (USRDS) 2009 and Japan Renology Society 2009 shows that the annual mortality of patients undergoing dialysis in Japan is 13% compared to 22.4% in the US. Five-year survival of patients under dialysis is 59.9% in Japan and 38% in the US.

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Do low risk patients flood the system?

In Japan medical cost tends to be quite low compared to those in other developed countries, but utilization rates are much higher.  Japan has about three times as many hospitals per capita as the US and, on average, Japanese people visit the hospital more than four times as often as the average American.  Due to large numbers of people visiting hospitals for relatively minor problems, shortage of medical resources can be an issue in some regions. The problem has become a wide concern in Japan, particularly in Tokyo. A report has shown that more than 14,000 emergency patients were rejected at least three times by hospitals in Japan before getting treatment.

The so-called “tarai mawashi” (ambulances being rejected by multiple hospitals before an emergency patient is admitted) has been attributed to several factors such as medical imbursements set so low that hospitals need to maintain very high occupancy rates in order to stay solvent, hospital stays being cheaper for the patient than low cost hotels, the shortage of specialist doctors and low risk patients with minimal need for treatment flooding the system.

Summary

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Since 1961 Japan has provided universal health coverage, which allows virtually all access to preventive, curative and rehabilitative services at an affordable cost.

Japan is the home to some of the world’s most famous and accomplished doctors. Japanese outcomes for high level medical treatment is generally competitive with that of the US.

Due to large numbers of people visiting hospitals for relatively minor problems, shortage of medical resources can be an issue in some regions.
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