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Japan's Healthcare VS United States

Global Healthcare Assignment
by

Maylene Gonzalez

on 19 June 2013

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Transcript of Japan's Healthcare VS United States

Japan
United States
Japan's Healthcare V.S . United States
Japan's health care system is characterized by universal coverage, free choice of health care providers by patients, a multi-payer, employment-based system of financing, and a predominant role for private hospitals along with a fee-for-service practice.


-Healthcare in the U.S. is provided by many distinct organizations.
- Healthcare facilities are largely owned and operated by private sector businesses. This is the biggest difference between Japan and the US.
-The US healthcare is market based.
-They have a highly stratified system with separate tiers for different categories of people receiving different levels of care.

Japan
Since1961, Japan has run its Universal Health system similarly to many European countries. Japan's system is mainly divided into three categories:
Employee's health insurance
, which is directed by health insurance associations;
public servants health insurance
, which is directed by central government and local government benefit associations;
self employed health insurance
also known as
National Health Insurance
, which is directed by the government according to the type of employment. In addition, Japan has a type of system for the late stage elderly (over 75 years old) that is run by the local government.
How is the healthcare system
financed?
Health insurance expenditures in Japan are
financed by payroll taxes paid by employers
and employees and by income based premiums paid by the self employed. In contrast to the U.S., where the federal, state and local governments finance roughly 42.9 percent of all healthcare expenditures and out of pocket payments contribute another 22 percent. Japan only uses 31.7 percent of national health care expenditures that derive from national and local public funds. Also, 12.2 percent come from out of pocket payments.
The largest share of healthcare financing in Japan is raised by means of compulsory premium based on individual subscribers (34.6%) and employers (21.7%). In simple terms the patient assumes 30% of these costs while the government pays the remaining 70%.
All residents of Japan are covered without regard to any medical problems they may have,or to their actual risk of succumbing to illness. In other words they are covered regardless of illness or risk for illness.
Premiums are based on income and ability to pay. (This can be compared to Medicaids rates for families, or Community health income based plans) control of the delivery of care is left largely to medical professionals and there appears to be no public concern about health care rationing.
Like the Australian, Canadian and many European health care systems, Japan's national health insurance program is compulsory. But Japan surpasses all 24 member countries of the Organization for Economic Cooperation and Development (OECD) in life expectancy at birth and also has the lowest infant mortality rate.
Japan
Japan’s financial system features multiple payers just as the U.S. system. But the similarity ends there.
Every citizen must have an attachment to one of the social insurance plans, which finance virtually all of the care. 70% as mentioned before. =)

The plans offer a uniform set of comprehensive medical benefits, including screening, medications, long-term care, dental care, and SOME preventive care.

Claims are filed with the insurance plans by providers, and services are provided to patients as benefits in kind.

Virtually all medical care is provided under a nationally uniform fee schedule. “Uniform” means that the same fee is paid by all insurers to all providers, regardless of whether the service is performed in a tertiary hospital or a rural clinic, by an experienced specialist or a RECENTLY qualified physician.

Neither insurers or providers have the freedom to negotiate individually a different fee schedule. Which means to us as Americans we can view this as being " mute" or without an opinion or voice towards our care.
Consumers do not have any real choice in selecting their health insurance plan; they must join the one plan that is offered by their employers or, if they are self-employed, that is administered by their local governments or trade associations. However, the uniformity is not frowned upon it is often accepted and graciously appreciated.
Japanese Financial System
Access
Healthcare in Japan is universal coverage. Healthcare is accessible to all of their citizens at a lower more affordable cost. “Dr. Kono Hitoshi is a typical doctor. He runs a private, 19-bed hospital in the Tokyo neighborhood of Soshigaya."The best thing about the Japanese medical system is that all citizens are covered," Kono says. "Anyone, anywhere, anytime — and it's cheap." Patients don't have to make appointments at his hospital, either. The Japanese go to the doctor about three times as often as Americans. Because there are no gatekeepers, they can see any specialist they want.” Should you have to pass a gate when you're sick?
Is the healthcare system well accepted in the country?

Yes, the healthcare system is well accepted in this country.
Statistics:
“We cannot perfectly compare national healthcare systems, nor can we wholly adopt anothers. Japan's system, for example, is bolstered by low levels of violence, drug addiction, obesity, and health-and-income disparity, which are all rampant in the United States. Japan's emphasis on preventive medicine, though, is partly responsible for producing one of the healthiest populations on earth, with a life expectancy over four years greater than that of the United States. “America now ranks 50th for life expectancy, according to the CIA World Factbook.”
Japan has the world’s healthiest people. In general, there is a less percentage of people who are sick with chronic illnesses and higher number of life expectancy when compared to the United States. The Japanese live a better lifestyle than most Americans which plays a big role on why they are healthier, but, part of that reason is also the fact that they have complete access to healthcare regardless of socioeconomic status or any other reason.
Client outcomes in this country vs. the United States outcomes:
Presented by:
Maylene Gonzalez
Bridget Pelaez
Ivan Peralta
Rochelle Quintana
Personal Reflection:
I believe that if we had a healthcare system similar to the
one in Japan, there would be less illness and death in our country which would lead to an overall increase in the general wealth in our country. The holistic view of "WE" allows them not to live so myopically thus focusing on the general health of the current population and the future generations to come.
Health outcomes:
•The U.S. has a higher infant mortality rate and lower life expectancy than
comparable countries. (WHO 2007, Commonwealth Fund 2007)
• The U.S. has the highest rate of maternal mortality among high-income countries
(13 in 100,000), and also the highest rate of C-Sections (32%, as opposed to a
WHO recommended 5-15%)
•45,000 people die each year simply because they have no health insurance (American Journal of Public Health 2009)



Disparities in health care in the US:
•The quality of care given to people of low socioeconomic status is generally lower, regarding : the treatment of cancer, heart failure, and pneumonia. (Agency for Healthcare Research and Quality, 2009)

Both the poor and the wealthy can experience the negative health effects of air pollution; racial/ethnic minority groups, who are more likely to live in urban counties, continue to experience a larger impact.


References
Fahs, Marianne. "Japan's Universal and Affordable Healthcare." . N.p.. Web. 19 Jun 2013. <http://www.nyu.edu/projects/rodwin/lessons.html>.

"Healthcare System." Boehringer Ingelheim . N.p., n.d. Web. 19 Jun 2013. <http://www.boehringer-ingelheim.com/global_activities/aaa/japan/cost_containment.html>.

Reid, T.R. "Japanese Pay Less for More Health Care." (2008): n. page. Web. 19 Jun. 2013. <http://www.npr.org/templates/story/story.php?s
toryId=89626309>.

Wanjek, Christopher. "Healthcare Systems: U.S. VS. Japan." Live Science. (2009): n. page. Web. 19 Jun. 2013. <http://www.livescience.com/7830-healthcare-systems-japan.html>.


.
.
Barriers to care:
•Around 50 million people do not have health insurance. Over
half of them are African Americans. (Center for American
Progress 2009)
•Of those who are insured, at least 25 million are under insured.
They often forgo care because of high deductibles and co-pays.
(Commonwealth Fund 2008)
•700,000 families go bankrupt each year just by trying to pay
for their health care – even though three quarters of them
are insured. (Health Affairs 2006). In comparison, the five largest
insurance companies made a combined profit of around $12
billion in 2009. (Department of Health and Human Services 2010)
•U.S. has fewer doctors and nurses than other high-income
countries. (WHO 2007)
•Hospitals and doctors are disproportionately located in
wealthier areas. Public hospitals are closing in areas where
they are most needed.
•The U.S. ranks lowest among high-income countries in its primary care
infrastructure. There is a projected shortage of 44,000 primary care
doctors within the next 15 years. (WHO, Health Affairs 2008)
.
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