In today’s edition of the ‘Healthcare Systems…’ series we’re looking at Japan. Japan operates a system not too dissimilar from places like France and several other develop world nations. However, there are some key differences and issues that Japan is facing which we would do well to address from now.
First things first, we need an overview of how things work over there. As most nations, Japan has an insurance based system comprised of a payment contribution to care of 10-30% by patients and the rest covered by the government. In many cases the insurance is provided by an employer though there is a national insurance system which is controlled by local authorities much like that of Italy.
Access to quality care is universal and most medical costs are kept acceptable through government intervention. Patients also have the free reign and choice of the French and Italian systems where they can attend any hospital or clinic they choose.
Hospitals in Japan are also non-profit by law and must be run by physicians. The fact the leaders are healthcare staff may be one of the reasons for their success.
Dr Amanda Goodall from the Cass Business School in 2011 performed an analysis of the the 100 leading hospitals and 300 CEOs in the United States and found that there was a strong correlation (statistically significant) between between the higher rank of a hospital and its CEO having a background as a trained physician. I think that’s a trend we should listen to but that’s a different matter for future blog posts.
Importantly, although Japan can boast the highest life expectancy in the world but that doesn’t come without its own set of problems. A burgeoning ageing population, associated with a much higher tendency to seek medical help is placing the Japanese healthcare system under an unprecedented burden. Japan also faces a shortage of doctors and sub-specialists particularly in rural communities where healthcare access can be frightfully difficult.
Right now, there isn’t a clear solution since increasing spending isn’t a sustainable solution. Consider this, 40% of the population is projected to be >65 by 2050. That demographic will be associated with a far greater number of conditions then those below that age group.
There are cultural issues at play too as many patients not only visit their doctor four times more often than their OECD counterparts but also have a predilection for inpatient treatment which is accommodated by the tremendous number of available hospital beds, another unsustainable cost-management problem.
Japan’s healthy nation is supported by a fantastic preventative system, giving access to screening tests and preventative care and therapies. Beyond that though there comes a point with age that ill-health catches up with everyone.
How long can Japan go on for? How will they manage their ageing population?
Hopefully, they’ll figure out the answers because soon enough it’s going to be our problem.
Have Your Say, [RE]Tweet me @Saif_Abed
Dr Saif F Abed
AbedGraham Healthcare Strategies Ltd