I have to politely disagree with almost everything you said re Japan's health care system. I and my family have lived in Japan for many years and we found the health care system top notch. I can't obviously generalize but here some facts, then some anecdotal evidence, and some opinions:
Facts:
- Japan employs a national health care system, the quality of the system is fairly good, the patient pays 30% of the actual cost, 70% is covered by the insurance. The 30% that come out of the pocket of each patient can be covered via additional private insurance.
- Every Resident is forced to be health insured via the national health insurance system, hence everyone pays in.
- Companies can elect to provide additional coverage to its employees above the services rendered by the national insurance.
- The Japanese health care system is a co-pay system, the employer pays half the insurance premium, the other half is covered by the main insured employee.
- Waiting times for screenings, MRI, ... , are acceptable, I have not heard of anyone having to travel to other countries because waiting times were too long or services, necessary, were not rendered
Anecdotal evidence:
- We never had a complaint about health care treatment. There are many hospitals (especially in larger cities) where there is English speaking staff (if needed), or translators.
- We were always promptly treated, emergencies were handled as an emergency should be treated (nobody asked us upfront for our insurance card or credit card (shock in US)
- The additional services rendered by the premium insurance on top of the national insurance that my previous companies offered were top notch, I could elect to be treated by professors at the leading hospitals of the country (Tokyo University Hospital, Sacred Heart, St Luke, ...), private rooms, additional testing and screening not covered as part of the national care plan,...
- I heard of some expats who traveled back to the US for treatment, not sure why, and I am not speculating at this point, maybe they had a good reason, maybe it was just that they were misinformed about the quality of service in Japan, no idea. But again, we always received top notch treatment, and CT scans or MRIs were done with a waiting period of less than a month, sometimes within days.
Opinion:
- Overworked doctors? Hmm, that is what I hear about in the US, I have not heard of doctors who work 100 hours in Japan. Especially most every doctor who works in clinics rather than hospitals can choose their own work hours, in fact they can keep the clinic closed at their own discretion if they choose to do so.
- Not enough time for research? With all due respect, doctors are supposed to treat patients and work rather than perform research. If a medical professional wants to perform research they can do so at a university hospital and are free to do so. You can google and find tons of leading medical research that originates from hospitals such as Todai or Kyoto hospitals and the like.
- Low pay? Maybe we need to re-define what fair pay is for a doctor. Should a doctor earn 300k a year? I do not think so. Most every other professional earns the same or less and in order to be a true professional the medical care system is not the only one that necessitates years of training. Every architect, trader, financial adviser, nurse, pilot has to hone their skills in the same way than an upcoming medical doctor has to. If one wants to make millions in the medical care industry one should go independent and maybe perform plastic surgery or so. There are those who do that in Japan as well. People have choices.
- There is definitely no shortage, at least not much more than elsewhere, in Japan. Almost every hospital we went in Tokyo was properly staffed and patients were treated promptly and waiting periods were very manageable.
- There is definitely no over prescribing of drugs in Japan. It is extremely hard in fact to ask the doctor to prescribe medication for a couple more days than the doctor deems necessary. Also, I never heard of cases in Japan where doctors prescribe outrageously dangerous drugs that exhibit addictive properties. Those are stories everyone can google and watch on youtube about the American health care system but the same cannot be said of Japan. In fact one of the big reasons of the surging heroin addiction in the US can be attributed to abuse of prescription drugs. Guess who prescribes prescription drugs...
- Japan does not need medical tourism. Not sure why you count that as a deficit in Japan. As long as Japanese and legal residents get proper treatment all is good.
- You seem to turn the argument on its head: Just because the quality of medical care in Japan cannot be fully credited for the longevity of Japanese residents does not mean the opposite holds true. You basically infer that those who have medical issues in Japan (despite the healthy diet) are not fairly and properly treated as in other leading industrial countries. I cannot agree with that having lived in Japan for close to a decade.
- Not everything that is written in some news articles holds true or is up to date, at the very least it hardly ever beats empirical evidence and facts gathered by those who have actually lived and worked in Japan for a long time.
re: Japanese health system
Like other service industries in Japan, there are cumbersome rules, too many small players and few incentives to improve. Doctors are too few—one-third less than the rich-world average, relative to the population—because of state quotas. Shortages of doctors are severe in rural areas and in certain specialities, such as surgery, paediatrics and obstetrics. The latter two shortages are blamed on the country's low birth rate, but practitioners say that they really arise because income is partly determined by numbers of tests and drugs prescribed, and there are fewer of these for children and pregnant women. Doctors are worked to the bone for relatively low pay (around $125,000 a year at mid-career). One doctor in his 30s says he works more than 100 hours a week. “How can I find time to do research? Write an article? Check back on patients?” he asks. On the positive side, patients can nearly always see a doctor within a day. But they must often wait hours for a three-minute consultation. Complicated cases get too little attention. The Japanese are only a quarter as likely as the Americans or French to suffer a heart attack, but twice as likely to die if they do. Some doctors see as many as 100 patients a day. Because their salaries are low, they tend to overprescribe tests and drugs. (Clinics often own their own pharmacies.) They also earn money, hotel-like, by keeping patients in bed. Simple surgery that in the West would involve no overnight stay, such as a hernia operation, entails a five-day hospital stay in Japan. Emergency care is often poor. In lesser cities it is not uncommon for ambulances to cruise the streets calling a succession of emergency rooms to find one that can cram in a patient. In a few cases people have died because of this. One reason for a shortage of emergency care is an abundance of small clinics instead of big hospitals. Doctors prefer them because they can work less and earn more. The system is slow to adopt cutting-edge (and therefore costly) treatments. New drugs are approved faster in Indonesia or Turkey, according to the OECD. Few data are collected on how patients respond to treatments. As the Lancet says, prices are heavily regulated but quality is not. This will make it hard for Japan to make medical tourism a pillar of future economic growth, as the government plans. The Japanese are justly proud of their health-care system. People get good basic care and are never bankrupted by medical bills. But kaihoken cannot take all the credit for the longevity of a people who eat less and stay trimmer than the citizens of any other rich country. And without deep cost-cutting and reform, the system will struggle to cope with the coming incredible shrinking of Japan.
http://www.economist.com/node/21528660