The health care in Japan 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%. Payment for personal medical services is offered through a universal health care insurance system that provides relative equality of access, with fees set by a government committee. All residents of Japan are required by the law to have health insurance coverage. People without insurance through employers can participate in a national health insurance programme 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.
As of the moment, Japan's Universal Healthcare System is being revamped by the current Prime Minister Shinto Abe as popularized by Genomics.
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.Also, monthly thresholds are set for each household, again, depending on income and age, and medical fees exceeding the threshold are waived or reimbursed by the government. 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.
Cost
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. In the 1980, health care spending was rapidly increasing as was the case with many industrialized nations. While some countries like the U.S. allowed costs to rise, Japan tightly regulated the health industry to rein in costs.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. If physicians attempt to game the system by ordering more procedures to generate income, the government may lower the fees for those procedures at the next round of fee setting.This was the case when the fee for an MRI was lowered by 35% in 2002 by the government.Thus, as of 2009, in the U.S. an MRI of the neck region could cost $1,500, but in Japan it cost US$98.Japan has had "catastrophic coverage" since 1973. Once a patient's monthly co-payment reaches a cap, no further co-payment is required.The threshold for the monthly co-payment amount is tiered into three levels according to income and age.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 (COED) countries. That amount was less than the average of 9.6% across COED 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 COED countries.
Quality[edit]
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 Sacramento et al.suggest that outcomes for Castro-oesophageal 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 2009 and Japan Oenology 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.
In an article titled "Does Japanese Coronary Artery Bypass Grafting Qualify as a Global Leader?"[20] Masai Chi of Nippon Medical School points out that Japanese coronary bypass surgeries surpass those of other countries in multiple criteria. According to the International Association of Heart and Lung Transplantation, the five-year survival of heart transplant recipients around the world who had their heart transplants between 1992 and 2009 was 71.9% while the five-year survival of Japanese heart transplant recipients is 96.2% according to a report by Osaka University. However, only 120 heart transplants have been performed domestically by 2011 due to a lack of donors.
The 47 local government prefectures have some responsibility for overseeing the quality of health care, but there is no systematic collection of treatment or outcome data. They oversee annual hospital inspections. The Japan Council for Quality Health Care accredits about 25% of hospitals
No comments:
Post a Comment