W3 Reflection: No Gatekeepers in Japan

“Sick Around The World”, sponsored by Frontline and PBS, is a comparative healthcare review that compares the United States healthcare system with those of Britain, Japan, Germany, Taiwan and Switzerland. For this week’s reflection, I chose to continue examining Japanese healthcare. I chose this society because Japan has the highest life expectancy in the entire world and the lowest infant mortality rate. What’s impressive about these statistics is that Japan actually spends HALF of what we spend per capita (8% GDP Japan vs 16% GDP United States at the time the film was released) on healthcare. Japanese healthcare isn’t funded via taxpayer money, but by a “social insurance” system instead, which every citizen must carry. While the insurance operates in the public sector, most of the hospitals and doctor’s offices are privately owned and operated.

The healers in this system are biomedical doctors, just like here in the United States. They use many of the same techniques and interact with their patients in many similar ways including X-rays, scans, prescription medications, surgeries and check-ups. The human body is, again, seen in roughly the same light as Western biomedicine and treatments are designed to fix the underlying cause, rather than just alleviating symptoms. These doctors, however, do not have the same social status that their Western counterparts enjoy, and many doctors in Japan feel undervalued and underpaid. Healthcare costs are kept low by the government, with prices argued and adjusted every 2 years, which means doctors aren’t able to boost their income by overcharging for a specific procedure or inflating their caseload. Another interesting fact is that there are no “gatekeepers” in their system; a person can go see any physician, any time, for any reason. Patients often have low waiting times and never need to schedule an appointment, however, these office visits are usually around 3-5 minutes long. At first glance, it appears that the Japanese system is excellent, but studies show that Japan actually doesn’t charge enough for healthcare, and as many as 50% of hospitals in Japan are operating at a loss.


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