U.S. health care spending highest, Japan lowest: study

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  • -3

    some14some

    OECD needs to speed up and provide latest data since economy has worsened in last 3~4 years especially in these industrialized countries.

  • -4

    Yubaru

    These numbers are skewed by the fact that, for example using the US and Japan as comparisons here, one is socialized medicine and the other consumer driven.

    However this puzzles me.....

    A study of 13 industrialized countries released Thursday showed Japan spends the least on health care, while the United States spends the most without providing superior care for the money.

    Spend the most without providing superior care? So is the writer inferring that since Japan spends the least it's level of care is last as well?

  • 9

    gaijinfo

    Japan operates a fee-for-service system, while offering unrestricted access to specialists and hospitals

    Does this include those people who die in ambulances because they can't find any hospitals with a vacancy?

  • 6

    hoserfella

    Spend the most without providing superior care? So is the writer inferring that since Japan spends the least it's level of care is last as well?

    Yubaru - The writer didn't infer any such thing about Japan. That was your own curious reasoning.

  • -10

    gaijinfo

    Also, according to their website (re: Japan)

    Of the countries studied, Japan has the lowest health spending, which it achieves primarily through aggressive price regulation.

    Any economist will tell you that price regulation leads to shortages. Also when doctors/dentists are limited to how much they can charge, they simply find other ways to increase their income, such as keeping people in the hospital for a week (when they could be out of there in a day or two), and making people visit the dentist several times for a simple filling.

    One of the reasons that costs in the U.S. are so high is the opposite reasons. They don't restrict prices, but they restrict the supply of doctors. There are the same amount of medical schools, producing the same amount of doctors per year as there were a hundred years ago, while the population has more than tripled.

    Also, a third payer system makes it much easier for people to spend more than they normally would, causing prices to go up even further.

    In short, all health care problems are a direct result of government intervention in the economy.

  • 7

    Yubaru

    Yubaru - The writer didn't infer any such thing about Japan. That was your own curious reasoning.

    I could have written as well that even though the US pays the most the inference could be made that they are not getting what they pay for too.

    I do not knock the Japanese system, been both a patient and long time employee of a hospital. Sure improvements and upgrades are needed and the system needs to adapt here better for the ever increasing number of elderly. Yet overall, and for the cost to me and my family as a patient it really isnt bad.

    I have actually been to a doctor here with my son, and the doctor charged us nothing. I wonder how many times a doctor in the US would see a patient, give them a thorough check-up and not bill them for it?

  • 6

    David B

    @gaijinfo, if that was the case why do other countries which have better healthcare for less money also have more government involvement than the US?

  • 3

    sfjp330

    In Japan last year, more than 16,000 emergency patients brought by ambulances to hospitals last year were refused admission by at least three hospitals. Japan hospital policy sounds like third world country when you have no means to pay for it. In the U.S. it is illegal to refuse emergency treatment, even if the patient is an illegal immigrant.

  • 1

    Schopenhauer

    First, I couldn't believe my eyes about the headline "U.S. health care spending highest, Japan lowest" My understanding is in America where self help is priority, poor people who cannot go to hospitals must die. Now I understand "U.S. health care spending highest" really means. That is only because hospitals and doctors charge a lot more than in Japan.

  • 5

    sfjp330

    In Japan, there has been a number of pregnant women have been transported by ambulance from one hospital to another after being refused admittance, and this has even resulted in the failure to save the lives of their babies. Anyone can understand that not having a vacant room is not a good reason to turn away a patient who should have been hospitalized even temporarily and received some sort of care. The Japanese medical practice and medical care systems have their own restrictions, but in case of an emergency, shouldn't this sort of restriction be eased a bit?

  • 8

    techall

    @sfjp330 My understanding is in America where self help is priority, poor people who cannot go to hospitals must die.

    This is a very common misconception. EMTALA (Emergency Treatment and Active Labor Act), enacted by the federal government in 1986, requires hospital emergency departments treat emergency conditions of all patients regardless of their ability to pay. In fact, more than half of all emergency care in the U.S. now goes uncompensated.There are also such programs as MEDICARE, MEDICAID and VA hospitals for veterans. A close friend on mine had an medical emergency while vacationing in San Francisco (intestinal blockage) and was taken by ambulance to an emergency room in the middle of the night. After he was admitted and treatment started the administration staff asked if they had insurance. His wife said they had Japanese insurance but didn't know if it covered him when he was in the U.S. That was it, they were never asked for a number, even when he was released and they never heard anything for the Japanese side either, so the care was basically pro bono. The hospital just writes it off as noncollectable.

  • 3

    GG2141

    One of the main reasons 'socialized medicine' is such a hot topic in the USA is not that the Americans really care so much about it (or being Americans, think about it), but the VAST AMOUNTS OF CASH flowing around it. You essentially have a situation where politicians are bribed to scream about the dangers of creeping communism whenever someone raises the issue of universal healthcare. I find it amusing that Americans are enslaved by their love of 'freedom'.

  • 3

    sfjp330

    techall, above was not my comment. It was made by somebody else. I said " In the U.S. it is illegal to refuse emergency treatment, even if the patient is an illegal immigrant."

  • -1

    orange

    Japanese healthcare might cost the least, but in our experience it is very hit and miss in terms of quality. As far as compassion goes, forget it, even when dealing with children we have found doctors and nurses to be utterly heartless, cold, lacking in empathy or sympathy, and sometimes distinctly unprofessional.

    We have had one instance where medication which was unsuitable, and in fact downright dangerous, was prescribed, and been asked for more money over the unconscious body of a loved one.

  • 1

    techall

    Sorry sfjp330, I meant to address that to Schopenhauer. Mea culpa.

  • 9

    zichi

    50 million Americans can no longer afford health care. My 85-year-old mother struggles to pay her monthly health bills and she's one of better off.

  • -3

    Alphaape

    in America where self help is priority, poor people who cannot go to hospitals must die.

    @ Schopenhauer: That is the image that those who are for universal health care in America try to convey. In the US, the very poor have Medicaid, where they can see doctors and get medical assistance, while the elderly get medicare. The problem with the US system is that the rates that medicaid and medicare pay are set by the government, and they are low. So some doctors can refuse to take those patients. Those same reates that medicare pays doctors are the same rates that military retirees (like myself) get. So now you have some doctors that will not take miitary retirees due to the low reimbursement rates. Also, the American system is rife with fraud. There have been several high profile cases in the USA on Medicare fraud, with one of the most recent ones being in Florida in a scam run by some Russians.

    Also, unlike in Japan, you don't have to be a US citizen to get medical care in the US. That is why there is a big push against illegal immigrants, because if they get sick, they have to be treated in Emergency rooms in the US, and they are eligible to get Medicaid. So not only are the US poor able to receive care, but illegals who do not pay taxes get the services also.

  • -1

    Alphaape

    Also, a third payer system makes it much easier for people to spend more than they normally would, causing prices to go up even further.

    @ gaijinfo: You are correct. The problem with American health care is the insurance industry. They get to set the price for services, and they are there to make a profit. So they will try to find ways to not have to pay. Also, most policies can't go from state to state. So if you have the California Blue Cross, it may not work in New York if you are there. Another big problem in the USA is the trial lawyers. They can go in and sue doctors for malpractice, and get huge awards, so the doctors have to pay high malpractice premiums, and the doctors just add the price on to their services.

    There are a lot of reasons why the cost of health care is high in America. But, even with that, it is still one of the best in the world in terms of care.

  • 5

    some07791

    But, even with that, it is still one of the best in the world in terms of care.

    Alpha, it is indeed one of the best in terms of healthcare - for those can afford adequate cover. Unfortunately, there is a substantial minority in the USA who cant. This leads to the USA not only having higher incidences of stroke, heart attacks etc, as per the article, but also a much higher incidence of infant mortality, cancer survival rates, longevity and other key indicators of healthcare. The socialised systems of Japan, UK, other Europeans NZ etc are superior than the american system because they succeed in providing a reasonably priced healthcare system which contributes to the health bottom line of the countries. Healthcare in the USA is not laudable.

  • 3

    sfjp330

    DogMay. 04, 2012 - 09:27AM JST. Is it really too much to ask that people do the most basic research before they opine and make an ass of themselves? WRONG!!!!!!!!!!

    the illegals do not need medicare. They all use medicaid. Persons covered by medicare often have to purchase additional coverage from private insurance companys to supplement their medicare payments. Illegals just go to the emergency rooms and walk out without paying anything. That is where medicaid kicks in.

  • 2

    kwatt

    So if you have the California Blue Cross, it may not work in New York if you are there. Another big problem in the USA is the trial lawyers. They can go in and sue doctors for malpractice, and get huge awards, so the doctors have to pay high malpractice premiums, and the doctors just add the price on to their services.

    If the US had a kinda (Federal)National Health Insurance system for all states, it would work well anywhere for all patients who wants to go see doctors. As for too many lawsuits to doctors, Americans easily sue doctors on medical practice. Patients and lawyers together always try to find something wrong of medical treatments. This thing really would make medical cost higher and higher.

  • 5

    sfjp330

    kwatt May. 04, 2012 - 09:37AM JST. Patients and lawyers together always try to find something wrong of medical treatments. This thing really would make medical cost higher and higher.

    In the U.S., many Doctors often order tests they don't really think a patient needs because they fear being sued if the diagnosis was wrong or they miss detecting a problem. This is why Doctors practice defensive medicine. Many of the tests are often more for the doctor's benefit than the patient's. There's a need for overhaul state medical malpractice laws as a way to reduce unnecessary tests that drive up health care costs. If doctors sense you might second-guess them or cause trouble, you could potentially be risking more tests being done. Many patients feel better when a doctor orders lots of tests until they get the bill.

  • -2

    Alphaape

    Is it really too much to ask that people do the most basic research before they opine and make an ass of themselves

    @ Dog: There was a recent case in Fresno, CA where an illegal spent 374 days in a hsoptial, the longest stay in that hospital for any uninterrupted case. A 35 year old illegal immigrant who came from Mexico had gall stones and other complications. All of this was paid for by the California and US taxpayers at no cost to him. To note, the hosptial did go on record to state that it spent $100 million in charity care last year. You can find the article on the web if you search.

    That is one reason why there has been such push back in the US on socialize medicne. Most people in the US agree that there needs to be some reform in the system, to keep costs down and to cut down on fraud. But, the US can's afford to take care of the world's poor in addition to its own poor.

  • 2

    sfjp330

    DogMay. 04, 2012 - 09:44AM JST. Do you think it is any different here in Japan

    Yes, 2011, in Japan, 16,000 emergency patients brought by ambulances to hospitals last year were refused admission by at least three hospitals.

  • 0

    kwatt

    Yes, 2011, in Japan, 16,000 emergency patients brought by ambulances to hospitals last year were refused admission by at least three hospitals.

    They were refused it by at least 3 hospitals, but most people would make it to survive in hospitals but some died unfortunately. I've heard that many doctors in Japan don't want to be a surgeon and a gynecologist as they are worried about lawsuits.

  • 6

    Serrano

    The cost of health care in the U.S. is absurd. And it's going to remain absurd for a long time.

  • -3

    Franchesca Miyara Yang

    One of the great things about living in Japan...No weird obsession with going to the doctor for X or Y preventive medicine screenings and those awful so called "well woman exams". Been here for a decade and its paradise when to comes to complete freedom of will and there is no one trying to bull you into useless and barbaric pelvic/pap/mammograms when you are a completely healthy asymptomatic person, unlike in the U.S. where they want to test EVERYONE, including teenagers and virgins.(Annually, only 44,000 will get cervical cancer out of 300 million people in the U.S.!!)That culture"preventive medicine" tests and screenings for every single thing is a scam and a billion dollar industry. People getting tested for everything without even being sick? Ugly business. If you are NOT sick or having any symptom, Do not go to the hospital, you are taking time and resources from the sick people that really need it. ;-)

  • -2

    Alphaape

    If one is poor and an illegal in Japan, and go to the hosptial ER, how do they pay for the treatment? Does the J-gov pay for it? I had to have an emergency treatment that the USNH Yokosuka couldn't do. So I went to a hosptial in Yokohama. I was treated, but I still had to pay by my own credit card since the insurance I have is not accepted by the JN hosptial.

    Also, people coming to Japan to visit persons living on the bases must and want to stay on-base must show proof of valid travelers insurance before the pass is given. The reason being because cases of people getting injured over here in Japan and their US insurance didn't cover. So the people just skipped out on the bill and there was nothing that the miltary could do about it, so they make it a requirement to show some proof of insurance before they issue a guest pass for long visits.

    So again I ask, how do the poor and persons who are here on visa overstays get treatment in Japan.

  • -1

    BigBoy69

    2 Things... When billionaires/milionaires from other countries need the best medical care .. they go to New York and find the best Jewish doctors including the Oil Shieks from the middle east.... and 2). Yes, obesity and all the problems that go along with it is rapant in the USA ... sad sad sad

  • 6

    iceshoecream

    Keep eating Burger King, McDonald, etc and drinking your diet cokes and that's exactly what you'll get, the highest health care spending.

  • -2

    Aries Post

    Judging by the negligence of people in the radiation areas, Japan needs to care more about individuals

  • 7

    zichi

    Alphaape

    So again I ask, how do the poor and persons who are here on visa overstays get treatment in Japan.

    Well they don't. Everyone must have have a health card and paying into the system unless exempt. We still pay 30% of the costs anyway. Anyone else would have to pay the full amount which would be much cheaper the America.

    I think also unless it was a matter of life or death an illegal would avoid any kind of officialism.

    But you can just walk into a hospital, give your personal details, get treatment and walk out without paying since it's based on honesty.

    You can even make an arrangement with hospitals to pay by installments.

    @BigBoy69

    When billionaires/milionaires from other countries need the best medical care .. they go to New York

    Actually many of them head to London, to Harley St like the private hospital, The London Clinic were I worked for a couple of years. Like staying in a 7 star hotel with some of the world's best doctors and latest technology.

  • 3

    some07791

    Dog National health systems are judged on 2 criteria: -cost of the service -benefit gained from that expenditure

    The system in the USA fails on both counts being the most expensive and yet having very low key health indicators (infant mortality, heart attack survival etc as per the above article.)

    It makes americans look arrogant and ignorant when they claim they have the best health care system in the world when countries such as NZ, UK, Canada Japan, with more socialized systems, provide better healthcare for a lower cost for the population of those countries.

    Treating illegal immigrants is not the reason the american system is so dire, all the above listed countries will also treat emergency admissions for free.

  • 0

    warnerbro

    It's hard to compare the two but America is forcing poor people not to seek medical treatment until the health problem becomes an emergency. Then they go to an emergency room and, as many have observed, they will be treated. However, everyone else is picking up the tab. That is, the cost is socialised, all the while that Americans whinge about the horrors of socialised medicine.

  • 1

    bruinfan

    Two good criteria to measure outcomes of medical system are: (1) infant mortality rates, (2) life expectancies. Look at the data of various countries and compare.

  • 2

    ebisen

    I was a patient in 4 of the countries in this list. Out of them, Japan had by a very large margin the highest quality of service, at very acceptable prices.

  • 3

    some07791

    An independent ranking of health systems: http://en.wikipedia.org/wiki/WorldHealthOrganizationrankingofhealthsystems

    The best being France. The ranking from WHO backs up this articles simmary: Japanese healthcare works, despite its low cost; American healthcare is a failure.

  • 6

    zichi

    In Japan the hospitals will get 70% of the health care costs regardless of whether the patient pays the other 30% or not. So even if an illegal gets health care but does not pay the required 30%, the hospital will still get the other 70%.

    I have several close friends who are doctors who until recently all had their own clinics but their biggest complaint with the national health was the amount of time required with all the multi form filling to claim their payments.

    Over the last few years they have closed their clinics and returned to working in hospitals.

    In the UK I've heard that now it's difficult to find a dentist who works for the national health because again they were defeated by the paperwork and many now only treat private patients?

  • -3

    Alphaape

    countries such as NZ, UK, Canada Japan, with more socialized systems, provide better healthcare for a lower cost for the population of those countries.

    @ some07791: You do know that in Canada, they have outlawed private health insurance. Too many people were opting to have their own insurnace and instead of wating for a Canadian specialist to be available, they would just go across the border to the USA.

    A year or so ago, the Premier of Newfoundland needed heart surgery so he did what any wealthy politican from Canada would do, he went to the US to get hs procedure done. When asked why he didn't want to get it done in Canda, he is quoted as saying: " "I did not sign away my right to get the best possible health care for myself when I entered politics," That's not much of an endorsement for Canada's vaunted public health system.

  • 5

    some07791

    Ape, you are ignoring the evidence, eg the WHO and the report this article is based on..

    What happens to rich men (Canadian politicians, oil sheiks etc) is irrelevant, its the healthcare available to the average citizen that counts and all the indicators say that the USA system is a failure: the most expensive with the least value for money (compared to similarly rich countries)

    Always amusing to see americans deny that anything american is lest than the best when presented with overhwelming evidence to the contrary...

  • 6

    some07791

    Ape - by the way Im not attacking america (nor I think many of th other posters) just pointing out the conclusions of this article. America is a world leader in many areas such as univeristy education, technology, etc

    However, it fails in healthcare, which is what this article is discussing and your anecdotes about canadian politicians and jewish Drs in NY dont change the fact that the American healthcare system is failure for a country which leads the world in so many other areas. This is just objective analysis..

  • -8

    WilliB

    Not to worry.... Obama has legislated that it will become cheaper, and hundreds of thousands of new government positions have already been created to make sure that it becomes cheaper. Nationializing is the way to go.... ask North Korea and Cuba about it!

  • -2

    herefornow

    Well all I have to say is that I needed an emergency procedure done here in the states early last fall,, and, yup, it was expensive, over $100,000, or which my portion was about $20,000. But I'm alive today and I doubt I could say the same if I had still been in Japan. There I probably would have died in the ambulance. Critisizing the U.S. health system because Americans eat too much and that leads to problems like heart disease and diabetes is a red-herring, and this group knows it. Ask anyone at The Commonwealth Fund if one of their parents needed open-heart surgery, and they had the choice of doing it in the best hospital in New York, or the best in Tokyo, and see what they say.

  • 1

    AiserX

    There is this pervasive myth that U.S H.C is not socialized and somehow proof that a free market in H.C does not work. One only needs to look at Medicare, Medicaid, HIPPA, MSEHPA, and the recently introduced "Affordable H.C Act ( oxymoron ) and H.C and Education reconciliation Act ( Both make up what is known as "ObamaCare" ).

    http://mises.org/freemarket_detail.aspx?control=458,http://mises.org/daily/3586.

    The amount of Govt intervention within the America H.C sector is amazing that outsiders still consider it as non-socialized. If anything America H.C was already Universal long before Obama's campaign promise for Uni-Care. Bush just beat him to it.

  • 3

    FruitsBasketFan

    Obama's healthcare bill is not even nationalized healthcare.....it is based on a Republican alternative to univeral healthcare by relying on mandatory PRIVATE insurance instead of Clinton's nationalized healthcare plan in the 90s!

    Honestly, it is like conservatives have a short term memory or easily swayed by the political climate without doing actual research and how the US healthcare system is a financial mess with no better results than most other first world countries.

    And by the way, Obama's healthcare bill is not even in full effect until 2014!

    Do research before blabbing "it has not dropped prices yet"......

  • 6

    FruitsBasketFan

    Japan's has its flaws, but it is certainly much affordable compared to the US and the results are a somewhat better.....although, France's healthcare (and Scandanavian countries, especially) are way ahead of both the US and Japan when it comes to providing good care for its citizens.

    You do not hear news that involves thousands of citizens are denied care or have to wait very long just to receive care in those countries that are prevalent in the US (and to a lesser extent, Japan).

  • 0

    Laguna

    Japan excels at preventive health care, and there is a reason for this: in a socialized system, keeping costs down makes sense. In the United States, primary health coverage is offered through private insurance companies, which have no skin in the game regarding overall costs: they simply serve as a mechanism to transfer payment from buyer to supplier. Proof of this can be found in Medicare: its costs have risen 1% more slowly per year than private insurance over the past 40 years while providing the same coverage - and that has built up to substantial savings.

    More must be done. Rewards must be put on results rather than procedures; parity in terms of negotiating for pharmaceuticals must be achieved; and, importantly, Americans must be weaned from the culture that believes a pill is the solution to all problems, from attention disorder to obesity. Google the number of babies born addicted to prescription painkillers, which has nearly tripled in the past decade.

    Obamacare is a very solid first step towards addressing these issues, but much work remains to be done.

  • -8

    Hôjô Sôun

    "Rather than containing costs by restricting access, Japan instead sets health care prices to keep total health spending within a budget allotted by the government."

    This is socialism and this is unacceptable in America.

  • 3

    FruitsBasketFan

    So is our policemen, fire department, US postal service, military, highways, public schools, and more.....all paid for by the government and thus would be considered: socialism......

    The US already accepts some forms of socialism.....do research before spouting that.

  • -1

    gaijinfo

    @Alphaape

    There are a lot of reasons why the cost of health care is high in America. But, even with that, it is still one of the best in the world in terms of care.

    Exactly. That's why the super rich ALWAYS travel to the U.S. for medical care, because it's the best in the world. The myth of better health care in other countries for cheaper is just that, a myth. Sure it's cheaper, but the service is lousy. People die while waiting their turn for socialized medicine, just like in Japan.

  • 2

    Apino

    Please don't forget to note that in the United States, the poor get treated for free, via the emergency room. It's the indigent care policy. These costs get rolled into the costs everyone else pays through their insurance, inflating the cost of things like tongue depressor and cotton swabs to ridiculous levels.

  • 5

    FruitsBasketFan

    The emergency room only treats you in a emergency....it does not treat you in the earlier stages (even if you have growing case of cancer or an infection) despite doing so would be much cheaper than waiting until it becomes an emergency when it becomes more expensive.

    If the US had universal healthcare that covered preventive care, then you would have less poor people waiting until their sickness goes into a dangerous stage when it becomes expensive to treat and prices would not be so high.

  • 3

    FruitsBasketFan

    And even then, getting emergency care does not guarantee you will walk out without paying (unless you are a hobo, possibly). You can be poor or whatnot, but if you give a hint that you live somewhere with an address....the hospital will send you a big bill.

  • -2

    Alphaape

    But you can just walk into a hospital, give your personal details, get treatment and walk out without paying since it's based on honesty.

    @ zichi: I doubt that the honest policy would work very well in America. If a person comes into a country illegally and not through normal channels, I doubt if they will give the proper information when faced with the possibility of a large medical bill.

    Also, the trust and honesty that the hospitials are willing to provide does run out. The example I cited about long term guests of base residents must show proof of travelers health insurance. There have been too many cases of foreigners associated with base personnel coming over and using Japanese health care for emergency services and leaving without paying. One hosptial in the Atsugi area no longer sees referrals from the US medical here in Japan since they have had problems in collecting the bills.

  • 0

    Alphaape

    What happens to rich men (Canadian politicians, oil sheiks etc) is irrelevant, its the healthcare available to the average citizen that counts and all the indicators say that the USA system is a failure:

    @ some07791: I think it is very relevant. The supposed overall value of socailzed medicine is to be that all people will get the best care and treatment regardless of wealth. The fact that those who have the money to circumvent the system can go elsewhere says a lot about what they really think of the system. For a rich private citizen I have no problem with. But a supposed leader in the government, whose party is for the system and makes the rules for everyone, decides not to use it then I have a problem.

    Just like in America, take a look at the Congressional health plan. They are exempt from Obama care. I say if they voted for it, they should scrap their own and become a part of it. But they aren't, so that tells you a lot about what the overall effects will be.

  • 5

    mdepaiva

    Conservatives (i.e GOP) in the USA have a phobia concerning anything Socialistic. That's why they fought so hard against Obama's health care plan. Now we end up with a "watered" down version and they are still against it.

  • 4

    zichi

    Alphaape, yes thank you but I don't understand why those living on military bases should even be paying for their medical treatment. If they need treatment which isn not available on the bases and requires a visit to a Japanese hospital then the military should be paying the cost, in my opinion.

  • 3

    Frank Vaughn

    Yes all hospitals in the U.S. are required to treat anybody who walks in the door no matter how big or little their health problem and whether the have insurance or not and if they are a citizen or not and if not even if they don't have a green-card. A hospital unlike the federal government can not operate in the red for very long so the cost of all that free treatment does get passed onto those who can pay.

    Yes doctors do order excessive tests to cover their buts because the American people are lawsuit happy. Should a lawsuit make it to trial the jury is only too happy to hand out excessive rewards. I do not remember the source but I recall reading that depending on the speciality, the part of the fee for treatment for the malpractice insurance is between 8% to as much as 20%, so if you have a visit with a high-risk specialist for say $250, probably $50 was for his insurance in case you decide to sue him.

    And because health care is so expensive in America a lot of people do not seek treatment until it is an emergency, so a procedure that would have only cost $XX in a doctors office now ends up costing $XXXX in a hospital ER and may require some time in the hospital adding more $$$ to the cost.

    Medicine is big business in America, any of you who have visited, have you noticed the countless medical treatment adds on TV, from "come to this hospital" to "have your doctor prescribe you our miracle drug"? As stated above somewhere, drug costs in America are the highest in the world (again part of that is "malpractice" insurance for the drug company).

    Then there is shortage of doctors and nurses ( qualified doctors and nurses receive priority visa handling if they want to immigrate to the U.S.) The medical schools are turning out a good supply of doctors, but the U.S. has become the training ground for doctors practicing in other countries. Go to medical adds for India or Taiwan for example, they brag that they have medical care equal to the U.S. because that is where they get their doctors from or trained. And a small percentage of doctors also leave the U.S. for other countries because of the legal climate in the U.S. A shortage of medical personal, the law of supply and demand. And if look in the Internet you will find that the average med-school grad is $500,000 in debt before he(she) starts practicing medicine, additional cost to be passed on.

    And yes the U.S. has most of the best medical technology in the world. But that is expensive to R&D and then to place in the field. Then there is the "malpractice" thing again in case a machine harms a person. Oh yea I mentioned the TV adds, well that applies here too, and that can "force" a doctor or hospital to go out and purchase said technology because their patients are demanding it and the cost of that machine gets passed onto the patients, back to the "Big Business" angle.

    If health care in the U.S. the best in the world? sadly for the average person, NO it's good but not the best. However if you are wealthy enough or famous enough then yes.

    I have no answer other than medicine needs to go back to what it used to be or is envisioned to be and that is to help people in need. (sorry this is so long)

  • 2

    nishikat

    One big difference between here (and many other countries with universal/mandated care) is that in the USA there are too many bills not being paid. You can really notice that difference when you go from the USA to another country where almost everyone has better access to modern care. If you suddenly go to a hospital in the USA that hospital has no idea how much money it will get from you and what happens is they charge everyone sky high bills then they are worked down by the private insurance companies, cash negotiation, or bankruptcy. For the rich it is no problem. And the poor it's not a big problem too. But the middle class have to pay these ridiculous healthcare premiums as a result. And these private healthcare plans are really not that reliable for the amount you pay. When hospitals are chasing down people for all these unpaid bills with collection agencies and lawsuits (with a good amount ending in bankruptcy) it really does not promote good financial practice. So in America it's more of a financial problem and not a medical problem.

    instead of wating for a Canadian specialist to be available, they would just go across the border to the USA.

    This is a two-way street and with many countries. It's also rare and based on political falsehoods. Many Americans also LEAVE the USA and go to other countries for healthcare. An Ameican woman once went to Japan and paid 1.5 million yen cash for stomach cancer treatment. Some Americans even go to private hospitals in England for cash treatment.

    Obamacare is a very solid first step towards addressing these issues, but much work remains to be done.

    I agree. And don't forget Nixon also had a plan that had a lot of similarities as Obama's plan decades ago. The idea is to get those bills paid!!

  • 1

    almxx

    When billionaires/milionaires from other countries need the best medical care .. they go to New York That's where they die of the illness they came to get their "cure". If you want the best treatment for heart surgery, go to India.

  • 0

    nishikat

    Just because you are a millionaire or billionaire doesn't mean your money will save you if you are sick -- in any hospital. Well, there is Michael Jackson.

    ...but more serious examples...

    The kind cancer Steve Jobs had, I read that other people who had his kind of cancer survived longer than Steve Jobs did.

    The Member of the Monkeys Davey Jones had medical complaints and went for medical help. Was sent home and died later.

    I'm sure there are many examples like that.

    The point is if you are programmed to live only to a certain age there really isn't anything any doctor can do for you. Even if your doctor is Dr. House M.D.

  • 2

    KariHaruka

    Could this be due to weight related issues I wonder? Heart Attacks, high blood pressure, diabetes etc.

  • -4

    Jerome_from_Utah

    Back in the mid 60s, I noticed a huge difference between US and Japanese health care delivery that related to the providers and the prescription laws. Everything in the US has to be blessed by the all mighty Doctor and the AMA that uses the force of Government to snuff out competition. The result was that Japan had a ten to one cost advantage over the US and a huge advantage in accessibility. In medicine, Pareto's Law is about 20 to 1 while in normal business it is known as the 80-20 rule. That means a provider with four years of training can handle 19 out of the 20 patients in the room while that one person gets transferred to the hospital where they have the extra power. This is common sense. Unfortunately, in the USA we are going the other way to centralized "medicine" under Obamacare, a looming disaster.

  • -2

    JapanGal

    I like the honesty of the hospitals here. If they cannot accept you, as some of you claim that over 16,000 had to go to 3 or more hospitals to be accepted, I think that is great. They were honest. They either did not have the doctors to take you on, or the equipment and skills.

    American hospitals in emergency rooms role you into a hallway and leave you there with no one asking you squat. You can sit on a gurney for a week before someone notices that you are dead.

    Japan health care is great. I love it and would not want any other.

  • 1

    AreYouKiddingMe

    Top specialists in various medical fields exist in every country, however, there is a large concentration of these specialists in the United States. One can presume that prestige and salary are contributing factors to this well-known fact. One of the major reasons America's health care expenditures are so high is undoubtedly attributed to a small fraction of the population who use the majority of our most expensive health care resources because they are chronically ill, terminally ill, or the like. This accounts for about 10% of patients. In America, for better or worse, we don't (generally) stop a life saving $900,000 treatment because it will only add 4 months to someone's life. In a socialized system, the cost-benefit analysis would deem such procedures absurd.

  • 1

    Yubaru

    So again I ask, how do the poor and persons who are here on visa overstays get treatment in Japan.

    The poor are covered by not having to pay insurance premiums which are based upon one's income. There are two basic systems here the NHI (National Health Insurance Tax) or SHI (Social Health Insurance) which is paid jointly by employers and employees. By law one has to be under one or the other, even if on a visa one is supposed to be covered by insurance which is VERY easy to get at one's town office.

    Visa overstays and health insurance are two different animals. If the person didnt get insurance when their visa was valid it's their own damn fault as I see it if something happens. Insurance is what it is, there in case you NEED it, and if a person isnt smart enough to carry it I have doubts that they should be here in the first place.

  • 1

    sf2k

    amputations

    Yikes! The United States is an aberration of First World nations in many ways such that any healthcare comparison doesn't make sense. Americans are winning the war on making sure the next generation has diabetes or type 2 diabetes, and that their educational standards to improve their food choices are at the whim of corporations. And that the intellectual capacity of Bill O'Reilly represents the pinnacle of American culture. What could possibly happen?

    The only hope America has is that if nanites were released into their bloodstream to repair their health because the human is too stupid to eat properly and go for a walk.

    Have always loved the food in Japan, in spite of the subsidies and protectionism. If that's what it takes to maintain a thin and healthy society then so be it. Note as well though that most major cities are quire walkable, transit abounds and driving is mostly unnecessary (unless in smaller towns). Riding a bicycle is normal. As well as a lack of elevators on even 7 storey buildings! There is an implied level of fitness even if it is not stated. Lots to love about Japan in that regard

    However I would like to thank the Okinawan elders for once again skewing Japanese statistics in spite of the recent hamburger craze.

    I am thankful everyday being born a Canadian. I had need of multiple surgeries as a young boy and my family was not burdened financially by it at all. I think of France as a model on health but that's because I love red wine ;) America will never get it and is too afraid of their own citizens to allow it. They want socialism but not the word, so they insist on suffering. Very sad.

  • -1

    sf2k

    AreYouKiddingMe

    This accounts for about 10% of patients. In America, for better or worse, we don't (generally) stop a life saving $900,000 treatment because it will only add 4 months to someone's life. In a socialized system, the cost-benefit analysis would deem such procedures absurd.

    It's not absurd, we generally don't have need for lots of gunshot doctors because Canadians are not shot by guns so often that we have the staff to handle such cases in a pinch. I've read of cases where a patient goes down to the States for a procedure problematic here but it's still mostly covered by our provincial plan.

    We benefit from both. You don't from either. Ironic.

  • -2

    sf2k

    a few fine, we have the doctors, but say a dozen like a typical night in America, and we don't have that kind of preparation

  • 0

    Thunderbird2

    In the UK the National Health Service is free at the point of delivery... which means anyone who needs it gets medical attention. We pay for the NHS from our taxes. I work for the NHS in Scotland and we are putting the patients first.

    Surely everyone in Japan paying for their health needs from taxes would be preferable to having to fork out tens of thousands of yen? Or taking out health insurance? It would allow even the very poorest access to the same levels of healthcare as everyone else.

  • -2

    nishikat

    Thunderbird2, I heard UK people are basically fine with the health system which some say needs some reforms (?) They want to keep it, it's just they want this same system improved. Do you see any big changes coming? For example could they have co-pays for people at certain incomes? Or is it possible they might integrate private practice in UK's national system like they do in Japan?

    I know in Japan for private practitioners there is a different fee schedule compared to going to a doctor in a big hospital. Also, there is a lobby that represents private doctors' interests.

  • -1

    cloa513

    >

    What preventative health care- I have had none in 3 years in Japan- they have rediculous age limits to stop you getting free dental checkup which is worldwide regarded as preventative medicine- just because it make sense to support preventative medicine in a socialised system - which a great of Japanese supplement with health insurance (Aflak- American insurance company is bigger in Japan than the US)- doesn't mean they do it. Just like a lot Japanese government decisions.

    Hospitals won't accept patients not because they can't adequately treat them but rather because they can't cover any possible eventuality with their facilities- there is no Good Samaritan legislation in Japan so the hospital and doctors can be sued- judges have said doctors took on the responsible when they took you as patient to heal you and must succeed.

  • 0

    nishikat

    cloa513,

    I get a notice from the public health center every year to get my health check. Maybe they don't know about you. Why don't you go and inquire?

    Also, the insurance system here covers dental checks and cleaning (are you talking about kids?). I get those as much as needed. It also covers basic eye exams.

    I have never been to the hospital and never had a serious health problem but I know many people who have. None of them had trouble going to the hospital. And big hospitals here have various departments and specialists just like they do back home.

    Personally I would not go for the supplemental insurance such as Aflac. And cancer insurance is always a rip off.

  • 1

    Thunderbird2

    nishikat - the conservative politicians here are always trying to tinker with the NHS, such as developing a 2-tier system where those earning a higher income pay, but there is always resistance from the medical practitioners themselves as well as the general public. Some people take out medical insurance and go private so they can get treatment more quickly, but by and large the British are happy to pay for the NHS from taxes... we'll all need it at some time in our lives.
    I was grateful for it when my father had a stroke and a 3 month stay in hospital... I can't imagine what that would have cost in the private sector, or in Japan.

  • 1

    presto345

    America is a great country. But even this great country is not great to everyone all of the time. For a developed country having failed to provide health care to all of its citizens on fair terms in the 21 century is a sad social failure.

  • 1

    nishikat

    Thunderbird2, in case you were curious. If have my facts straight the max co-pay in Japan is about 60,000 yen per month so three months treatment amounts to that times 3. It covers treatment and not the hospital stay so the room is paid in cash. If you have less money you share the room with more people and that room is reasonable enough. More money you can have your own private room, if you want. Also I think meals and other things non-medical are paid cash.

    I guess for your father's situation it would be about a few thousand dollars with co-pays and cash fees together. But still much cheaper than in the USA. I know of a case of a person who went to a US hospital for just weeks for a stroke and the bill was six figures.

    we'll all need it at some time in our lives.

    That's an important point and a big problem with the American system. It's too much risk assessment on a financial level. In other countries' systems as you pay over the years eventually you will get that amount back in the medical treatment you get over your lifetime compared to the average person. If you don't then at least it helps other people you know and care about.

  • 2

    kcjapan

    "U.S. health care spending amounted to more than 17% of gross domestic product in 2009"

    Simple message: US medicine is for profit not for a humanitarian need. Is it any wonder when private corporations own hospitals and nursing homes preying on the public and governmental payment systems is the normal course of a business model?

    At 17%, (the last quarter of 2009, at 14,087.4 billion USD) meant 2,394.858 billion was spent on health care spending. When big business wants to stop the conversation, or legislation or oversight, they have plenty of money to gag the public interest.

    In the end, it’s not about the money. It’s about stopping examination of the health care spending system by the public, government and legislators. Wealth is power, and in this case it’s the power to make you sick.

  • 0

    Samantha Ueno

    US healthcare system is not the greatest in the world. I'm pregnant and will have a homebirth with midwife because I do not trust the hospital to do what is best for me and my baby, rather than what is most convenient and will make them the most money. Plus the infant mortality rate in the US is much, much higher than most developed countries that still use midwives and practice natural childbirth.

  • 0

    LFRAgain

    Frank Vaughn,

    Nice post at 03:03PM JST. You pulled a lot of the arguments together in a succinct analysis.

    I agree with you wholeheartedly: The point of medicine was, is, and always should be simply to help people who need it.

    Honestly, nothing raises the bile in my throat more than the "If you can pay for it, why not?" defense of a U.S. health care system designed to give the best service in the world to the wealthy, or the barest minimum of emergency treatment to the very poorest Americans.

    Medical care should absolutely never be a for-profit enterprise, I don't care how much innovation comes from free-market competition. If the sole motivation for creating a device or procedure that can save the life of a fellow human being is the potential to get rich from it, then perhaps the person thinking it up has no business around his/her fellow human beings to begin with.

  • 0

    noriyosan73

    An American who is 65 and on Medi-Care and who earns $65000 USD/month pays a minimum of $145 USD per month to Medi-Care from Social Security or other income plus $350 USD to an independent insurance company for supplemental health care insurance. The average amount of time a woman stays in the hospital after a Cesarean birth is 24-36 HOURS. A simple treadmill stress test supervised by a RN and MD costs $5000 USD at the hospital. Cost are outrageous in the USA.

  • -1

    johninnaha

    It would be much better for the U.S.A. to spend more money on a social medical system than to waste it on pointless wars that cannot be won.

  • 0

    peanut666

    The difference is simple. America operates healthcare to make profit. It is the only country in the world, which the consumers pay for being healthy. Why do you think the Republicans, the conservatives, and big healthcare businesses do not want a national healthcare policy? Because it would be bad for the economy. They can't make money off of the people. Japan operates healthcare to take care of the public, not to make a profit, so it cost less to operate. Come on people, think. This debate has been going on for over 3 decades!

  • 0

    peanut666

    noriyosan73May. 06, 2012 - 06:28AM JST An American who is 65 and on Medi-Care and who earns $65000 USD/month pays a minimum of $145 USD per month to Medi-Care from Social Security or other income plus $350 USD to an independent insurance company for supplemental health care insurance. The average amount of time a woman stays in the hospital after a Cesarean birth is 24-36 HOURS. A simple treadmill stress test supervised by a RN and MD costs $5000 USD at the hospital. Cost are outrageous in the USA.

    This is somewhat true, but he doesn't earn $65000 USD/month. That is what Medicare is paying the hospital to take care of him. The reason is that the hospital runs on profit, not on service. It is the American way.

  • 0

    noriyosan73

    Correction accepted. Thank you. "$65000 USD per year" of which all of it is income tax free from the USA, state and Japan. One point that was left out is that Medi-Care also has a $250/year deductible, which has to be met before anything is paid. The USA system is a "for profit" health care operation, and the workers pay for all of the non-insured. It makes many Americans want to quit and go on welfare.

  • 1

    Patrick Hagger

    The problem with healthcare cost in the United States is the waste, fraud and corruption by public entities that contribute to the cost. having more public healthcare facilities is just the greatest chances that cost will be administative and outright waste, fraud and corruption. There is no care at all when this occur, the lack of healthcare is what have most Americans upset the public facilaties.

  • 1

    peanut666

    noriyosan73May. 08, 2012 - 09:46AM JST Correction accepted. Thank you. "$65000 USD per year" of which all of it is income tax free from the USA, state and Japan. One point that was left out is that Medi-Care also has a $250/year deductible, which has to be met before anything is paid. The USA system is a "for profit" health care operation, and the workers pay for all of the non-insured. It makes many Americans want to quit and go on welfare.

    I understand your concern. But most people who go on welfare don't do it because they want to. Most senior citizens who worked minimum wage jobs all their lives PAID into the system so when they get older they will have medical coverage because they know they can't afford it in their later years. The problem is that healthcare is for profit in America. And because it is for profit and not regulated, hospitals can charge whatever they want for their services.

    Think about it in these terms. If you are a parent and have a child suffering from cancer, you will most likely spend all your money trying to cure your child. If you are dying and know that a doctor or hospital can cure you, but it will be very expensive you will try your best to get that care. That is human nature and the healthcare system and insurance companies know this. They use this to charge the patient and their families incredible amounts of money and they know that the government will pitch in to help cover the costs using medicare, medical, or whatever available funding they have.

    It isn't the poor abusing the system. It's system abusing the poor.

  • 0

    roberto60

    thanks to the Japanese food is healthier than the American

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