Japan, a nation with a long life expectancy, a rapidly aging population and a reputation as being expensive, surprising has one of the lowest per capita health care costs among the developed nations. Here is a basic look at the system, how it controls costs and some of its positive and negative points.
Residents of Japan are obliged to join one of two types of health insurance systems. One type is a social insurance plan which is normally for corporate employees. The other is national health insurance, which is for the self-employed, students and others not covered under a social insurance plan.
When someone goes to a hospital in Japan, insurance will usually cover 70%-80% of the costs upfront with the patient paying the difference. For more expensive treatments, the patient can receive a reimbursement for costs incurred.
By law, the insurance plans cannot deny a legitimate claim or refuse anyone regardless of preexisting conditions. Also, medical care is not rationed by age or for any other reason. Most hospitals are privately owned. However, the rates they can charge for most services and drugs are set by Japanese Health Ministry every couple of years.
People are free to choose whichever hospital they like. In spite of the fact Japanese people receive more medical care and spend more time in hospitals, Japan spends less on health care, and health insurance costs are much lower.
Negative points of the Japanese system
Doctors on average see more patients and thus spend less time with each individual patient than in the US. Hospital conditions are often not as nice as those found in the US. For example, unless paying for a private room, most patients stay in shared rooms with the patients separated by curtains. Most hospitals do not take reservations. Patients simply go to the hospital and wait their turn.
Drugs are often over prescribed. One reason for this is that since doctors spend less time with each patient, the sometimes simply prescribe drugs for initial visits instead of more thoroughly diagnosing the problem. The other reason is that hospitals sometimes can make money off the prescriptions.
Since going to the hospital is relatively cheap, people abuse the system and seek medical treatment when it is not really needed. Many hospitals are losing money since prices are often set too low. Also, there is underinvestment in some areas and the system is laden in paperwork and regulation.
While premiums are still much lower than the US, they are rising and an increasing number of people cannot afford them. However, this is often offset by programs that provide medical care for the children and the elderly. Overall, while the Japanese health care system does a good job at providing nearly universal coverage at an affordable price, it is not without it problems.
