I cannot imagine why this might be. Isn't the USA the richest country on the planet?? You'd think spending all that money would get you something, right??
(health care spending per capita on the left, life expectancy on the right)
I cannot imagine why this might be. Isn't the USA the richest country on the planet?? You'd think spending all that money would get you something, right??
(health care spending per capita on the left, life expectancy on the right)
Japan is widely regarded as having the best health care system in the world. And here we see it's relatively cheap per capita, too, which... says a lot, frankly.
bUt TheY'rE a HomOgenOUs cULtUre sO IT woRks thEre
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Just flip it back on them
"Japan only works so well because there's no white people"
I think in this one case that actually does explain a lot. The Japanese diet is far healthier than the American one.
Their healthcare system is also one of the least socialized on this list here. The government only covers 70% of costs.
They're much healthier than us, way less obesity. So our care costs more since we have more ailments.
pretty sure that actual health conditions and treatments aren't the root cause of the high cost here
pretty sure Japan wouldn't charge me $5k for a ride to the medical facility, or $43 for a Vicodin
Interestingly, Japan is considered to have the best health care system... but it's not universal! It's a universal insurance system, where citizens are responsible for 30% of their bill (or less if they're poor). I don't think it's single-payer on the hospital side either, but don't quote me on that.
I mean, it's really obvious why the usa's system is so shit, and expensive. But why Japan's is so good is much less obvious. It's one of the only top-tier health care systems that isn't full-on universal health care, and it's also one of the cheapest per capita. Go figure!
Japan's use of public transit and walking, alongside one of the healthiest diets in the world very likely contributes to this stuff.
Also while I hate these arguments, a lack of diversity absolutely does impact health outcomes. If it didn't, the health disparities we see from when non black doctors have black patients in the US that exist across class lines wouldn't exist in the same way.
I would argue that's a function of racism, and not diversity.
Also this data seems important: https://www.healthsystemtracker.org/chart-collection/health-expenditures-vary-across-population/?_sf_s=How+Do+Health+Expenditures+Vary+Across+the+Population#item-whites-have-higher-health-spending-in-most-age-categories-than-people-in-other-groups_2016
Some observations:
Blacks end up spending less until 45 years old, when they suddenly start spending more than both Asians and Hispanics. (consistent with the ACEs thing, just saying)
Whites aged under 19 spend about the same as non-Whites aged 35 to 45.
White people spend the most so it does not make any possible sense to blame non-Whites for high average health costs. (or what, reverse-racism confirmed?)
Overall healthcare spending is very skewed, if you look at the rest of that page...
Worth nothing that 89% saying they are in at least good health doesn't mean much in a study like this; because really bad health is usually a transient thing (because you get better, or you die, or you have a chronic condition in the remaining 11%), so it doesn't mean they are well served by the healthcare system.
Is worth noting that doctors will often run extra even unnecessary diagnostics and such if they expect you can afford it.
Much of old people spending more is not just that they get sick, but that they have a juicy retirement fund.
Adverse Childhood Experiences (ACEs) and trauma or stress in general are strongly associated with bad heath outcomes basically across the board.
Because Japan is more culturally and ethnically homogeneous, there is not such a huge fraction of the population enduring constant oppression and abuse or neglect due to racism.
Chronic trauma related responses (such as fight/flight/freeze/anxiety/depression/etc) have harmful hormone and immune system effects.
This leads to more inflammation, ulcers, heart disease, cancers, autoimmune disorders, diabetes, and obviously addictions.
(it is worth noting Nadine Burke Harris is correct about ADHD; many symptoms appearing as ADHD also exist in cPTSD, the issue is complex, both ADHD and cPTSD are very real, serious, and common conditions. Short version is that ADHD is largely a dopamine issue, and dopamine is also involved in stress responses.)
More than one thing can be true at the same time. Japan has one of the least socialized systems on this list above with substantial out of pocket costs. Only really Canada, UK, and Taiwan (maybe Denmark too) have true single payer.
America is unhealthier for reasons that relate to capitalism too, such as dependency on cars and a fixation on certain ingredients in prepared food.
It's basically a system designed to give everyone lots of health care but also keep prices down. It's true that people have to pay 30% of costs out-of-pocket (within a monthly maximum based on your income, with the percentage reduced for the elderly and reduced or waived for the poor), but it's less well known that the government sets the price for every possible treatment. And they set the prices really low. So it's basically impossible for doctors to get wealthy (except for a handful that serve the rich and famous privately), and the only way to even stay afloat is to see patients constantly. Which Japanese people are more than happy to provide, going to the doctors two or three times as often as in the West.
T. R. Reid's "Sick Around the World" on PBS gives you a good taste in the Japan section.
It’s really fascinating, even as a frankenstein market reform tool, because whatever this system does, it works really well. Government price-setting is the ‘must’ that makes it tick, and I appreciate that there’s a built-in incentivization to go to the doctor more. Everyone should get a yearly check-up, at least, and I haven’t in a decade because the universal system is chronically underfunded, and thusly overworked.
Of course, you’ll take my universal health care from my cold dead hands, but it’s interesting, so thanks for the info and the link .
It's a interesting "third-way" type system. Absolutely not single-payer, and almost all hospitals are privately run. But the government sets the rules and tightly controls everything. So insurance companies and hospitals/doctors are ostensibly privately run, but insurance companies aren't allowed to make a profit and hospitals/doctors aren't allowed to set their own prices. Employers have to provide insurance for their workers, and they have to pay at least half of the costs. So it's in their interest to keep costs down, but they have no ability to restrict people's consumption. So the best they can do is try to run the insurance really efficiently, and large employers will even run their own hospitals directly to try and save money there.
Meanwhile, insurance has to cover just about everything: dental of course but also traditional Chinese medicine, massages, spa visits; anything a doctor thinks might help you. And there is no restriction on who you can see, every doctor in the country is "in-network", and people are freely allowed to go directly to specialists. Insurance also can't deny a claim, and only have the ability to contest it after they've paid; and even if they win the doctor has to pay it back, it never falls on the patient.
So it's like a private, non-socialized system, but with so much government control and oversight it functionally is 'socialized medicine.'
Incidentally this is basically the same way the excellent Japanese train system is run. Ostensibly private, with scores of separate for-profit companies, but with so much government regulation and oversight it feels like the whole country is run by one big nationalized operator.
There’s an interesting element I initially overlooked. In the end, 80% of health care spending in Japan is by the government.
In Canada, which is ‘universal’ health care, only 70% of health care spending is by the government.
Japan leaves some of the bill up to people, but less overall than an under-funded universal system that leaves dental and medicine costs up to people, for example! Japan might have explicitly more privatized spending, but effectively, it has little compared to many universally socialized health systems.