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)
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.