A Comparison of the American and the Japanese Health Care Systems

Both the United States and Japan ar part of the Organization for Economic Cooperation and Development (OECD, an organization composed of industrialize countries) and as such both countries atomic number 18 under the pressure to stretch out up to a original median when it comes to the quality of easilyness charge. apart(predicate) from the median created by OECD countries, the US and Japan ar alike nonethelessly pressured by such organizations as the World wellness Organization (WHO) that sets up checklists for good health c be ashess. In a report outlive 2000 on the health c are constitutions of 191 countries, WHO set some goals for a health sustenance placement.These goals are the following good health, responsiveness, and fairness in finance (WHO in Bureau of Labor Education of the University of Maine 2001, 1). By good health WHO refers to the good health status of the entire universe of discourse although out the gentle bes life cycle. Responsiveness, on the opposite hand, refers to the extent to which caregivers are responsive to the client/ uncomplaining acceptations with regard to non-health areas such as being treated with dignity and respect (Bureau of Labor and Education o the University of Maine 2001, 6).Fairness in financing gener anyy refers to the progressiveness of the health care organization wherein those who begin less are withal to spend less on health check care. These goals sh any be utilized to valuate and compare the Japanese and the the Statesn health care systems. But before an effective evaluation and analogy could be done, it will be important to individually describe the health care systems of these two countries. As such, this paper shall consist o the following sepa tell a description of the the Statesn health care system a description of the Japanese health care system an evaluation and the comparison of the two health care systems.The American health Care placement A. The Framework of the Ame rican wellness Care dust The American Health Care form could best be illustrated using figure 1. In figure 1, it could be noned that there are two damages systems in America, common and buck insular. Public amends system refers to Medicare, Medicaid, the State Childrens Health indemnity Program (S-CHIP), and the Veterans Administration (VA). clandestine amends system, on the other hand, refers to either employer-sponsored indemnification or private non-group insurance. We shall discuss each of these types.Medicare is a issue program that insures seniors aged 65 and above as well as some disabled individuals (Chua 2006, 2). This is a single-payer, organisation-administered program that covers hospital services, physician services, as well as prescription(prenominal) drug services (Chua 2006, 2). Medicare is financed three ways federal income tax r raseuees, payroll tax ( paying(a) both by employers and employees), and individual enrollee gifts (Chua 2006, 2). There a re individual enrollee subventions because even if Medicare provides the above-mentioned services, there are liquid important services that are not covered without the premium coverage.These premium services include treat facilities preventive care coverage and coverage for dental, hearing, or vision care. This meaning that the elderly who are covered by Medicare would many quantify still expect to avail of premium services and as such, they contribute a total of 22% of their income for the cost of health care (Chua 2006, 2). Medicaid is a call d ingest-administered health insurance program that provides coverage to low income citizens and disabled specifically, this insurance covers real unfortunate pregnant women, children, disabled, and parents (Chua 2006, 2).As for its administration, Medicaid is paid for by the state and the federal government. At the very least, the federal government pays $1 for every dollar that the state pays for (Chua 2006, 2). Unlike Medicare, Me dicaid offers a more comprehensive health benefits. S-CHIP is like Medicaid as regards administration but it is specifically for children whose parents do not qualify for Medicaid due to their income but still do not make enough bullion to provide insurance for their children. VA is a state-sponsored health insurance service for the veterans of the military.This insurance provides comprehensive health benefits that make the veteran spend al approximately secret code for health care. Employer-sponsored insurance refers to private health insurance services the premium of which are mostly paid for by employers. Under this system are the many organizations that offer health maintenance (HMOs). This is where corporations like Aetna and Kaiser Permanente fall. The coverage offered as well as the degree of co-sharing by the different HMOs differ also (Chua 2006, 3).Private non-group health insurance is the screen out of insurance availed by those who are freelance(a) and those that c ould not avail of employer-sponsored insurance. This sort of insurance allows the insurance company to confab rules regarding pre-existing conditions. Usually, pre-existing conditions are not covered by the insurance. This sort of insurance is fully administered by the HMOs and the benefits vary widely as well. B. Char good turneristics and Problems of the American Health Care system The American Health Care System is mostly a combination and interaction of in the public eye(predicate) and private entities.This is most exemplified by the two general types of health insurance services the public and the private. This detail could be demonstrated by a 2003 statistics on Health Insurance Coverage of the nonelderly (in Chua 2006, 1). This statistics shows that 62% of nonelderly Americans receive private employer-sponsored insurance, while 5% purchase their insurance in the market (Chua 2006, 1). 18% of these nonelderly individuals are in public insurance like Medicaid or Medicare, w hile the remaining 15% are uninsured (Chua 2006, 1).Elderly Americans aged 65 years and above are mostly insured through Medicaid (Chua 2006, 1). Or, better yet, we might as well look at statistics from the Centers of Medicare and Medicaid represented as a pie graph in figure 2(American infirmary Association 2005, 6). In the 2003 statistics on the Distribution of US Health Care Expenditures by Payer Source, of the total $1. 7 billion expenditures on health care, more than half are paid for by private entities. The lions share goes to private insurance. In this statistics, 35.8% are paid for by private insurance (American hospital Association 2005, 6). Consumers out-of-pocket spending on health care bank bill for 13. 7% of the 2003 health care expenditure, while other private expenditure account for 4. 8% of the expenditure. Medicare, a government health insurance system, pays for 17% of health care expenses, while Medicaid, another government health insurance system, shoulders 16 % of the expenditure. The remaining 12. 7% of expenditure is paid for by other government systems like the S-CHIP and VA (Centers American Hospital Association 2005, 6 Chua 2006, 2).As such, we could see that the American Health Care Systems expenditure is more than 50% private. In elicit of the big region in the budget that the federal government allots to health care, credibly the biggest budget allotment in the OECD countries, a big percentage of health expenditures is handled by private entities. It is worth mentioning that America is spending on the reasonable 15% of its GDP on health care when the average on OECD countries is simply 8. 6% (Chua 2006, 5).This also agency that America has the highest per capita spending on health care compared to other OECD Countries. It was put d admit that almost 10 years ago, the US was already the biggest per capita spender among its OECD colleagues. It fatigued $4,178 per capita while Switzerland, then second to the US on per capita spending, spent only $2794 per capita on health care. In nastiness of the big role of private entities and the high percentage in budget that health care system has, a big percentage of non-elderly adults are uninsured (15% are uninsured as we saw above).This means that millions of adults in the working age give way to spend their own money for health services. This also means that probably America is the only developed country that does not provide health services to all its citizens (Bureau of Labor Education in the University of Maine 2001, 3). Another bother is the fact that the United States has a high infant mortality rate compared to the other OECD counties. In fact, the United States ranked 26th in infant mortality rate among the industrialized countries (Bureau of Labor Education in the University of Maine 2001, 5).Neither did America rank well in disability-adjusted life expectancy ranking twenty-fourth among OECD countries (Bureau of Labor Education in the University o f Maine 2001, 5). This means that a number of Americans expect to live parts of their lives in disability which probably is a issue of not having access to health care (as a big percentage of nonelderly are uninsured). Aside from these problems, American health care is also characterized by a deficit in resources as most speck departments in hospitals report of being at or over capacity (American Hospital Association 2005, 25).In figure 3, we could see a bar graph show how some hospitals (especially teaching hospitals) could be at 43% beyond capacity. much(prenominal) a lack could be accounted for largely by the lack of full of life care beds, and not necessarily by overcrowding, in these emergency departments (American Hospital Association 2005, 27). This would mean that a number of hospitals, both in their emergency departments and intensive care units, would need to spend term on delight (American Hospital Association 2005, 26). These are all ironical problems in a country that is supposed to be most advanced in thriftiness and technology.The Japanese Health Care System A. The Framework of the Japanese Health Care System The Japanese Health Care System, in short letter to the American system, offers coverage for all the citizens. This system offers services that are evenhandedly comprehensive. Currently, the Japanese Health Care System provides a basic incase of benefits (including health check consultation, drugs, and other materials medical treatment, surgery, and other services home care treatment and nursing and hospitalization and nursing at medical institutions) and they whitethorn offer additional benefits (e.g. , funeral benefits, maternity allowances) under the collective scheme (Ward and Piccolo 2004). This system is best illustrated by figure 4. Health services are paid for in four ways health insurance contributions, by patient co-payments, by taxes, and by out-of-pocket payments (Jeong and Hurst 2001, 10). Health services are dispos ed(p) by providers which could be categorized according to the following hospitals, touch ons clinics, health centers, and pharmacies. nigh hospitals are categorized as general hospitals which mean that beds are allocated for presbyopic term care.These hospitals are closed to doctors who have clinics, these clinics being capable of lower limit bed capacity of 12 (Jeong and Hurst 2001, 11) and may have the latest medical devices needed for diagnosis. Pharmacies may have their own doctors who may dispense their own prognoses and prescriptions. Nursing services are also considered as health providers. The insurance services, though provided by more or less 5,000 HMOs, are largely non-autonomous non-governmental bodies (Jeong and Hurst 2001, 13). These HMOs are basically in charge of operating the compulsory subject area health insurance system (Jeong and Hurst 2001, 13).These HMOs experience control by the national and local governments. In fact, even doctors fees as well as other health services fees are standardized. The Japanese Health Care System may be categorized into two big divisions the Social Insurance System (SIS) and the National Health Insurance (NHI) (Ward and Piccolo 2004). People are delegate to a health insurance such that those who are working in a company or office are assigned in the SIS, while everyone else who cannot be classified as working in a company or office (including self-employed professionals) should fall under the NHI (Ward and Piccolo 2004).63% of the existence is insured under the SIS. Under the SIS, employers pay 50 to 80% of the premium while employees, depending on their income, pay around 8. 5% of their income for health insurance premium. In this system, the insured and their dependents pay 20-30% of in-patient and out-patient costs, at the same time act as co-payers in prescription drugs (Ward and Piccolo 2004). The NIH system, on the other hand, covers the remaining 37% of the population. Premiums paid by the insure d depend on incomes and assets. The insured as well as their dependents are required to be co-payers of 30% of the cost.In spite of the requirement for co-payment, Japan offers a co-payment cap The cap is at ? 63,600 (US$600) per month, with the average monthly disposable income being ? 561,000 (US$5,300) (Ward and Piccolo 2004). In addition, those who are elderly may benefit from long-term insurance which covers 90% of long-term maintenance costs. B. Problems with the Japanese Health Care System The Japanese Health Care System boasts of having state-of-the-art equipment accessible to its citizens. In fact, Japan has the highest CT and MRI scanners per capita among all countries.Japan also has low infant mortality rate in spite of lower GDP spending (7. 6%) for health care, well indoors the OECD median (Ward and Piccolo 2004). Japan is also able to provide co-payment cap though like the United States, Japans health system is also highly paid for by private entities Japan spent ? 29 . 8 trillion (US$280 billion) on healthcare, of which 53% was covered by insurance, 32. 3% by the government, and 14. 8% by patients co-payments (Ward and Piccolo 2004). Nevertheless, the Japanese Health Care System has its own share of problems.For one, unlike in most Western countries, specialization does not matter as much as in America. What matters is where a doctor is affiliated, thus making the distinction between a general practician and a specialist blurred. This makes having a family doctor difficult to have and standardisation difficult to come by (Jeong and Hurst 2001, 13). Also, Japan has 2 to 3 times longer hospitalization time compared to other countries which means that Japan would need more beds to accommodate patients (National Coalition on Health Care, 3).Probably the biggest problem that the system is facing is the increasing number of elderly population which would patently garble (National Coalition on Health Care, 3). There is also the problem of puny pre ventive care as well as low public awareness on taboo illnesses such as HIV and support (Ward and Piccolo 2004). Comparison Between the Two Health Care Systems In the introduction, we rung of the WHO requirement for good health, responsiveness, and fairness in financing. Let us evaluate the two systems based on these WHO goals.The American system, aside from the problems posed above, on the face of it lacks in its ability to provide good health for the entire population. For one, the American health care system does not cover the entire American population. There is just no mandate for such. The Japanese system is obviously different. Japan has a national mandate for universal coverage. This means that the Japanese system is made in such a way that all Japanese would have to fall into one of the two insurance systems.The fact that all Japanese are insured at the same time Japanese spending on health care against GNP is well within the OECD median is something that Americans would have to learn from. The very concept of a co-payment cap is a very good thing that makes health care more responsive to the call for good health for the entire population. As regards responsiveness, the fact that millions of Americans are uninsured automatically makes them not capable of even evaluating client/patient relations for issues such as dignity, respect, etcetera.Nevertheless, the Japanese system also has room for improvement as the existence of taboo sicknesses would obviously compromise the treatment of patients with dignity and respect. Lastly, as regards the requirement for fairness in financing, the Japanese system is way better than the American system. To a certain extent, the American system would make it difficult for certain parts of the population to be insured as they are not too poor to qualify for Medicaid but they are also not employed nor financially endowed enough to pay for private insurance. This is totally not a problem in the Japanese system.