Japan’s health care as a model

The health care debate in America has had an interesting item mentioned again and again in recent weeks — the Japanese health care system! Editorials and news reports have held up Japan as an example of good-quality health care.

While the background conditions in America and in Japan are perhaps too different to compare, Japan can be said to provide a very good, if not perfect, level of health care to its citizens. With the debate raging in the States and a new government in Japan, now is a good time to take stock of lingering problems.

What many articles in the American press point out is the overall choice and general quality of services in Japan. Per capita expenditures here are lower than in the States because of so much primary and preventive care, mostly at local clinics. While Japan’s specialization and high-tech care may not be as advanced, the level of access, number of annual checkups and basic care for the majority of Japanese mean that specialized and technology-oriented medicine is needed less often.

All of that is good, but other problems remain. Local clinics and hospitals have long waits. Further consultations about rare conditions or unusual symptoms can be extremely time-consuming. A shortage of gerontologists and geriatricians is balanced, ironically, by a shortage of obstetricians and pediatricians. Many hospitals in the countryside have had to close or limit operations. Emergency rooms and services are understaffed. The number of doctors who remain at large hospitals over the course of their careers continues to diminish. These are all problems that can be solved but need urgent attention and new policies.

As the population ages, significant changes in health care will have to be instituted. Diet, tobacco and alcohol, three lifestyle issues with the largest impact on health care, deserve fresh initiatives. The health care system also needs to devote more attention to suicide and depression, leading causes of death and suffering. The new government has a lot of work ahead of it to address these problems. Any system of medical care needs ongoing development to maintain its standards.

For the Japanese medical system to truly be considered a model for other countries, and a great service to those living here, much work remains to be done.