Newspaper logo  
 
 
Local Stories, Events

Ref. : Civic Events

Ref. : Arts & Education Events

Ref. : Public Service Notices

Books, Films, Arts & Education
Letters

Ref. : Letters to the editor

Health Care & Environment

09.23 Nasa launches satellite to precisely track how Earth's ice is melting

09.23 Climate study ‘pulls punches’ to keep polluters on board

09.21 Greed is killing Alaska's salmon habitat – but we can still save it

09.21 Trump administration poses new threat to birds in allowing ‘incidental’ killings

09.20 Al Gore Is Still Optimistic [24:06 video; rather than future Frankenstein governments, how can we better ensure having brilliantly efficient & competent governments?]

09.20 The $11 trillion question Chris Cillizza can't answer

09.20 Florence sparks pollution fears after excrement-filled 'hog lagoons' overflow

09.20 EU must end new petrol and diesel car sales by 2030 to meet climate targets – report

News Media Matters

09.22 Progressives to DNC: It Would Be 'Insane' Not to Hand Over Twitter Account to Ocasio-Cortez

09.20 Morning Edition’s Think Tank Sources Lean to the Right

09.19 Taibbi: Bernie Sanders’ Anti-Amazon Bill Is an Indictment of the Media, Too

Daily: FAIR Blog
The Daily Howler

US Politics, Policy & 'Culture'

09.23 MARYLAND GOVERNOR REBUFFS CALL FOR CRIMINAL INVESTIGATION INTO BRETT KAVANAUGH ATTEMPTED RAPE ALLEGATIONS [Republicans above the law...]

09.23 Trump Is Strangling the U.S. Refugee Program to Death

09.23 Michael Moore's "Fahrenheit 11/9" Aims Not at Trump But at Those Who Created the Conditions That Led to His Rise

09.23 The Trump Administration's Latest Tax Scam for the Rich [video]

09.23 One Tiny Tax Reform, Billions for America

09.22 As Right-Wingers Push Trump to Fire Rosenstein, Here's What to Do If He Does

09.21 400,000 Americans in 900 Cities Ready to Take to Streets If President Trump Fires Rosenstein After NYT Bombshell

Justice Matters

09.22 Making Tariffs Corrupt Again

09.22 Why isn't Mark Judge testifying about Kavanaugh? He is an alleged witness

High Crimes?

09.20 Trump Should Be More Worried About the Brennan Dossier

09.19 'Killing a generation': one million more children at risk from famine in Yemen [Does America's government have empathy? Does it understand the concept of morality? The Saudi Air Force would be ineffective without U.S. military assistance...]

09.19 ‘Tied to trees and raped’: UN report details Rohingya horrors

09.16 Merchants of Death Profit from the Bombing of Children as a US-Backed War Goes Largely Ignored

Economics, Crony Capitalism

09.23 The Spider’s Web: Britain’s Second Empire [1:18:01 documentary video]

09.23 Why We Have To Break Up Amazon

International & Futurism

09.23 For This Year’s International Day of Peace, Korea Takes the Lead

09.22 Which nation is 'most generous' to refugees? Certainly not the US

09.18 Racist rioting in Chemnitz has reopened Germany’s east-west split [After 10,000 generations, we are all mixed-race. So let's become friends with our cousins instead!]

We are a non-profit Internet-only newspaper publication founded in 1973. Your donation is essential to our survival.

You can also mail a check to:
Baltimore News Network, Inc.
P.O. Box 42581
Baltimore, MD 21284-2581
Google
This site Web
  Japan's Low-Cost, High Quality Health Care System
Newspaper logo

COMMENTARY:

Japan’s Low-Cost, High Quality Health Care System

The issue is not whether a health care system is public or private, but whether costs are rigorously controlled or not.

by James Ridgeway
First published in his blog Unsilent Generation yesterday, 28 October 2009

Japan’s health system provides health care to its citizens as a matter of right. It earns some of the highest marks on various measures of quality, and costs far less per capita than the U.S. system–and less, even, than most European systems. Frontline examined how the system works as part of its “Sick Around the World” series.

In October 2007, Frontline interviewed Ikegami, the program chair of the Department of Health Policy and Management at the Keio University School of Medicine, and widely regarded as Japan’s top health economist. As he explains it:

[T]he government is able to control the flow of money....[W]e have multiple payers and multiple providers, but there’s a single-payment system — not a single payer but a single-payment system — so that all payers must abide by the payment system, and all providers must be paid by the system...[T]his is done on a procedure-by-procedure basis and by a drug-by-drug basis, and the way that is done is that a survey is made of the financial situation of the providers.

Each year, the government publishes a directory of what each procedure should cost. Here’s how that plays out when it comes to just one of the drivers of U.S. health care costs: high-priced imaging technology.

Q: Let’s take an example of how these low costs work. In Denver, where I live, if you get an MRI of your neck region it’s $1,200, and the doctor we visited in Japan says he gets $98 for an MRI. So how do you do that?

A: Well, in 2002 the government says that the MRIs, we are paying too much, so in order to be within the total budget, we will cut them by 35 percent.

Q: If I’m a doctor, why don’t I say, “I’m not going to do them; it’s not enough money”?

A: You forgot that we have only one payment system. So if you want to do your MRIs, unless you can get private-pay patients, which is almost impossible in Japan, you go out of business. ...

Q:... The price of that MRI is so much cheaper in Japan. Doesn’t he have to pay the same price, $5,000, for an MRI machine like the man in America?

A: Well, it depends on what kind of image density the radiologist wants. And the MRIs that are available in Japan are much less expensive than those that are typically found in the United States.

Q: So the imaging machine is cheaper? ... To me that’s another advantage of negotiating low prices: Then the supplying industry has to cut its prices, and the MRI makers met this need.

A: Right. And MRIs have now become very big in [the] export industry.

Q: So the health ministry set a low price, the MRI makers make cheaper machines to help the doctors meet that price, and now Japan is exporting these around the world?

A: Right. ... This is a situation where the market does work in health care. ...

Here are some other excerpts, which shows how far we are from most other developed countries when it comes to our thinking on health care. The Japanese are charged co-pays for their services, but there is a ceiling on these out-of-pocket expenses, which is not only extremely low (by our standards), but also adjusted according to income. Keep in mind, as you read this, that some 60 percent of U.S. bankruptcies are related to medical bills, according to a recent study.

Q: [T]hey’ve got a system that makes sure people don’t go broke paying medical bills.

A: Right. I think the main goal of a public health insurance system is to prevent people [from] going broke.

Q: How many people in Japan go bankrupt because of medical bills?

A: None, or at least there should be none, because first of all, they should be covered, and if they’re not covered, then they can get covered by paying back one year’s premiums. And if they can’t pay back the one year’s premium, then they will be on public assistance....

Q: Do you think the Japanese people feel that everyone in this country should all have a basic package of medical coverage?

A: According to opinion polls, I would not only say basic but egalitarian coverage [for] all. Over 70 percent of the Japanese, when they’re asked that question, say they’re not only in favor of basic coverage, they are in favor of egalitarian coverage.

Videos of more health care systems...


Born in 1936, James Ridgeway has been reporting on politics for more than 45 years. He is currently Senior Washington Correspondent for Mother Jones, and recently wrote a blog on the 2008 presidential election for the Guardian online. He previously served as Washington Correspondent for the Village Voice; wrote for Ramparts and The New Republic; and founded and edited two independent newsletters, Hard Times and The Elements.

Ridgeway is the author of 16 books, including The Five Unanswered Questions About 9/11, It’s All for Sale: The Control of Global Resources, and Blood in the Face: The Ku Klux Klan, Aryan Nations, Nazi Skinheads, and the Rise of a New White Culture. He co-directed a companion film to Blood in the Face and a second documentary film, Feed, and has co-produced web videos for GuardianFilms.

Additional information and samples of James Ridgeway’s work can be found on his web site, http://jamesridgeway.net.

This article is republished in the Baltimore Chronicle with permission of the author.



Copyright © 2009 The Baltimore News Network. All rights reserved.

Republication or redistribution of Baltimore Chronicle content is expressly prohibited without their prior written consent.

Baltimore News Network, Inc., sponsor of this web site, is a nonprofit organization and does not make political endorsements. The opinions expressed in stories posted on this web site are the authors' own.

This story was published on October 29, 2009.
 



Public Service Ads:
Verifiable Voting in Maryland