Japan’s health care system is a source of great pride for the country. Japan attained universal health coverage over 50 years ago and the country's health outcomes are some of the best in the world by many measures, while health care spending is at relatively low levels.
Despite the many positive aspects of the system, it faces challenges. The demographic wave of rising numbers of elderly will put new pressures on the care delivery system and the nation’s budget. Moreover, the country has high utilization of many health care services, care delivery is often fragmented, and measures of quality are not commonly available or necessarily used for continuous improvement. How will Japan address these issues and manage the health care needs and rising costs of its aged and still aging society? What can other countries, such as the United States, learn from the Japanese experience, and can new care delivery innovations taking place around the globe help address Japan's challenges?
The document summarizes healthcare reforms in India and their implementation. It discusses the key components of the health system and health sector reforms. Major reforms included reorganizing and restructuring the existing healthcare system, involving communities in health system delivery, establishing a health management information system, and focusing on quality of care. Key national health missions addressed in the reforms were the National Rural Health Mission and National Urban Health Mission. Five Year Plans from the 8th to 12th Plans shifted policies to encourage private sector initiatives, prioritize primary healthcare, address issues of equity, and work towards universal health coverage. Effective health sector reforms require increased public spending on health, regulating the private sector, risk pooling, and strengthening health management information systems.
Community Participation In Primary Health Carecphe
The document discusses the importance of community participation in primary health care from the perspective of people's health movements in the global South. It describes how community participation was a key part of primary health care policies and programs before and after the Alma Ata Declaration of 1978, but was later distorted by the globalization of health systems. People's health movements aim to globalize health solidarity from below and bring "the community back into primary health care."
The document discusses public-private partnerships (PPPs) in healthcare. It defines PPPs as collaborative efforts between public and private sectors to deliver healthcare services, with clearly defined partnership structures, shared objectives, and performance indicators. PPPs involve some level of risk and reward sharing between the government and private partners. Several models of PPPs are described, including contracting, franchising, and joint ventures. The benefits of PPPs for both the public and private sectors are outlined. Key factors for successful PPPs include clarity of purpose, value creation, commitment between partners, and continuous communication.
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
THIS PPT IS ABOUT THE HEALTH CARE SYSTEM IN CHINA MOSTLY STUDIED IN ECONOMICS.
THIS ALSO SHOWS YOU ABOUT THE INSURANCE POLICY AND GDP RATE AND MANY MORE
Health Financing System of United KingdomAditya Sood
Discussing in brief bout the latest statistics of Health Financing in UK, with emphasis on National Health Services (NHS) model and the key challenges being faced by the UK health system financing.
This document provides an overview of healthcare financing in India. It begins with definitions of health care financing and outlines the key functions of accumulating, mobilizing, and allocating money for health needs. It then discusses the main mechanisms of healthcare financing globally and in India, including how money is raised through taxes, insurance contributions, and other means. It also addresses how funds are pooled and how health services are paid for. The document reviews India's current healthcare financing indicators and challenges, such as low public spending and high out-of-pocket costs. It concludes with initiatives by the Government of India and recommendations to improve healthcare financing in India.
The document summarizes several major health insurance schemes in India, including Rashtriya Swasthya Bima Yojana (RSBY), Employment State Insurance Scheme (ESIS), and Central Government Health Scheme (CGHS).
RSBY provides health insurance coverage to Below Poverty Line families, covering hospitalization costs up to Rs. 30,000 and transportation costs up to Rs. 1,000 per visit. Key features include portability of coverage across India and cashless/paperless transactions. ESIS covers employees in organized sectors, providing medical benefits from day one of employment as well as cash benefits for sickness, maternity, disability, and death. It is financed through contributions from employers and employees.
The document defines a health system as consisting of all organizations, people, and actions whose primary purpose is to promote, restore, or maintain health. It discusses health systems as complex adaptive systems with many interacting elements. It presents several conceptual frameworks for analyzing health systems, including the WHO health system building blocks and the Antwerp health system dynamics framework. It then discusses the concept of health system strengthening and changing global approaches to improving health systems over time, moving from a disease-focused approach to a more holistic health system strengthening approach.
Healthcare challenges & solutions in indiakripak93
This document discusses the key challenges facing India's healthcare system and potential solutions. The main challenges are the large burden of infectious and chronic diseases, high maternal and child mortality rates, lack of universal access to healthcare, shortage of resources, and inadequate healthcare financing. Proposed solutions include strengthening public health programs, improving access to healthcare in rural areas, providing incentives for medical professionals to work in underserved areas, leveraging public-private partnerships, and increasing public financing of healthcare.
Health sector reforms aim to improve the efficiency, equity and effectiveness of healthcare delivery. Key reforms implemented in India include decentralization through expansion of comprehensive primary healthcare centers, increasing healthcare financing and expenditures, expanding health insurance coverage, reorganizing the existing health system, improving health infrastructure and human resources, implementing digital health initiatives, and encouraging public-private partnerships. Challenges remain in strengthening implementation and ensuring equitable access across states, but ongoing reforms indicate progress toward more accessible and comprehensive healthcare nationwide.
Universal Health Coverage (UHC) Day 12.12.14, NepalDeepak Karki
This presentation is made on the first ever Universal Health Coverage (UHC) Day 12.12.14 celebration in Nepal by Nepal Health Economics Association (NHEA).
The Thailand HiT reports that sustained political commitment to the health of the population since the 1970s has resulted in significant investment in health infrastructure, in particular primary health care, district and provincial referral hospitals, and strengthened the overall functioning of the Thai health system. After Thailand achieved universal health coverage in 2002, public expenditure on health significantly increased from 63% to 77% and out-of-pocket expense was reduced from 27.2% to 12.4% of the total health spending in 2011.
Health Insurance in Nepal aims to ensure access to quality healthcare without financial hardship. The program began in 2016 and has since expanded to 49 districts. Members pay an annual premium of NRs. 2500-3500 for a family of 5. Benefits include coverage of up to NRs. 100,000 per family per year. Stakeholders provide both support and criticisms, citing issues around awareness, enrollment rates, benefit packages, and quality of care. Expanding the program, improving facilities, and addressing concerns will help achieve universal health coverage in Nepal.
presentation is all about ppp in one hand and ppp in health on the other. ppp is not only remain as collaboration for the use of government mobey by the private party but now has legal and administrative aspects as well. however, to make ppp as vibrant and result oriented, mutual trust has to biult between both the parties that would be supplemented by some successful cases of ppp specially in health sector.
This document discusses key concepts in health policy, including definitions of health policy, the aims of health policies in maintaining and improving population health status, and essential concepts like health status, health services, organization and financing of health systems, and the roles of public health, health commissioning, and ensuring appropriateness of care. It also covers international trends, provider-purchaser models, and major challenges for developing countries, including health reform, decentralization, tools for policymaking, and ensuring equity in health.
Health system in the perspectives of health economicsBPKIHS
Here is the slide on Health system in the perspectives of health economics. The content of this presentation doesn't belong to me. They are copied from several literature and internet
The document summarizes the 2013 ACCJ-EBC Health Policy White Paper. It begins with introductions from the ACCJ and EBC presidents. It then discusses key topics covered in the white paper such as non-communicable diseases, women's health, infectious diseases, healthcare safety, and more. Survey results are presented showing public support for initiatives like infection control programs, electronic health records, and smoking bans. The white paper contained 156 policy recommendations across 36 topics to promote health and economic growth in Japan.
The "Metabo Law" in Japan requires annual waist measurements for those aged 40-74 to curb obesity and metabolic syndrome. If waistlines exceed limits, individuals must attend counseling. Employers and insurers must ensure at least 65% participation and a 25% reduction in obesity by 2015 or face penalties to fund elderly healthcare. While raising health awareness, critics note low compliance with exams and advice, rising childhood obesity, and risks of discrimination.
This document discusses rising healthcare costs in the United States and strategies for controlling costs. It notes that the US will spend $2.80 trillion on healthcare in 2012, more than any other country per capita. While some point to defensive medicine, insurance profits, or demanding patients as the cause, the data shows these are a small part of overall costs. True savings may come from addressing the uneven distribution of costs among patients and choosing medical interventions wisely based on whether they improve outcomes or reduce side effects and costs. The document advocates for physicians to practice efficiently and consider costs responsibly when making treatment decisions.
This document compares the healthcare systems of the US, Japan, and Nigeria by analyzing health indicators such as infant mortality, total health expenditures, and hospital beds per capita. While the US spends the most on healthcare, Japan achieves better health outcomes like lower infant mortality despite spending less. Nigeria faces greater challenges with higher infant mortality linked to lower spending and poverty. The universal healthcare systems of Japan and Nigeria's National Health Insurance Scheme may contribute to their performance compared to the US partial coverage system.
This document provides an overview of a university course on Canadian health policy. It discusses obesity and chronic diseases as a policy issue that will be covered. The topics for today's lecture are introduced, including what policy is, policy tools, and writing a briefing note. Key information is presented on obesity trends, the social and physical determinants of chronic disease, and potential policy actions and the role of government. Government's role in addressing obesity is discussed, with differing views around libertarianism and collectivism.
The document discusses challenges facing New Zealand's health system, including an aging population, rising rates of chronic diseases, workforce issues, and rising costs. It notes improvements in some health outcomes but persisting inequalities. It argues for addressing modifiable risk factors, upstream investment, improved interventions, and new models of integrated care centered around patients and communities. Information systems will be important to drive quality improvement, performance monitoring, and new models of coordinated, proactive care.
The goal of this webinar was to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay.
The document outlines Japan's vision for its healthcare system in 2035. The vision is for a sustainable healthcare system that delivers high-quality outcomes through equitable care and contributes to prosperity in Japan and globally. Key aspects of the vision include implementing value-based healthcare, empowering personal choice through a supportive society, and leading global health. This will be achieved through strategic initiatives focused on prevention, innovation, information infrastructure, and a world-class Ministry of Health. The vision aims to position Japan as a global health leader through a system that meets the needs of a rapidly aging population amid advances in technology and changing social values.
Health care policy in the United States, Canada and ChinaYuzhou Sun
This document compares the health care systems of the United States, Canada, and China. It finds that while the US spends the most on health care as a percentage of GDP, it has a lower life expectancy than Canada. China spends the least but has increased funding for reform. Key factors discussed include pharmaceutical costs, administration costs, income levels, the uninsured population, lifestyle/obesity rates, and recent reforms in the US and China. Excessive medical treatment and fraud are also noted as increasing costs without improving health outcomes.
This document discusses prevention and health promotion in healthcare across Europe. It defines what good prevention and health promotion looks like, including health education programs, adult and child immunization policies, disease screening programs, infection prevention policies, and improving secondary prevention through risk factor reduction. The document emphasizes that while policymakers acknowledge the need to shift focus to prevention, progress has been variable. It argues that prevention is a cost-effective investment that can improve health and reduce disease burden and health inequalities.
Presenting the ACCJ-EBC Health Policy White Paper 2013ACCJ
The document summarizes the 2013 ACCJ-EBC Health Policy White Paper. It provides an overview of the white paper's goals of promoting economic growth in Japan through policies that lengthen healthy lifespans and reduce the economic burden of preventable and treatable diseases. The white paper covers 36 healthcare topics and makes over 150 policy recommendations across 6 chapters focusing on issues like non-communicable diseases, women's health, infectious diseases, healthcare safety and more. It is intended to build on the recommendations of previous ACCJ health policy white papers from 2010 and 2011.
- Traumatic brain injury (TBI) poses a significant burden globally, especially in low- and middle-income countries (LMICs) where the majority of cases occur but research is limited.
- Research on TBI disproportionately focuses on high-income countries despite LMICs facing the greatest burden. Disparities exist between regions with high TBI burden and where research is conducted.
- Conducting high-quality clinical research on TBI in LMICs faces many challenges including limited health infrastructure, resources, follow-up data collection, and differences in appropriate treatment compared to guidelines from high-income settings. Increased international collaboration may help address gaps.
This document makes the case for universal healthcare in the United States. It begins by defining universal healthcare and noting that no American should lack access to care due to inability to pay. It then reviews the moral, economic and cultural arguments for universal coverage. The moral argument is that denying care due to cost is wrong. The economic argument is that universal coverage could save money by reducing uncompensated care and increasing productivity. The cultural argument is that universal coverage aligns with American values like equality and pursuing happiness. The document advocates for universal coverage options that control costs.
The goal of this webinar is to help healthcare professionals improve care coordination for patients with advanced illness and to reduce hospital readmissions and length of stay (LOS).
G7 high-level side event in Niigata: Healthy ageing and prevention
Date: Wednesday 10 May 2023
Time: 2.00pm – 3.30pm (JST), followed by networking with refreshments
Location: Niigata, Japan
This document summarizes key findings from the OECD report "Health at a Glance 2015: How Japan Compares?". It finds that:
1) Quality of care in Japan is generally good, though there is room to improve diabetes care and reduce unnecessary hospital admissions. Mortality for heart attacks after admission is also high.
2) Japan has fewer doctors per capita than most OECD countries, though nurse supply is high. There are opportunities to better utilize nurses and improve efficiency.
3) Healthcare spending in Japan has risen faster than most OECD countries in recent years and is now higher than the OECD average as a share of GDP. Achieving greater value for money through efficiency gains is a priority
Depression and health system in Japan
Describe the mental health system in Japan
Depression and mental health epidemiology in japan
Attitude towards depression/mental health problem in the Japan
Risk factors of depression and thief prevalence in Japan
Strategies or polices of suicide prevention in Japan
This document discusses aging trends in Japan and proposals to promote healthy aging through information and communication technologies (ICT). It provides the following key points:
1) About 32% of Japan's population is elderly or disabled, and aging people account for half of healthcare costs and a growing percentage live alone.
2) Conferences were held to discuss ICT applications to support independent living and health for seniors, including expanding digital access and inclusion.
3) Proposals included establishing ICT-enabled health models using medical data to promote prevention, expanding medical data sharing infrastructure to improve care coordination, and creating "life support businesses" using technologies like sensors and robots.
1) Frailty is defined as a medical syndrome where there is decreased physiological reserve and resistance to stressors, due to declines across multiple body systems. This makes older adults more vulnerable to adverse health outcomes like disability, falls, and mortality.
2) In Japan, "weakness due to aging" is the major cause of disability certification and long-term care insurance use among the oldest old adults, those over age 90. This "weakness due to aging" can be considered equivalent to frailty due to aging.
3) There is no consensus on how to fully define frailty, but it is generally distinct from disability or comorbidity. Common factors used to define frailty include weakness, weight loss,
Similar to [Public Lecture Slides] Jennifer Friedman: Health care in Japan's aged society (20)
This document provides a theoretical framework on how inflation impacts retirement decisions and security. It summarizes several simplified lifecycle models showing how different levels and volatility of inflation can reduce real income, consumption, and savings over a person's working life. Higher and more volatile inflation is shown to lead people to accumulate less savings for retirement. The models also explore how inflation may impact labor supply decisions, finding that higher inflation could cause both earlier retirement through income effects, but also longer work through consumption constraints. The document reviews relevant data on how inflation is negatively impacting households currently and expectations around retirement. It previews how firm behavior and policy tools like COLAs could also be factors.
The Finnish and Swedish accessions to NATO—even though incomplete as of now—have been interpreted in some corners as the beginning of the end for neutrality. Not picking sides in a war of aggression is untenable, they hold, cheering the decisions of some former neutrals to give up their signature foreign policies while berating those who still do not send weapons to Ukraine or sanction Russia. Whatever one’s stance on the policy side is, one point has been lost in the debate: neutrality is not a question of ideology but a fact of conflict dynamics. It just won’t go away. Not even the two World Wars or the 40 years of the Cold War could get rid of the “fence-sitters.”
Neutrality, always and everywhere, is a reaction to conflict(s). The current one over Ukraine is no exception, giving rise to neutral policies in roughly two-thirds of the world. It is a moot question if there should be neutrality or not. Nonaligned behavior of third-party states is a fact of international life and will remain one. There are really only two questions that matter: First, which neutrals will leave the stage, and which ones will be born? Second, will the neutrals play a constructive role in the new global conflict, or will they be relegated to the margins?
This talk will disentangle the neutrality debate by differentiating the legal components from the political and strategic aspects and discuss recent neutrality developments in Europe, Asia, and the Americas.
Dual citizenship was once universally reviled as a moral abomination, then largely marginalized as an anomaly. During the twentieth century, states were able to police the status and manage incidental costs to the extent that full suppression proved impossible. More recent decades have seen wide acceptance of dual citizenship as those costs dissipated for both states and individuals. Powerful nonresident citizen communities have played a crucial role in winning recognition of the status. A handful of states -- Japan notable among them -- have held out against this clear trend and increasingly vocal emigrant and immigrant constituencies and children of bi-national couples. This session will situate Japan's resistance to dual citizenship in a global historical context.
The Jingu Gaien redevelopment plan in Tokyo has faced significant controversy. The plan would redevelop a historic urban park in central Tokyo that has provided a green space for 100 years. It would remove nearly 1000 trees, demolish two historic stadiums used for baseball and rugby, eliminate various sports facilities and cafes, and replace them with high-rise commercial buildings. Opponents argue the plan prioritizes old models of construction-centric development over environmental concerns or public input, and benefits cozy relationships between business and politicians over preservation of the park and community spaces. While an environmental assessment committee granted conditional approval, recent polls show over 69% of Tokyo residents oppose the redevelopment plan. Activists continue lobbying and raising awareness
November 17, 2022
8 November 2022 was the last day of voting for the US midterm elections. These elections reflected the mood of American voters and give us some idea of the future course of American policy and of the political and ideological balance of power in the United States. They will also affect the ability of the Biden Administration to pursue its agenda.
Professor Yashiro, one of Japan's leading economists, will look at the results of Abenomics (a term coined to describe Japan's economic policy while Shinzo Abe was premier) and Prime Minister Kishida's plans for what he calls a "New Capitalism."
Observers of Japanese security and foreign policies have largely focused on analyzing Japanese policies in the area of traditional security. However, they would be remiss to disregard the string of new developments that have been occurring in Japan – namely that of “economic security.”
Prompted by rising U.S.-China competition, Japan has been undergoing rapid change in its economic security policies over the last few years. These changes range from organizational transformation to new legislation as well as increasing support for the private sector. This trend is likely to accelerate under the incoming Kishida administration, which has created a new ministerial post for economic security.
How has Japan’s economic security policy evolved in the last few years? What kind of changes will we likely see in Japan’s economic security policies under the Kishida administration? What impact will this “economic security awakening” in Japan have on Japan-U.S. and Japan-China relations? How should Japan cooperate with other key actors, such as the European Union, the Quad countries, the Five Eyes states, and Southeast Asian countries?
This seminar will address these critical questions and more with Akira Igata, who has been advising international organizations, the Japanese government, bureaucracy, and the private sector in economic security issues for many years.
Speaker Biography:
Akira Igata is Executive Director and Visiting Professor at the Center for Rule-making Strategies at Tama University. He is also the Economic Security Advisor for the Inter-Parliamentary Alliance on China and Senior Adjunct Fellow at Pacific Forum, a U.S.-based think tank. He advises Japan’s bureaucracy, politicians, and private sector as well as international organizations on economic security issues.
A half a year ago, the prospect of an LDP presidential election did not inspire flights of the imagination. After all, what could break the hammerlock the top three party factions – the Hosoda, the Aso and the Nikai – had upon the process of selecting the party leader? Who or what could outmaneuver the wily LDP Secretary-General Nikai Toshihiro, whom two prime ministers in a row found themselves powerless to budge from his post at the apex of the party’s secretariat?
Over the summer of 2021, however, several factors became catalysts for changes in the party’s internal power structures. A presidential campaign like any other had unfolded, with the faction leaders and the party’s senior officials left gasping as erstwhile subordinates have run away with the narrative and the initiative. So many assumptions about how the LDP “works” have been challenged that the unprecedented situation of half of the candidates being women has been largely subsumed.
What will we have learned from this election? Michael Cucek will offer his views, along with suggestions of avenues of future research into the contemporary LDP.
This document summarizes key points about changing demographics and higher education in Japan:
- Japan has 782 universities, most of which are private and located in urban areas like Tokyo. The number of 18-year-olds, and thus potential students, is declining sharply due to low birth rates.
- University enrollments are projected to decrease by 20% by 2040, with rural areas hardest hit. Increased international student recruitment could help offset this.
- Currently, Japanese universities enroll 135,000 international students, most of whom study humanities or social sciences at private universities in the Tokyo area. Greater international student recruitment will be needed to sustain many universities.
This document provides background information on the Institute of Contemporary Asian Studies (ICAS) at Temple University Japan Campus. It discusses how ICAS has evolved from its origins in the 1990s as the Pacific Rim Lecture Series, focusing initially on Japanese politics and economics. Over time, ICAS expanded its scope to include broader Asian studies and cultural topics like Japanese pop culture. The document outlines ICAS's mission and notable programs, and expresses excitement about collaborating with other universities now that Temple University has moved locations. It provides a short history of ICAS and looks ahead to future events and programming.
Closed Loop, Open Borders: Wealth and Inequality in India
Speaker:
Anthony P. D’Costa, Eminent Scholar in Global Studies and Professor of Economics College of Business, The University of Alabama in Huntsville
Megumu Kamata is a Japanese tattoo artist whose work is influenced by American traditional and Japanese styles. Some of the notable artists who have influenced his work include Ed Hardy, Freddy Corbin, Charlie Roberts, and Lal Hardy. Kamata is known for his backpieces featuring Japanese dragons, as well as tattoos depicting skulls, spiders, ships, snakes, and religious imagery. He often puts his own spin on classic designs from American traditional artists like Bob Roberts, Mike Malone, and Greg Irons.
This document discusses the history and cultural context of tattoos and bans on tattoos in bathhouses in contemporary Japan. It provides background on the researcher and their work studying Japanese tattooing. It then explores how tattoos have been viewed differently depending on historical periods in Japan, being associated with outlaws, punishment, and later the yakuza organized crime group due to popular media. This led to many bathhouses and beaches posting signs banning those with tattoos, though tattoos are growing in popularity among young people and views may be changing as Japan welcomes more foreign tourists.
Japan and Russia: Contemporary Political, Economic, and Military Relations
Speaker: Yu Koizumi, Project Assistant Professor, University of Tokyo
Presentation: Russian Military Posture in Northern Territory
Japan and Russia: Contemporary Political, Economic, and Military Relations
Speaker: Elena Shadrina, Associate Professor, Waseda University
Presentation: What to Expect for Russia-Japan Relations: Contemplation against a Backdrop of Social and Economic Situation in Russia
Japan and Russia: Contemporary Political, Economic, and Military Relations
Speaker: James D. J. Brown, Associate Professor of Political Science at Temple University, Japan Campus
Presentation: Japan-Russia Joint Economic Projects on the Disputed Islands: What are they good for?
More from Institute of Contemporary Asian Studies (ICAS) at TUJ (20)
Dr. Nasir Mustafa CERTIFICATE OF APPRECIATION "NEUROANATOMY"Dr. Nasir Mustafa
CERTIFICATE OF APPRECIATION
"NEUROANATOMY"
DURING THE JOINT ONLINE LECTURE SERIES HELD BY
KUTAISI UNIVERSITY (GEORGIA) AND ISTANBUL GELISIM UNIVERSITY (TURKEY)
FROM JUNE 10TH TO JUNE 14TH, 2024
How to Use Pre Init hook in Odoo 17 -Odoo 17 SlidesCeline George
In Odoo, Hooks are Python methods or functions that are invoked at specific points during the execution of Odoo's processing cycle. The pre-init hook is a method provided by the Odoo framework to execute custom code before the initialization of the module's data. ie, it works before the module installation.
How To Sell Hamster Kombat Coin In Pre-marketSikandar Ali
How To Sell Hamster Kombat Coin In Pre Market
When you need to promote a cryptocurrency like Hamster Kombat Coin earlier than it officially hits the market, you want to connect to ability shoppers in locations wherein early trading occurs. Here’s how you can do it:
Make a message that explains why Hamster Kombat Coin is extremely good and why people have to spend money on it. Talk approximately its cool functions, the network in the back of it, or its destiny plans.
Search for cryptocurrency boards, social media groups (like Discord or Telegram), or special pre-market buying and selling structures wherein new crypto cash are traded. You can search for forums or companies that focus on new or lesser-acknowledged coins.
Join the Right Communities: If you are no longer already a member, be a part of those groups. Be active, share helpful statistics, and display which you recognize your stuff.
Post Your Offer: Once you experience comfortable and feature come to be a acquainted face, put up your offer to sell Hamster Kombat Coin. Be honest about how plenty you have got and the price you need.
Be short to reply to any questions capability customers may have. They may need to realize how the coin works, its destiny capability, or technical details. Make positive you have got the answers equipped.
Talk without delay with involved customers to agree on a charge and finalize the sale. Make sure both facets apprehend how the coins and money could be exchanged.
How To Sell Hamster Kombat Coin In Pre Market
Once everything is settled, move beforehand with the transaction as deliberate. You might switch the cash immediately or use a provider to assist.
Stay in Touch: After the sale, check in with the customer to ensure they were given the coins. If viable, leave feedback in the network to expose you’re truthful.
How To Sell Hamster Kombat Coin In Pre Market
When you need to promote a cryptocurrency like Hamster Kombat Coin earlier than it officially hits the market, you want to connect to ability shoppers in locations wherein early trading occurs. Here’s how you can do it:
Make a message that explains why Hamster Kombat Coin is extremely good and why people have to spend money on it. Talk approximately its cool functions, the network in the back of it, or its destiny plans.
Search for cryptocurrency boards, social media groups (like Discord or Telegram), or special pre-market buying and selling structures wherein new crypto cash are traded. You can search for forums or companies that focus on new or lesser-acknowledged coins.
Join the Right Communities: If you are no longer already a member, be a part of those groups. Be active, share helpful statistics, and display which you recognize your stuff.
Post Your Offer: Once you experience comfortable and feature come to be a acquainted face, put up your offer to sell Hamster Kombat Coin. Be honest about how plenty you have got and the price you need.
Hamster kombat free money Withdraw Easy free $500 mo
Life of Ah Gong and Ah Kim ~ A Story with Life Lessons (Hokkien, English & Ch...OH TEIK BIN
A PowerPoint Presentation of a fictitious story that imparts Life Lessons on loving-kindness, virtue, compassion and wisdom.
The texts are in Romanized Hokkien, English and Chinese.
For the Video Presentation with audio narration in Hokkien, please check out the Link:
https://vimeo.com/manage/videos/987932748
[Public Lecture Slides] Jennifer Friedman: Health care in Japan's aged society
1. Health Care in Japan’s Aged Society
May 14, 2015
Temple University
Institute of Contemporary Asian Studies
Jennifer Friedman
Council on Foreign Relations
International Affairs Fellow in Japan
Sponsored by Hitachi, Ltd
Meiji Institute for Global Affairs
2. Outline
• Disclaimers.
• Successes and Challenges of Japanese Health
Care System.
• Japanese Health Care Policies to Manage Care
Needs and Rising Costs of Aging Society.
• Health Care Delivery Reforms Abroad (focus
on the U.S.)
• Questions/Comments.
2
3. Successes of Japan’s Health Care System
3
In 2011, Japan celebrated 50 years of
universal health insurance
“Japan's success in achieving universal
health insurance has improved equity
in our health system, expanded
coverage for our citizens, and
controlled health-care costs. Our
experience shows how investment in
[Universal Health Coverage] brings
good returns.”
Prime Minister Shinzo Abe
The Lancet, Sept 27, 2013
4. Comparison of Japan and
U.S. Health Care Systems
Japan United States
Independent Providers Yes Yes
Fee-For-Service Payment
System
Yes Yes, along with closed
networks/managed care
and newer payment
models
Multiple Payers/Insurers Yes (>3400) Yes
Defined Benefit Yes Defined categories of
benefits, but variation
between states
Provider Access Open access Networks of providers
Prices Set by government Set/negotiated by payer
Universal Coverage Yes No
Long Term Care Social
Insurance
Yes No, Medicaid for low-
income and disabled. 4
5. Japan’s Open Access,
Fee-For-Service System
• Fee-For-Service (FFS) is a payment system where each
item or service is paid separately.
• Creates incentives to provide more care. Payment is
dependent on quantity, not quality, of care.
• U.S. and Japan do use other mechanisms to counter
this incentive, such as bundled payments for some
services.
• Open access means patient can choose to go to any
doctor. Insurance is not limited to a certain network of
providers. There is no “gatekeeper” or primary care
provider managing individual patient care.
5
6. Japan’s Multi-Payer System
• It is NOT single payer. There are 3400+ insurers in
Japan.
• Government sets rates that are used by all payers to
pay providers, for all items and services, with some
variation based on provider characteristics.
• Payment rates revised every two years by Chuikyo,
Central Social Insurance Medical Council.
• Payment rate for particular service may be cut if
volume appears to be growing inappropriately.
• Incentives built into rate system to encourage certain
types of provider behavior, such as care at home,
increased generic drug utilization.
6
7. U.S. Health Care Spending Dramatically
Exceeds Japan and OECD
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
18.0%
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
TotalHealthSpendingas%ofGDP
USA
Japan
OECD Average
7Source: OECD
8. U.S. Health Care Spending Dramatically
Exceeds Japan and OECD (continued)
$8,745
$3,649 $3,484
2012 Overall Spending Per Capita
(U.S.$ Purchasing Power Parity)
USA Japan OECD
8Source: OECD
9. Why is Japan Health Spending So Low..
• Japan’s multi-payer rate setting leads to lower
prices.
• Japanese payment rates set to discourage
costly surgical procedures and encourage
lower cost office visits.
9
Japan’s rate setting system, and resulting low
payment rates, is key reason why health care
spending has been kept low/on par with OECD.
10. …Or, Why is U.S. Health Spending So High
• Higher prices due to diluted purchasing power of
multiple payers.
• More resource intense (though shorter) hospital
stays; access to costly technology.
• Higher administrative costs due to multiple payers
running their own systems, marketing costs, and
underwriting system (pre-health reform).
• Higher physician salaries for U.S. doctors.
10
Higher U.S. health spending
driven by higher prices.
11. High U.S. Spending Mainly Due to Prices
High U.S. spending “cannot be attributed to higher income, an older
population, or greater supply or utilization of hospitals and doctors….
higher spending is more likely due to higher prices and perhaps more
readily accessible technology and greater obesity…. Of the countries
studied, Japan has the lowest health spending, which it achieves
primarily through aggressive price regulation”
– Commonwealth Fund, “Explaining High Health Care Spending in the
United States: An International Comparison of Supply, Utilization, Prices
and Quality,” (2012).
“In 2000 the United States spent considerably more on health care than
any other country…. At the same time, most measures of aggregate
utilization… were below the OECD median…. this implies that much
higher prices are paid in the United States than in other countries. U.S.
policymakers… could conclude: It’s the prices, stupid.”
– “It’s The Prices, Stupid: Why The United States Is So Different From Other
Countries, Health Affairs (2003)
11
12. Japan Spending Growth Rate Higher
Than U.S. in Recent Years…
3.6%
2.6%
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
9.0% 2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
HealthExpenditure
AnnualGrowthRate
USA Japan
12Source: OECD
Average Annual Growth
Rate (2000 to 2012):
U.S. 3.9%
Japan 3.3%
OECD: 3.8%
13. …But Per Capita Growth Rate Tells a
More Complicated Story
3.4%
1.3%
3.0%
2.8%
4.9%
3.0%
4.1%
0.2%
3.4%
2000 - 2009 2009 - 2011 2000 - 2011
HealthSpendingPerCapita
AverageAnnualGrowthRate
U.S.A. Japan OECD
13Source: OECD
14. Medical Spending Estimated to Grow
By More than Half by 2025…
¥20.1 ¥22.0
¥28.1
¥14.8
¥16.9
¥25.0
¥5.8
¥6.3
¥7.9
¥40.7
¥45.2
¥61.0
¥-
¥10.0
¥20.0
¥30.0
¥40.0
¥50.0
¥60.0
¥70.0
¥80.0
2012 2015 2025
JPYinTrillions
premiums public fund copays
…From 8.5% of GDP to 10% of GDP.
14Source: MHLW
15. Aging and New Technology Usage
Drive Spending Increases
2006 2007 2008 2009 2010 2011 2012 2013 2014
Increase in health
expenditures 0.00% 3.00% 2.00% 3.40% 3.90% 3.10% 1.60% 2.20%
Biannual fee
schedule revision -3.16% NA -0.82% NA 0.19% NA 0.004% NA 0.1%
Population change 0.00% 0.00% -0.10%
-
0.10% 0.00% -0.20% -0.20% -0.20%
Aging effect 1.30% 1.50% 1.30% 1.40% 1.60% 1.20% 1.40% 1.30%
Residual
(technological
advances/other) 1.80% 1.50% 1.50% 2.20% 2.10% 2.10% 0.40% 1.10%
15Sources: MHLW and MOF
17. Japan’s Aging, and Shrinking, Society
Japan is the most aged society in the world, with 24.1% of the population older
than 65 in 2012, rising to 40% of the population by 2060.
Japan’s population of 127 million has been shrinking since 2010 and estimates are
that it will decrease to 86.7 million by 2060. 17
19. A Different Estimate of Health
Spending Projections
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
50.0%
2010 2020 2030 2040 2050 2060
HealthSpendingas%ofGDP
0%/year
1%/year
2%/year
Same analysis finds a historical trend of 0.9% excess cost growth during the last
two decades. Assuming the same trend going forward, health spending will
reach 15.6% of GDP in 2030 and 26.6% of GDP by 2060.
Excess Cost Growth =
excess of growth in
per capita health
spending over per
capita GDP growth,
after controlling for
the effect of
demographic change.
19
Source: IMF
20. Areas of High Health Care Utilization
Japan USA OECD Average
Hospital beds 1/ 13.4 3.1 4.8
Hospital average length of stay 2/ 17.5 4.8 7.4
Discharge rate 3/ 11,055 12,549 15,590
Doctor consultations 4/ 13 4 6.7
MRI 5/ 46.9 35.5 13.9
Generic Drug Penetration 6/ 23% to <~50% 78% 41%
1/ Per 1000 population. Japan and OECD (2012). USA (2010).
2/ Average length of hospital stay, all causes, days. Japan and OECD (2012). USA (2010)
3/ Discharge rate per 100,000 population. Japan (2011). USA (2010). OECD (2012).
4/ Per capita. USA (2010). Japan (2011). OECD (2012)
5/ MRI machines total, per 1,000,000 population. USA (2013). Japan (2011). OECD (2012)
6/ U.S. Congressional Budget Office (2010). Japan range due to varying methodologies, OECD
(2011 data). MHLW and EFPIA (2013 data).
20
Source: OECD
21. Other Issues
• Open access to any provider means there is not a
strong culture of a primary care provider who
coordinates care.
• Open access also has fostered competition
between providers, which in turn results in lack of
information sharing.
• Limited sharing of electronic health records/ICT
to improve care coordination.
• Quality measurement voluntary, not made public,
limited measures. Is it used to drive
improvement?
21
22. Many Good Health Outcomes,
but Others Mixed
Japan U.S.
Life expectancy at birth 83.2 years
(ranked 1st out of 34)
78.7 years
(ranked 27th out of 34)
Mortality from
cardiovascular disease
Ranked 33rd
(Lower is better)
Ranked 17th
(Lower is better)
Mortality from cancer Ranked 28th
(Lower is better)
Ranked 25th
(Lower is better)
Adult obesity (as
measured)
Ranked 16th out of 16. Ranked 1st out of 16.
Daily smokers 20.7%
(ranked 16th)
14.2%
(ranked 31st)
Alcohol consumption
(liters per capita)
7.2 (ranked 28th) 8.6 (ranked 23rd)
Suicide rate
(per 100,000 population)
20.9 (ranked 3rd out of
33)
12.5 (ranked 12th out of 33)
22
Source: OECD
23. Japan’s Health Care Policies
(not exhaustive list)
Cost-savings
• Increase utilization of
generic drugs.
• Health technology
assessment (pilot in
2016).
• Reduce reimbursement
for hospital meals.
• Increase copays.
• Annual price revision
for Rx?
System Reforms to
Improve Efficiency and
Value
• Hospital bed
realignment.
• Fee for care at large
hospital without
referral.
• Shifting national health
insurance system to
prefecture?
Meeting Care Needs of
Elderly
• Integrated communities
of care.
• Other policies listed can
also meet goal of
improving how care
needs of elderly are
met.
These three categories are not mutually exclusive; many policies meet multiple goals.
23
24. Increase Generic Drug Utilization
76%
41%
23%
9%
78%
0%
20%
40%
60%
80%
100%
GenericRxSharebyVolume
• Alternative methodology
estimates Japan generic
penetration at <~50% in 2013.
• Goal of increasing penetration
to 60% by 2018. Discussion of
accelerating timetable or
raising target.
• Industry estimates generic
penetration from promotion
measures of 59% by 2017,
70% by 2025.
• Industry estimates potential
savings of ¥593b/year, ¥8.3T
(2012-2025).
24Sources: OECD, U.S. CBO, EFPIA
25. Health Technology Assessment (HTA)
• Economic analysis may be cost effectiveness (cost/QALY),
budget impact, comparative effectiveness to inform pricing,
other.
• HTA pilot by 2016.
• Will HTA be used to limit coverage (unlikely), modify
reimbursement, and/or delist older drugs?
• Who will pay for the necessary research?
• Who will conduct the research?
• Impact on timelines for drugs/device to enter market and
patient access? 25
Definition: “Multidisciplinary process to evaluate the social, economic,
organizational and ethical issues of a health intervention or health
technology. The main purpose of conducting an assessment is to inform a
policy decision making [coverage or reimbursement decisions].” - World
Health Organization.
26. Shifting National Health Insurance to
Prefectures
• Currently, municipalities manage national health
insurance for individuals who do not have corporate or
civil servant insurance , mainly self-employed, part-
time workers and retirees < 75 years old.
• Shifting responsibility for managing and financing
health insurance from municipalities to prefectures,
starting 2018.
• Shift responsibility for long-term strategic planning
from national government to region/prefectures.
• Increase federal government investment.
• What will be the impact of consolidating responsibility
at prefectural level?
26
27. General acute
~350,000 beds
Highly acute 180,000 beds
Sub-acute/Recovery
~ 260,000 beds
Long-term care
280,000 beds
Highly acute/General acute:
Reduce average length of stay.
Revise standards for long-term
inpatients and high nursing
levels.
Sub-Acute/Recovery: New
beds for post-acute, including
sub-acute. Support home care
and return to daily life.
Long-term care: Facilities for
long-term care patients.
Other Issues : Promote home
care. Consideration of regions
with scarce medical resources
and clinics with inpatient
facilities.
7:1
¥15,660
10:1
¥13,110
13:1
¥11,030
15:1
¥9,450
357,569
beds
210,566
26,926
54,301
Care
ward
216,653
Shift Patient Care to Lower Cost Settings
Patient to nurse ratio
JPY/day in 2012
2012 2025 27
Sources: MHLW and MOF
Outpatient treatment
Home care
28. Integrated Communities of Care
• Create “community-based integrated care,” defined as a system
that provides appropriate living arrangements for the elderly and
social care, such as daily life supports, in addition to long-term and
medical care. Use proper housing and home care services to
reduce costly institutional care.
• Shift elderly from costly hospital settings of care to home care.
• New funds to localities to support medical care and long-term care.
• How will this transition take place? What supports exist to assist in
the transition?
Goal: Better coordination between
medical and long-term care for elderly.
28
29. Delivery System Reforms in the U.S.
• Affordable Care Act (ObamaCare) testing new payment systems to counter
the incentives of fee-for-service, encourage more efficient delivery of care.
• Goal is to encourage better coordination across providers and reduction in
unnecessary services while maintaining or improving quality. Pay for
“value”, not “volume”.
• Some similarity to Japanese goal of shifting patients to lower cost settings
of care.
• U.S. focus on encouraging integrated care, but integrated care defined
differently.
– U.S.: integration of patient care across the continuum from primary
care to acute care (hospital) to post-acute care.
– Japan: integration of LTC and medical care. Integration of ownership.
29
30. Delivery System Reforms in the U.S.
(continued)
• Medicare Models include: Accountable Care Organizations (ACOs), Value
Based Purchasing (VBP)/Pay-for-Performance (P4P), Bundled Payments,
Medical Homes, etc. Medicaid and private payers also pursuing reforms.
• Cautions:
– These models are being tested, not yet proven.
– Need good patient data, ability to share data, and analytic capabilities
to assess patient population and identify costly patients or those at-
risk of high cost.
– Need good quality measurement tools to ensure that quality is
maintained/improved and to protect against stinting of care.
• These delivery system reforms not unique to U.S.
30
31. Accountable Care Organizations
(ACOs)
• Medicare Accountable Care Organizations (ACO) Definition:
– Groups of doctors, hospitals, and other health care providers
who come together voluntarily to provide coordinated care to
Medicare patients.
– If ACOs save Medicare money as compared to a projected trend
for their patient population, they share in those savings as long
as quality is maintained or improved.
– Goal is to reduce unnecessary services, prevent medical errors,
ensure patients get the right care at the right time.
• Payments still based on fee-for-service system.
• Beneficiary still has open access to other providers.
• 450+ Medicare ACOs, nearly 8 million beneficiaries in 49
states.
31
32. Continuum of ACOs
Advance
Payment/
Investment
Model (35):
Shared savings
participants
receiving help
with upfront
costs (rural or no
hospital).
Shared Savings
Program (404):
Most only share
in savings during
first contract
cycle.
Pioneer ACOs
(32, now 19):
Share in gains
and losses. Can
receive
population based
payment in
exchange for
reduced FFS
payment.
Next Generation
ACOs (Expect 15-
20):
Greater sharing
of gains and
losses, possibility
of capitated
payments.
32
There are different ACO models with varying
levels of shared savings and losses, reflecting
readiness of providers to take on risk.
33. Independent Evaluation of Pioneer ACOs
• 32 ACOs, 670,000 beneficiaries (2012).
• Pioneer ACO’s saved a total of $384 million over first two
years.
• Fewer inpatient stays, procedures, imaging and tests.
• Quality measures stable or improving: reduction in admissions
for COPD, adult asthma, and heart failure. Earlier doctor’s
appointments after discharge.
• Few changes in patient perception of quality/satisfaction.
33
Source: L&M Policy Research
34. 2012 2013
Total Spending (in millions) -$279.7 -$104.5
Total spending (per beneficiary per month) -$35.62 -$11.18
Acute care inpatient stays -9,926 -8,444
Acute care inpatient days -40,799 -15,314
Acute care inpatient stays
(per 1000 beneficiary months)
-1.26 -0.9
Acute care inpatient days (per 100 beneficiary months) -0.52 -0.16
Primary care evaluation and management services
(per 100 beneficiary months)
-0.52 -0.15
Procedures (per 100 beneficiary months) -3.0 -1.97
Imaging services (per 100 beneficiary months) -1.76 -0.84
Tests (per 100 beneficiary months) -5.24 -4.33
34
Source: L&M Policy Research
Independent Evaluation of Pioneer ACOs
35. Independent Evaluation of Pioneer ACOs
Ongoing Challenges:
• Care transitions widely considered important but ability to
manage this aspect of care affected largely by availability of
timely admissions data.
• Data sharing is an issue – need to navigate multiple EHRs,
build and improve data warehousing capabilities,
communicate electronically across different care settings.
“Based on historical evidence from the formal evaluation of
the Pioneer ACO Model as well as independent internal
analysis of financial impacts…I certify that expansion of the
Pioneer Model would reduce net program spending…. “
- Chief Actuary, Centers for Medicare and
Medicaid Services
35
36. Accountable Care in Japan?
• A tool to incentivize more efficient care, which
can get at that “other” driving spending
increases.
• Need providers to work together to coordinate
care.
• Need gatekeeper or patient loyalty to specific
providers.
• Need data analysis capabilities and information
sharing.
• Need quality measures.
36
37. Conclusion
• Japan’s health care system successful at providing
equitable benefits, managing costs.
• Japan has areas of high health care utilization.
• Along with aging, high utilization/technology
driving spending increases.
• Different strategies underway to shift care to
lower cost settings, save money, provide
integrated medical and long-term care for elderly.
• But, could U.S. and other models of “accountable
care,” help to further address areas of high
utilization and slow spending growth?
37