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Health care system of japan
- 1. Health care system of JAPAN Public health department of global health By, Dr. Amina T Khan Lsmu, Kaunas, Lithuania
- 2. Introduction • Japan has one of the top healthcare systems, which aims to provide healthcare to all without rising costs, as Japan believes it a right everyone is entitled to. • Medical fees are strictly regulated by the government to keep them affordable. Depending on the family income and the age of the insured, patients are responsible for paying 10%, 20%, or 30% of medical fees, with the government paying the remaining fee.
- 3. • There has been tremendous improvement in life expectancy in Japan over the last 50 years and Japan now leads to international life expectancy. • Reasons: the rapid growth in wealth and narrowing of the differences in its distribution, together with the typical diet with its continuing relatively low fat intake and recent decreases in salt intake have all contributed to this favourable situation.
- 4. Japan health ranking • WHO Ranking for Health Attainment: 1 • WHO Overall Ranking: 10 • % GDP spent on health care: 7.9% (OECD median 8.6%) Source; http://www.who.int/countries/jpn/en/
- 5. Gross indicators • Population (proj., 000)2016 is 127 million. • GDP: Gross domestic product (million current US$)2013 is 4.92 trillion dollar , ranked 4th in the world. • GDP per capita (current US$)2014 is 36298.2 • Health: Total expenditure (% of GDP)2014 is 10.2 Source; http://www.who.int/countries/jpn/en/
- 6. Life expectancy by country http://worldhistoryblogpaloma.blogspot.lt/2015/10/longer-life-expectancy.html
- 7. History • The beginning of the Japanese Health care system happened in 1927 when the first Employee Health Insurance plan was created. • In 1961, Japan achieved universal health insurance coverage, and almost everyone became insured. • By the early 1990s, there were more than 8,700 general hospitals, and 1,000 comprehensive hospitals with a total capacity of 1.5 million beds. • In addition, 79,000 clinics offered primarily out-patient services, and there were 48,000 dental clinics. Most physicians and hospitals sold medication directly to patients, but there were 36,000 pharmacies where patients could purchase synthetic or herbal medication. • Despite its long history of development, Japanese health care system especially of public health system has been strongly influenced by Europe. Source: Wikipedia/ healthcare of Japan;/history of healthcare
- 8. Structure • Structurally the ministry of health and welfare is responsible for health administration. Ministry of education for school health, the ministry of labour for industrial health, and environmental agency for environmental hazards. • In addition the public health council, with its experts subgroups advices the ministry of health and welfare. • Most new public policies and strategies are formulated by central government and implementation is delegated to local government. ( source from pubmed central figure, ; prev med public health /www.ncbi.nlm.nih.gov/pmc/articles/PMC4050210/figure/F2/
- 9. Mass screening especially for cancer (one of the leading causes of death) has been a major form of preventive activity in Japan. Also supported by 1982 act for health of elderly , is mass screening of gastric cancer, cervical cancer, breast cancer, and lung cancer. ( major causes of mortality ) this act integrated health promotion ,financial aid and medical care for 40 years and above Source: effectiveness of mass screening for cancer in Japan, ; https://www.researchgate.net/publication
- 10. Health expenditure or financing of health care 1. Low health care costs: 8.0% of GDP (2005, OECD) • Low compared with other major OECD countries (20th) • Macro and micro management by government have led to decreases in expenditures in 2002, and nearly zero since 2. Basically egalitarian system with universal coverage 3. Excellent health indices • Infant mortality rate: 4 per thousand children. Source: OECD Health Data 2008, OECD (2008) Healthcare expenditures, per capita PPP US$, ratio to GDP (2005) 0 2 4 6 8 10 12 14 16 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000
- 11. Source of financing source: OECD health data 2010
- 12. Provision of health in Japan • In 2008 per 1000 population, the number of practicing physicians was 2.2, which was almost the same as that in U.S. (2.4), and the number of practicing nurses was 9.5, which was a little lower than that in U.S. (10.8), and almost the same as that in UK (9.5) or in Canada (9.2).[4] • Source - (4) OECD. "OECD Health Data". OECD. Retrieved 2 February 2012.
- 13. Access to health care in Japan • In Japan, services are provided either through regional/national public hospitals or through private hospitals/clinics, and patients have universal access to any facility. • Japanese patients favour medical technology such as CT scans and MRIs, and they receive MRIs at a per capita rate 8 times higher than the British and twice as high as Americans.[8] • Source- health_services/service_delivery_profile_japan
- 14. The health insurance system in Japan There are a total of eight health insurance systems in Japan,[28] . They can be divided into two categories, Employees' Health Insurance (健康保険 Kenkō- Hoken?) and National Health Insurance (国民健康保険 Kokumin-Kenkō-Hoken?). Employees’ Health Insurance is broken down to the following systems:[28] Union Managed Health Insurance Government Managed Health Insurance Seaman’s Insurance National Public Workers Mutual Aid Association Insurance Local Public Workers Mutual Aid Association Insurance Private School Teachers’ and Employees’ Mutual Aid Association Insurance National Health Insurance is generally reserved for self-employed people and students, and social insurance is normally for corporate employees. National Health Insurance has two categories:[28]: National Health Insurance for each city, town or village National Health Insurance Union Source; (28) "Health Insurance". City of Kagoshima 2010. Retrieved January 28, 2010.
- 15. Japan - strengths and weaknesses Strengths • The health insurance coverage is universal. • All costs are controlled by national fee schedule imposed by the government with limits on expenditure increases. • Freedom to choose from physicians to hospitals as less wait time when in need of treatment. • Each medical provider is paid same across the board weaknesses • The coverage does not include preventive health screening. • The financial incentives uses excess use of labs, high tech equipments, and prescription drugs. • The medical services given are fragmented making clinics and hospitals suffer excess capacity and duplication of services.
- 16. Interesting facts of Japanese healthcare •People per doctor: 610 (compared to 32,650 in Ethiopia, 611 in the United States and 210 in Italy). •U.S. Health Care Spending Highest, Japan Lowest: Study • In May 2011, a study of 13 industrialized countries released showed Japan spends the least on health care, while the United States spends the most without providing superior care for the money.
- 17. Conclusion The major gains in health status in Japan over last few decades have not been primarily due to public health programmes. Rather the driving force seems to have been economic growth and relative equality in income distribution; specifically supportive social networks. Japan still has 3 major challenges to face: 1. The ageing population 2. The rise in epidemic of tobacco caused disease 3. Westernisation of diet. The Japanese, however, do have more capacity to address problems more purposefully and with appropriate action than is apparent in most other countries.
- 18. References (4) OECD. "OECD Health Data". OECD. Retrieved 2 February 2012. (8) "Sick around the world". Frontline. April 15, 2008. 17 minutes in. PBS. http://web-japan.org/factsheet/en/pdf/e44_healthcare.pdf (28) "Health Insurance". City of Kagoshima. 2010. Retrieved January 28, 2010. https://en.wikipedia.org/wiki/Health_care_system_in_Japan#cite_note- kagoshima-28 Bibliographic references: The global health management – public health in wealthy countries – public health in japan.