Japan’s Health care System

Reconstruction after World War II contributed to Japan’s contemporary health status by enhancing the distribution of basic needs across Japanese communities. After the war, access to necessities such as food, housing, water, and sanitation increased, thus reducing the vulnerability of Japan to ill-health. For example, the government instituted price controls, a move that facilitated an equal distribution of rice across all households (World Health Organization, n.d.). Moreover, cooperation policies like the dispensation of disinfectants and waste collection boosted child growth by protecting children from sanitation-related diseases. Hence, the wide distribution of basic needs, courtesy of reconstruction, enhanced public health in Japan.

The political and legal features of Japan’s contemporary health care system that have ameliorated public health include universal health insurance and the Long Term Care Insurance Law. The strong egalitarian principles implemented by the government led to the introduction of National Health Insurance (NHI). Under NHI, health coverage is extended to the entire population under Employees’ Health Insurance and Community Health Insurance (CHI) plans (World Health Organization, 2018). In the legal context, the introduction of the Long Term Care Insurance Law provides coverage for elderly care. Under this law, any senior citizen battling health issues is legible for coverage (Suzuki, 2018). Its merits include diminishing caregiver burden and increasing access to the resources vital for the aging population. Therefore, Japan owes its contemporary health status to universal health insurance and Long Term Care insurance Law.

Universal health care and labor policies have contributed to disparities in health between Americans and Japanese. In Japan, universal health care is available to all people. However, only senior citizens enjoy this privilege in the U.S. (Suzuki, 2018). Furthermore, labor and employment protection policies are weaker in the U.S. than in Japan. For instance, by 2010, single-earner nuclear families with two children earned 45% in long-term unemployment insurance, while the rates were 90% in Japan (Avendano & Kawachi, 2014). Hence, the U.S. lags in health status due to the lack of universal coverage and weak labor laws.

Other countries should emulate Japan’s lifestyles and doctor compensation systems. Physical activities like walking are embraced in Japan, given the high cost of driving (Suzuki, 2018). Moreover, the Japanese are incentivized to eat less since food prices are high. Americans should thus emulate Japan, given their physical inactivity and binge eating habits. Likewise, Canada should scrap its fee-for-service model where doctor’s compensation depends on the services offered. The framework motivates physicians to provide expensive, unnecessary treatments (Laberge et al., 2017). They should copy Japan’s system of putting some specialists on salaries to lower health care costs. Hence, Japan’s health status woes other countries to be physically active and shun fee-for-service models.

Jasmine T. James

References

Avendano, M., & Kawachi, I. (2014). Why do Americans have shorter life expectancy and worse health than do people in other high-income countries? Annual Review of Public Health, 35, 307-325. https://dx.doi.org/10.1146%2Fannurev-publhealth-032013-182411

Laberge, M., Wodchis, W. P., Barnsley, J., & Laporte, A. (2017). Costs of health care across primary care models in Ontario. BMC Health Services Research, 17(1), 511. https://doi.org/10.1186/s12913-017-2455-1

Suzuki, T. (2018). Health status of older adults living in the community in Japan: Recent changes and significance in the super?aged society. Geriatrics & Gerontology International, 18(5), 667-677. https://doi.org/10.1111/ggi.13266

World Health Organization. (2018). Japan health system review. Health Systems in Transition, 8(1), pp. 7. https://apps.who.int/iris/bitstream/handle/10665/259941/9789290226260-eng.pdf;jsessionid=D71EC76B9D491C7DE77732D94C0D9741?sequence=1

World Health Organization. (n.d.). Global database on the Implementation of Nutrition Action (GINA). https://extranet.who.int/nutrition/gina/en/node/33095

Health status in japan

Analysis of how reconstruction after World War II contributed to Japan’s health status.

After the defeat of Japan in the second world war (WWII), the health situation of the country was very poor, so much that the country ranked low in comparison to many countries in terms of health indicators while the United States of America was one of the healthiest nations of the world. After the destruction of Japan by the war, the subsequent years that followed, saw Japan being led by the Allied Force, which the United States was a member of. The Allied force occupied Japan for some time and created the famous reformation of military, political, economic, and social changes in Japan. These were done primarily in three ways: Through demilitarization, democratization, and decentralization. After this historical period and after the creation and enactment of numerous health policies, Japan became one of the healthiest nations in the world. (Suzuki, 2018) (Bezruchka, 2011).

Political Feature That Contributed to Japan’s Population Health Status.

The war was devastating for Japanese but after the war, the Allied Force who took over the country were able to create a democratic state of governance. After democratization and the enactment of the constitution thereafter, the new constitution gave the Japanese citizen a right to vote, academic freedom, free education, and public health as one of its focus. The constitution empowered the government to reduce economic disparities and improve the health of the citizen. Today we would be able to conclude that the continued health status being relished by the country was facilitated by the democratic political government that established the constitutions and the policies, public health policies included. (Suzuki, 2018) (Bezruchka, 2011).

Legal Feature That Contributed to Japan’s Population Health Status.

After the War, through the decentralization of the Japanese government, Japan was able to introduce legislation and create policies that were able to address equity. This included land reform and equal distribution of wealth and power. (Bezruchka, 2011). Provision of basic needs like food water, sanitation, and shelter after the war facilitated subsequent health improvements. Strict legislation of the staple food, (rice) also ensured the equal distribution of rice which is the main nutrition for the citizens. Japan’s good health status today is primarily the result of the country’s health care legislative system that focus on economic equality. (Suzuki, 2018)

Two reasons for the disparity between the Japanese and American populations in health achievement.

As of 2016, Statistics obtained from the World Health organization shows that Japan has a Life expectancy at birth for female at 87 and male at 81. The total expenditure on health per capita remains at 3,727 while the total expenditure on health as % of GDP is at 10.2. While on the other hand, the United States of America (USA) has a life expectancy at birth for females at 81 and male at 76. The total expenditure on health per capita remains at 9,403 while the total expenditure on health as % of GDP is at 17.1(2016). These numbers were obtained in less than 35 years after the war, due to the policies enacted by the country. First, the Japanese government focus on Legislation that dealt with Land reform which gave 94% of the land to the people, bridging the gap between the have and the have nots. These policies focused on continued economic equality that would foster continued public health. With these measures and legislation, the country became an economic egalitarian society that contributed to the deep changes in disparities. Secondly, the Japanese believe in the culture and values of collectiveness called the “wa”, which also means “social Harmony”. Although this system was practice prewar, it still exists today. The Japanese viewed the value of collective functioning which enable them to work together to enact laws, and policies, making japan, one of the healthiest nations in the world. (Bezruchka, 2011) (Suzuki, 2018).

Insights

After the defeat of Japan in World War II, the United States led the Allies, in the bid to reconstruct the country, enacted widespread military, political, economic, and social reforms. And during the reconstructive years and up till date, the Japanese local and national government enacted laws to ensure quality health care for its citizens. This reconstruction empowered japan towards a remarkable health care system that showcases the health advances they have, making it one of the healthiest nations in the world Bezruchka, S. (2011). Japan’s statutory health insurance system (SHIS) offers coverage to 98.3 percent of the populace, including Citizens, and residents/noncitizens, however, undocumented immigrants and visitors are excluded from coverage (Tikkanen et al, 2020). The pathway to this insurance coverage erupted from the strong egalitarian principles and policies enacted by the country, therefore, the Japanese health care system should be an example for the United States of America. (Bezruchka, 2011).

Reference

Bezruchka, S. (2011). Laureate Education (Producer). Global health and issues in disease prevention. “Health Status in Japan”. [Multimedia file]. Retrieved from https://class.walden.edu

Milestones: 1945–1952. (n.d.). Office of the Historian. https://history.state.gov/milestones/1945-1952/japan-reconstruction.

Suzuki, T. (2018). Health status of older adults living in the community in Japan: Recent changes and significance in the super-aged society. Geriatrics & Gerontology International, 18(5), 667–677. doi:10.1111/ggi.13266

Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., Wharton, G. (2020). International Health Care System Profiles. Japan. Commonwealth Fund. Retrieved 7/15/2020 from https://www.commonwealthfund.org/international-health-policy-center/countries/japan

World Health Organization. (n.2016). Japan. Retrieved July 4, 2020, from WHO website: https://www.who.int/countries/jpn/en/

Japan is at the forefront of the international health index, boasting one of the highest life expectancies in the world (OECD, 2019). This has not always been the case, however, as the country suffered one of the poorest health rates during World War II. Their rise to prominence occurred after the political power exchanged hands after the war.

Japan’s Reconstruction after WWII and the Healthcare System

Following the conclusion of WWII, Japan suffered one of the lowest health rates in the continent. However, multiple changes in policies, political organization and social perspectives were implemented over three decades, leading to an upsurge in results. The Allied occupation that regulated the region after the war instated a democratic government to succeed the previous regime (Bezruchka, Namekata & Sistrom, 2008). This substitute implemented a collection of new policies that were established by the occupying force which led to the improvement of the healthcare system.

A cross-sectional connection between health levels and income distribution is noted via the enhanced life expectancy of the region (Sakamoto et al., 2018). This suggests that improved economic conditions can have a positive influence on the health status of a population. As such, Japan’s efforts towards creating a better life for their citizens resulted in better levels of healthcare in the process (WHO, 2016). The government’s egalitarian approach also ensures that issues such as increased income disparity are effectively addressed and negated. This was achieved through the decentralization of wealth and power, demilitarization of the society, and democratization of political processes (Bezruchka, Namekata & Sistrom, 2008). As such, the Japanese army was abolished and a new constitution was drafted to govern the region.

Economic influence was also ceased from the ruling families that had previously dominated the nation. This was done through the rewriting of the civil code and the takeover of education from the central bureaucracy. Maximum wage was also legislated, while the emergence of labor unions was genuinely fostered (Bezruchka, Namekata & Sistrom, 2008). The land reforms instituted after the war allowed tenants to purchase the land they tilled, enhancing the distribution of wealth.

The overall improvement of Japan’s political and economic system encouraged the sustained improvement of its health status. The focus on a variety of elements including economic stability, income distribution and government support affected healthcare through multiple diverging facets. This change was further backed by the actual healthcare policies set in place for the community.

Japan’s Contemporary Healthcare System

A major political factor that played a role in the development of Japan’s healthcare system is the egalitarian principles practiced by their government. Though other countries aim to focus their policies based on the welfare of their citizens, the level of implementation is not similar to Japan. The country details the rights and duties of its people in 31 clauses, three of which bend the government towards addressing economic disparity, as well as improving the healthcare of its citizens (Bezruchka, Namekata & Sistrom, 2008). This is a major difference compared to other constitutions such as the United States. An excellent example of this dedication was seen in the enactment of the Health Insurance Act of 1922, which was dedicated to providing sufficient healthcare to all workers. This bill was supported by both the government and different industrial sectors (Sakamoto et al., 2018).

A significant legal feature in the Japanese healthcare system can be found in the regulation of ownership and management of hospitals and other institutions in this sector. Japanese hospitals are required by law to operate as non-profit establishments and can only be managed by qualified physicians (Hiromoto, Suwa & Hamada, 2019). All for-profit organizations are strictly prohibited from owning such facilities. This regulation ensures that the primary objective of any hospital is the provision of healthcare services to members of the community, as there is no business opportunity related to the venture. The requirement of an official physician running the facilities also ensures that the appropriate individuals are placed in charge. By insisting that hospitals be run by doctors, the healthcare system effectively enhances the potential functionality of these institutions (Hiromoto, Suwa & Hamada, 2019).

The Disparities between the Japanese and American Healthcare System

A major political difference between the Japanese and US healthcare system is the egalitarian approach implemented by the government of the former. The bond between citizens and the social structure of the Japanese culture has affected the manner in which the government conducts its business (Sakamoto et al., 2018). Leaders from Japan view the delivery of effective services to their citizens as a proud achievement that is strived for while in office. US leaders have a lower level of commitment to their responsibilities, as seen by their constant struggle to amass more influence to their office.

The legal regulations influencing the control and management of healthcare institutions such as hospitals can be another reason for the disparity between US and Japanese systems. The enforced non-profit status of hospitals in Japan automatically negates the involvement of money-minded profiteers who would lower quality to enhance margins. The presence of a distinct functionary role as a provider of an essential utility means that these positions attract individuals who are interested in the provision of these services as a calling and not an enterprise (Hiromoto, Suwa & Hamada, 2019). This enhances the level of quality available from each hospital, as well as ensures the uniform distribution of medical services and products to members of the community.

The Japanese Healthcare Experience

A major lesson that can be learned from studying the Japanese healthcare system in relation to the social structure and political influence involved is the application of an egalitarian approach. The provision of equal rights and opportunities to the public greatly enhances the distribution of resources within a system. This approach should be taken by everyone involved, including citizens, public officials and related government policies (Bezruchka, Namekata & Sistrom, 2008). The US system is greatly prohibited by the financial implications involved with healthcare delivery, as people are treated according to their economic standing in life. Getting rid of this imbalance is crucial in developing a new and improved healthcare system.

The increased regulation of hospitals and related institutions is another crucial lesson that can be taken from studying the Japanese system. Expensive medication is a problem for many countries due to the exorbitant prices charged by hospitals in the industry. Restricting these facilities from making a profit effectively reduces the potential price of products and services provided. It also stabilizes the cost of living in connection to acquiring appropriate healthcare services.

References

Bezruchka, S., Namekata, T., & Sistrom, M. (2008). Interplay of Politics and Law to Promote

Health. Retrieved 8 July 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2376982/

Hiromoto, F., Suwa, N., & Hamada, M. (2019). Healthcare Law Review – Japan. Retrieved 8

July 2020, from https://thelawreviews.co.uk/edition/the-healthcare-law-review-edition-3/1197533/japan

OECD, (2019). OECD Reviews of Public Health: Japan: A Healthier Tomorrow, OECD Publishing, Paris. https://doi.org/10.1787/9789264311602-en.

Sakamoto, H., Rahman, M., Namura, S., Koike, S., Yasunaga, H., & Okamoto, E. et al. (2018).

eng.pdf;jsessionid=AAAAD8121D7966D1D4D297530A3674D5?sequence=1

Response 4

Odion Clunis

RE: Discussion – Week 7

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WHO, (2016). Key Country Indicator Summaries. Japan. Retrieved on 14 July 2020, from https://apps.who.int/gho/data/node.cco.ki-JPN?lang=en