The Downside of Japanese Health Care
[P]atients can nearly always see a doctor within a day. But they must often wait hours for a three-minute consultation. Complicated cases get too little attention. The Japanese are only a quarter as likely as the Americans or French to suffer a heart attack, but twice as likely to die if they do.
Some doctors see as many as 100 patients a day. Because their salaries are low, they tend to overprescribe tests and drugs. (Clinics often own their own pharmacies.) They also earn money, hotel-like, by keeping patients in bed. Simple surgery that in the West would involve no overnight stay, such as a hernia operation, entails a five-day hospital stay in Japan.
Emergency care is often poor. In lesser cities it is not uncommon for ambulances to cruise the streets calling a succession of emergency rooms to find one that can cram in a patient. In a few cases people have died because of this. One reason for a shortage of emergency care is an abundance of small clinics instead of big hospitals. Doctors prefer them because they can work less and earn more.
Their aging population will further complicate things.
It is interesting how simple regulations change the culture of medicine. The Japanese have poor emergency care due to the fact they emphasize clinics instead of large hospitals — mostly because doctors earn more at clinics.
This highlights another truth: the best prevention is not to get sick in the first place. The Japanese have one-quarter of heart attacks but are twice as likely to die when the do.
The downside is that it is very inefficient.
I found a source which suggests that the cost of living in Japan is about one third higher than in the U.S. (http://tinyurl.com/4x4c8he). If a doctor earns $125,000 annually in Japan as the Economist article reports) that is the equivalent of about $85,000 in the U.S. And this is at mid-career! No wonder there is a shortage!
I cannot really see a good way out of this crisis, given Japan’s rapidly aging population. If the government could react properly, it would give the elderly vouchers and free up providers to compete. However, because these elderly patients are also the largest voting bloc, politicians will continue to have incentives to pretend they are giving them “free” health care.