1. 1
Running Head: Japan Healthcare System
Healthcare System of Japan vs. U.S. Healthcare System
HCS 400
Karyssaann Costagliola
Professor Durant
November 19, 2014

2. 2
JapanHealthcare System
Abstract
The healthcare system is an important and ever changing subject all over the world. Japan has
one of the best health care systems that some aspects are highly sought after by Americans.
Japan is able to provide health care across the board to everyone at a lower cost than that of the
United States.

3. 3
JapanHealthcare System
The healthcare system of Japan is one that is able to give equal benefits to all its citizens
while still maintaining costs and keeping them low. It is said that, “they hold the belief that if
equity and universality of access are goals, then cross-subsidization of payments must occur
between people of different economic means, and government must regulate this process”
(Ikegami 2014). The U.S. healthcare system is ranked second in costs for health care spending
and rising costs and inability for some to get insurance makes it difficult for some Americans to
obtain insurance. It is noted that the people of Japan are one of the healthiest and have record
rates of living longer than most developed nations.
Japan has designed a healthcare system that makes any and all medical services available
to all its citizens by way of having employer-purchased insurance which controls expenditures.
This way of healthcare has made them one of the healthiest nations and a nation that is keeping
the cost of healthcare down unlike that of the United States. Since 1961 they had in place the
universal healthcare system that is still being used today. In U.S. after many changes the ACA
what we know today’s healthcare as was enacted in 2010. The two health systems are strong in
their own respect and have come a long way since being introduced to each country. Japan looks
at healthcare insurance being a right that all citizens’ even temporary citizens should get. Japan
pays for this health insurance through payroll deductions, tax dollars, and the copayments made
by patients during office visits.
As compared to Japan’s outlook on healthcare the U.S. has a view that it is more of a
privilege to have insurance and it should come with a cost. In the U.S. we do not have the
healthiest people and not everyone is focused on an overall better health. It is proven through
life expectancy rates compared to Japan. In the U.S. the life expectancy rate is 80.6 and Japan
has a life expectancy rate of 86.4 as of 2011. The infant mortality rate for Japan is 2% and the

4. 4
JapanHealthcare System
U.S. holding at 6.2%. The factors of mortality rate in infants are due to way of living and
treatment between the two countries. In the United States there is more lapse in care for
pregnant mothers’ because of their own doing or the way they are treated within the household.
In Japan there is a lot of care and food choices are much better in the homes of Japan. The
length of stay in Japan averages at 52.1 days with the U.S. being considerably lower at 4.6 days.
Although it seems way better in the U.S. the cost of both of those stays for one patient with the
same condition the U.S. is much higher in cost than that of Japan. One of the reasons for the
length of stay in Japan is partially due to the population mainly being elderly and not having a
nursing home it leads to longer stays in hospitals. Some other differences between the two
systems are the cost for appointments. In Japan most visits to doctors cost what it would for a
co-pay here in the United States. The average cost for healthcare for a family is $280 monthly
compared to anywhere from $300 or more for a family in the United States possibly even just for
a single person depending on the coverage level. Another big difference in the two is the costs
for tests. Here in the U.S. tests can range from $500-$2,000 just for a simple MRI. In Japan
these same tests and quality machines can cost as little as $100. The United States is one of the
top states in spending costs for healthcare per capita, but yet see little efficacy for that money
spent.
Each system has its’ strengths in the way it is run and the delivery of healthcare.
A strength that is known for the United States is it offers top quality care to people who can pay
for it or have insurance that will. Secondly, the U.S. is also known for it is at the top as far as
clinical research and in technological advancements and breakthroughs in treatment of many
different types of diseases. The U.S. also has a lot of specialty doctors and medical providers’
throughout the country. Japan also has its’ share of strengths that make it so functional like it is.

5. 5
JapanHealthcare System
One of the strengths is the universal coverage that it gives to the people of Japan. The next
strength that Japan has is that all costs are controlled by a national fee schedule imposed by the
government that has limits on all expenditure increases. The patients and insured of Japan have
the ability to choose their provider or specialist that they wish to see with no question or wait to
be seen. For Japan all medical providers are paid the same for the same treatment across the
board preventing unnecessary inflation for certain doctors. Lastly, a strength of Japan is dental is
also included along with prescription coverage.
With strengths comes weakness and these two systems have a few that limit the
care that is given. In the U.S. the weaknesses that are seen are that even though the
implementation has occurred with the ACA over 37 million people are still uninsured and might
remain this way due to the flaws in the ACA. The costs of healthcare are the highest per capita
and are continuing to steadily rise. The healthcare outcomes in the United States are poor
compared to other developed countries showing how the U.S. is 20th in infant mortality rate, 29th
for premature or low birth weight infants, and 6th in life expectancy. In the United States people
are still being denied based off preexisting conditions or they are still finding the “Affordable”
Care Act unaffordable. There are also shift costs where hospitals are charging more to one
insurance than another to try and cover lost money from the uninsured or underinsured patients.
The United States have a somewhat steady rate of providers, but they are not evenly placed or
available in places that really need them. Japan has its’ share of weakness that could be
improved upon. The universal healthcare coverage does not cover preventative health exams. It
also has the financial incentives that cause overuse of labs tests, high-tech equipment, and
prescription drugs which Japan is one of the highest users of prescription drugs costs. There is
an issue of long hospital stays due to lack of nursing homes for their elderly population. The

6. 6
JapanHealthcare System
medical services that are given are fragmented and often duplicated causing unnecessary costs to
their health system which also causes excess capacity problems.
If Japan would make some adjustments to availability of nursing homes especially with the
rising numbers of elderly it can only benefit them. It has the entire basis to a great system and to
focus more on cutting unnecessary spending even though it isn’t at a really high cost to the
consumer it can benefit the country greatly. In turn if the U.S. healthcare system would adapt
some of these practices and realize that giving everyone better opportunity for healthcare that is
actually affordable it can benefit them in the long run. If you have a healthier population rather
than one that consists of a lot of sick people due to inability to have insurance it would lower
costs and make the healthcare system function better as a whole.

7. 7
JapanHealthcare System
References
Ikegami, N (1991). Japan’s Universal and Affordable Health Care. Retrieved from
http://www.nyu.edu/projects/rodwin/lessons.html
The Economist Newspaper (2011, September 10). Not all smiles. Retrieved from
www.economist.com/node/21528660
Commonwealth Fund (2013, November 14). International Profiles of Health Care Systems.
Retrieved from http://www.commonwealthfund.org
Wanjek, C (2009, July 28). Healthcare Systems: U.S. vs Japan. Retrieved from
http://livescience .com/7830-healthcare-systems-japan.html