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ACCJ-EBC Health Policy White Paper 2013


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ACCJ-EBC Health Policy White Paper 2013

  1. 1. Presenting the ACCJ-EBCHealth Policy White Paper 2013May 31, 2013Lengthening Healthy Lifespansto Boost Economic Growth
  2. 2. Laurence W. BatesACCJ President
  3. 3. About American Chamber of Commerce inJapanEstablished1948Committee structure drives Chamberactivities around three pillars:• Information• Networking• AdvocacyApproximately2700 membersrepresenting1000 companiesOver 500 eventsper year in threechapters acrossJapanApproximatelyhalf of membersare Japanese
  4. 4. Achieving Growth TogetherJapan EconomicGrowthACCJ MembershipGrowthACCJ MemberPersonal GrowthACCJ’s Three Primary Areas for Growth成 長 共 就
  5. 5. Preventive Health Investment Drives GrowthJapan’s aging is rapidly increasing healthcare utilizationWorker productivity is key to sustain healthcare and growthe economy• Disease costs Japanese economy 3.3 trillion yen per year in lostproductivity (2011 ACCJ National Survey)A shift to prevention and early detection is necessary to: Increase healthy life years Lower economic burden of disease Support economic growth
  6. 6. • Gaps between average life expectancy and healthy life expectancyrepresent an unhealthy period with daily life constraints• There may be medical and nursing expenses during this period70.4279.646073.6286.3965 70 75 80 85 90Year9.22 years12.77 yearsAverage life expectancy Healthy life expectancy (No daily life constraints)Gap between average and healthy life expectancyMaleFemaleSource: Healthy Japan 21 (Second Version)Importance of Healthier Life Expectancy
  7. 7. ACCJ-EBC Health Policy White Paper 2013Promoting economic growth in Japanthrough policies to lengthen healthylifespans andreduce economic burden of preventable,detectable and treatable diseases36 healthcare topicsOver 150 policyrecommendations
  8. 8. Duco B. DelgorgeEBC Chairman
  9. 9. About European Business Council in JapanTrade policy armof 17 EuropeanNationalChambers ofCommerce andBusinessAssociations inJapanWorking to improve the trade andinvestment environment for Europeancompanies in Japan since1972Approximately 3000 local Europeancorporate and individual membersApproximately400 companiesparticipatingdirectly
  10. 10. Rise in Non-Communicable Diseases Is aLeading Threat to Global Economic GrowthWHO report: each 10% rise in non-communicable diseases is linked to a0.5% dip in annual economic growth;recent global rise in NCDs is“economically unsustainable.”The World Economic Forum forecaststhat NCDs will cost the global economy$47 trillion over the next 20 years.• Stuckler D. “Population causes & consequences of leading chronic diseases: a comparative analysis of prevailing explanations.”Milbank Quarterly, 2008, 86:273–326. Reported in Global Status Report on Noncommunicable Diseases 2010,” WHO,• Working Towards Wellness: The Business Rationale. World Economic Forum, Geneva, 2008. Bloom, et al., 2011.
  11. 11. NCDs account for about 30% of national healthcare expenditure andabout 60% of total deathsHealthcare ExpenditureCancers 11.1%Hypertension-relateddiseases 7.1%Cerebral vasculardiseases 6.3%Diabetes 4.4%Cardiovasculardiseases 2.9%Others68.3%Cancers29.5%Cardiovasculardiseases 15.8%Cerebral vasculardiseases 10.3%Diabetes 1.2%Hypertension-relateddiseases 0.6%Others42.6%MortalitySource: Healthy Japan 21 (Part 2)Non-Communicable Diseases in Japan areCostly, Deadly and Often Preventable
  12. 12. “Every 1 year increase in lifeexpectancy is linked to a 4.3%increase in global GDP.”Sources: Stuckler D. “Population causes & consequences of leading chronic diseases: a comparative analysis of prevailing explanations.”Milbank Quarterly, 2008, 86:273–326. Reported in Global Status Report on Noncommunicable Diseases 2010, WHO, to Promote Health is a Very GoodEconomic Investment
  13. 13. William BishopChair, ACCJ Healthcare Committee
  14. 14. 20102010 Health Policy White Paper2010
  15. 15. 2011 Health Policy White Paper2011Scope:• 27 Topic Sections• 124 RecommendationsResults:• 46 of 124 recommendations (roughly 37%)fulfilled “in part" or in wholeAreas of Progress:• Continued government funding of nationalcancer screening• Substantial increased funding to enhanceinfection prevention and control at hospitalsin Japan (four fold for hospitals with >300beds).• Expanded use of IVD Rapid Diagnostics• Diabetes Management• Osteoporosis Prevention• Chronic Pain Research Funding• Vaccination Policy• Hepatitis Screening & Awareness Initiatives
  16. 16. Source: InhibitexNearly 6 million HAIsannually in U.S., Europe andJapan1.7 million cases and 99,000deaths annually in the U.S.In some developing countries,more than 25% of patientsadmitted to hospitals acquireHAIsHundreds of millions ofpatients impacted worldwideeach yearHealthcare Associated Infections (HAIs):A Global Healthcare IssueMillions of Infections864202002 2005 2009 2010 20155.6 5.96.3 6.46.9JapanEuropeU.S.
  17. 17. Q. How important do you think it is for the government to have a nationalprogram to reduce the risk of infections associated with hospitals, clinicsor other healthcare facilities?75.7% of General Public in Japan Think it isImportant to Have a National Program to Reducethe Risk of HAIs (80% for population over 65)■ Important ■ Slightly important ■ Neither nor ■ Do not know ■ Not very important ■ Not important52.448.948.543.037.331.429.440.840.240.527.430.632.936.236.439.238.135.934.435.27.712.911.212.115.917.618.614.414.214.310. 20% 40% 60% 80% 100%80+ yrs old (n=208)70-79 yrs old (n=790)60-69 yrs old (n=882)50-59 yrs old (n=779)40-49 yrs old (n=800)30-39 yrs old (n=863)20-29 yrs old (n=678)Female (n=2599)Male (n=2401)Overall (n=5000)Is Important75.7%74.6%76.6%67.4%70.6%73.6%79.2%81.4%79.5%79.8%Not Important3.3%3.9%2.6%6.6%3.9%3.2%2.9%1.8%2.0%1.9%Survey on Prevention, Early Detection and the Economic Burden of Disease in Japan (2011) by The American Chamber of Commerce inJapan. Internet survey conducted October 31 – November 2, 2011. 5,000 respondents from Rakuten Research’s registry that representthe Japanese population.
  18. 18. 20132013 ACCJ-EBC Health Policy White PaperScope:• 36 Topic Sections• 156 RecommendationsChapters:1. General Health Themes2. Non-communicable Disease(NCD) Topics3. Women’s Health Topics4. Key Infectious Disease Topics5. Importance of Enhanced Safety& Infection Control6. Special Focus Needed onHealthcare Worker Safety
  19. 19. Danny RisbergChair, EBC Medical Equipment Committee
  20. 20. Deaths Caused by and Patients ofCerebrovascular Diseases10012515017520002505007501,0001,2501,5001,7502,0001996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008# of death(1,000 ppl)# of Patients(1,000 ppl)# ofPatients# ofDeathSource: Ministry of Health, Labor, and Welfare (Trend of Medical Institution)
  21. 21. 76.8%13.3%2.4% 7.5%Cerebral hemorrhageCerebral infarctionSubarachnoid hemorrhageOthers19601999Source: Ministry of Health, Labor, and Welfare (Vital Statistics)Deaths Caused By CerebrovascularDiseases23.0%62.7%10.8% 3.5%
  22. 22. Vessel Wall Imaging Done by MRI
  23. 23. Sleep Apnea Syndrome(over 3 million patients)13% have diabetes(390,000 patients)21% have cardiovascular diseases(630,000 patients)41% no complication(1,230,000 patients)51% have hypertension(1,530,000 patients)UndergoingTreatment(250,000 patients)Increase Sleep Apnea Syndrome Screening
  24. 24. Eriko AsaiChair, ACCJ Health IT Subcommittee
  25. 25. 71.5% of Japanese Back Introduction of ElectronicHealth Records at Hospitals, ClinicsSupport/Agree Slightly Support/Agree NeitherDon’t know Slightly Oppose/Disagree Oppose/Disagree50.048.252.442.240.335.936.137.948.743.123.628.024.328.428.333.429.831.625.028.414.416. 20% 40% 60% 80% 100%80+ yrs old (n=208)70-79 yrs old (n=790)60-69 yrs old (n=882)50-59 yrs old (n=779)40-49 yrs old (n=800)30-39 yrs old (n=863)20-29 yrs old (n=678)Female (n=2599)Male (n=2401)Overall (n=5000) 71.5%73.7%69.4%65.9%69.3%68.5%70.6%76.6%76.2%73.6%Support Oppose2.9%2.9%2.9%5.0%3.7%2.9%1.8%1.8%2.7%1.9%Q: Do you support or oppose the introduction of electronic health records athospitals and clinics in Japan?Source: ACCJ National Survey on Prevention, Early Detection & the Burden of Disease in Japan, Nov, 2011.
  26. 26. Supporters of EHR System ExpectMore Efficiency, Safer Medical Service(n=3,574)Q: Why do you support the introduction of an electronic health record (EHR) systemat hospitals and clinics in Japan? (multiple answers)Source: ACCJ National Survey on Prevention, Early Detection & the Burden of Disease in Japan, Nov. 2011.
  27. 27. 24.3%70% 75%Breast Cancer Screening Rates Lower ThanOECD AverageSources:, http://www.oecdtoMammographyscreening ratesin Japan rising,but still low62.2%Free National Breast Cancer ScreeningLaunched in 2009Scope: Women aged 40, 45, 50, 55, and 60Funding: 100% by central governmentJapan Goal: 50% screening rate by 2011Recruitment: Send coupons to eligible women
  28. 28.  Has a 28% survivalrate over five years Costs up to ¥4million to treat Has 96% survivalrate over fiveyears Costs about¥760,000 to treatBreast cancer diagnosedin early stagesBreast cancer diagnosedafter it has metastasizedBreast Cancer Screening:Cost Effective and Saves Lives Sense no need, as have nolump Lack of opportunity High feesTop three reasonswomen do not havea mammogram
  29. 29. Bruce EllsworthACCJ GovernorHealthcare Committee Liaison
  30. 30. Two Thirds Support a Mandated IndoorWorksite Smoking BanQuestion: What would you think if the national or local governments legally requireda complete smoking ban in all indoor workplaces and public spaces, includingrestaurants, bars and taxis, to protect the health of non-smoking workers?Source: Japan national survey on passive smoking in the workplace for 8,000 indoor workers by Johnson &Johnson K.K. Consumer Company, released on July 19th, 2012
  31. 31. 70% of Indoor Workers: Legal Smoking BanWould Not Negatively Impact BusinessQuestion: How would your business be impacted if national or local governmentslegally required a total smoking ban in all indoor workplaces and publicspaces, including restaurants, bars and taxis, to protect the health of non-smokingworkers?Source: Japan national survey on passive smoking in the workplace of 8,000 indoor workers by Johnson & Johnson K.K. Consumer Company, July 2012
  32. 32. 322011 MHLW’ National Survey on Getting-tested status of Hepatitis Screening (Interviewed 74,000 Japanese people aged 20 thru 79 years old)Only Half of Adults in Japan Have BeenScreened for HepatitisJapanese government has provided free hepatitis screening since 2002 as thetime of regular health checkup services by municipal governments. Freescreening was first provided at public health centers and later also available athospitals and clinics.Need to further increase screening rate, especially for people aged 40 and over.HCV Screening Rate: Est. 48%HCB Screening Rate: Est. 57%Tested at timeofsurgery, pregnancy, blooddonation 40%No, I havenot or donot know42%Yes, I havebeen tested(self-reported)18%Yes, I havebeen tested(self-reported)18%No, I havenot or donot know52%Tested at timeofsurgery, pregnancy, blooddonation 30%
  33. 33. Large CompanyEmployersSmall and MediumCompany EmployersSelf-Employed andOthersType of healthinsurance in whichemployee enrollsManaged by healthinsurance societies orassociationsManaged by membersof Japan HealthInsurance AssociationManaged bymunicipalities, NationalHealth InsuranceassociationsProvision of healthcheckups based onIndustrial Safety &Health ActYes, required(Employers are required to provide)Not requiredProvision of specialhealth checkups basedon Law for the Welfareof the Elderly (aged 40or over)Yes, provision is required(Insurance provider is required to provide)Rate at which hepatitisscreening is part ofspecial health checkupApprox. 50% Approx. 95%Individuals must pay ¥595as co-payment and applyseparately for this optionalhepatitis virus testing.Approx. 80%Free but implementationvaries by town, city.Screening notices usuallygo to specific age groups.Source: MHLW, “Status of implementation of Specific Medical Checkups/Health Guidance in FY2010” of Hepatitis Screening VariesWidely According to Type of Insurer
  34. 34. 2013 ACCJ-EBC Health Policy White Paper• Paradigm shift from treatment to prevention Focusing on prevention, screening, early detection and early treatment ofdisease• Efficient allocation of healthcare resources Enhancing productivity and reducing waste• Evidence-based global best practices Recommendations with potential to yield significant positive impact• Alignment with government growth policy goals Recommendations with potential to boost economic growthDisease prevention • Cost effective interventions• Better patient outcomes and quality of life •Enhanced labor productivity
  35. 35. Presenting the ACCJ-EBCHealth Policy White Paper 2013May 31, 2013Lengthening Healthy Lifespansto Boost Economic Growth