A Brief Comparison of Health Care System in the US and Japan


Every country has a system of health care for its citizens and residents. Health care planning of a country is considered as an evolved unit, resulting from the participation of multi-stakeholders such as hospitals, government bodies, general public /citizens, educational institutions, diagnostic and therapeutic facilities, health professionals, charitable organizations, etc. The common goal or purpose of any health system is to improve the health of its target population (citizens and residents). Though the purpose and intent of health care remains common across all countries, the way a health system is built and administered depends on economic, cultural, historical and political factors prevalent in the respective countries. For example, the US and Japan are developed countries that have advanced health systems, but there are significant differences in the way health care is administered. This essay points up some key differences in health care in the two developed countries.

An OECD report indicates eight major dimensions that are important in evaluating the health system of a country i.e. status of health, non-medical determinants of health, health workforce, health care activities, quality of care, access to care, health expenditure and financing, and aging / long term care. The report also lists out the sub-categories in each of these dimensions, which totals up to more than eighty indicators that need to be taken into account while evaluating the full spectrum of health care system of a nation. However, the current essay limits its scope to comparing only a few aspects of the health care in countries in discussion.

In the health care dimension of Life expectancy (an important parameter of health system), Japan has improved much more than the US. Among the OECD countries, Japan holds the second position in life expectancy (81.2 years), while Unites States has 27th position with life expectancy of 78.7 years. The OECD report (Health at a Glance) attributes this difference to United States’ failure to insure all the citizens and administer proper primary care to the sick citizens. However, the US spends highest on health (per capita) than any of the OECD countries; it spends about $8,500 while Japan spends less than $ 4,000. This is a striking anomaly because, expenditure on health care should reflect in higher life expectancy; Japan has four years higher life expectancy with lesser per capita expenditure.

With respect to cancer care, the US health care system stands above Japan, especially in screening activities and increasing survival rates. But, the quality of treatment for chronic diseases such as asthma, diabetes, obstructive pulmonary diseases, etc. is higher in Japan than in the US. As mentioned earlier, the primary care in the US has dwindled when compared to the care in earlier decades.

Wanjek shares personal experience and observation about health care in Japan that no citizen there has become bankrupt due to medical fees. The health care in Japan is affordable and less expensive than in the US. Another important observation is that while US employs sophisticated gadgets in treating serious diseases, the Japanese focus on prevention of diseases rather than the post disease treatments.

Though the international bodies such as OECD, WHO, etc. have adopted uniform approaches in ranking countries, according to set standards, it may be impossible to adopt best practices of another country due to the diversity of the habits, culture, economy and the trends existing in each country. A quick review of the health care data of various countries indicates that economic, technological, and intellectual supremacy alone are not enough to achieve better health care.

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