Japan Health Care

8/14/2019 Japan Health Care

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DAIKANGEI


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Contents

PART I

Introduction to Japan

Vital Statistics

Organisation of Ministry of Health Japan

Regulations and Policies in vogue

Vision of the Ministry of Health Japan 21

Social Marketing

Health Financing

Health Insurance

Health Care Reforms

Conclusion


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PART I

The World Health Organization (WHO)announced in the report WHO 2000 that thestate of Japanese health is ranked the first inthe world, and the performance of theJapanese health care system is tenth in theworld


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Country Demography

Independence: 660 BC (founded by Emperor Jimmu)

Area: 377,864 sq. km.

Constitutional Monarchy

Japanese 99.4%, other 0.6% (mostly Korean)

Religions are both Shinto and Buddhist 84%, other 16%Literacy: 99% (age 15 who can read and write)

Capital: Tokyo

Administrative Divisions: 47 prefectures

Constitution: 3 May 1947


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Population and Health Data (2002 estimates)

Population [Total] 127 435 000 Life expectancyat birth (years)[0-14 years] 18 102 000

(14.20%)[Male] 78.32

[65+ years] 23 628 000(18.54%)

[Female] 85.23

Crude birth rate(per 1 000 population)

9.20 Total fertility rate 1.32

Crude death rate(per 1000 population)

7.80 Populationserved withsafe water

96.70 %

Infant mortality rate(per 1000 live births)

3.00 Population with adequatesanitary facilities

98.40 %

Maternal mortality rate(per 100 000 live births)

7.10

Vital Health Statistics


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Health Care Facilities (2002estimates)

Predominantly owned and operated by the private sector

Hospitals 9,731 (Provide out-patient and in-patient care)

72% of the hospitals (54.6% hospital beds) are classified as private sector

General Health Clinics: 85,588 (92% primarily offer out-patient services)

Dental clinics: 57,213

Beds ratio: 1 bed / 65 persons

Doctors: 230,000 (184 doctors for 100,000 people)

Most physicians and hospitals sell medicine directly to patients

36,000 Pharmacies provide synthetic or herbal medication


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Ministry of Health, Labour &Welfare


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Ministry of Health & Welfare

External Bureaus

Affiliated Institutions

Local Branches

Internal Bureaus


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Organisational Highlights MOH Japan

In Japan Healthcare is classified as:In-patient services

Out-patient services

There are NO categories named day-careDay-surgery is classified as out-patient services


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Organisational Highlights MOH Japan

Health care facilities range from

Small neighbourhood clinics to hospitals that provide moreintensive careSome companies run their own hospitals for employees

Public Health Centres provide:Health educationImmunizationPre- and post-natal carePreventive health care

Public Health services includeFree screening examinations for particular diseasesPrenatal care

Infectious disease control


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Health Care System Regulations

The Ministry of Justice Obihiro Comprehensive Office Building


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Highly centralized system

Government determines nearly all aspects of healthcareregulation including:

Pricing and financing

Covered proceduresStructure of healthcare delivery systems

Acts for Decentralization (July99) facilitates the shift towarda decentralized system of Government

Helps Local Governments to create their own policies

Gives local residents more participation

Japanese Medical Association (JMA) looks after the

providers interests

Hospital can bill the patient for extraroom & board charges only


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The Japanese Board of Medical Specialties, promotes knowledge

and skills under the standardized system

Medical Service Act of 1948 covers policies to include minimum

criteria of medical facilities

Ten Year Gold Plan initiated by the National Government (1989),

plans for elderly health and welfare by the year 2000

The Maternal Protection Law 1996

Ordinance-150 (2002) related to the calculation of contributions

by Insurers to the Long-term Care Insurance Scheme

Food Sanitation Law (amended 2002) prevents the occurrence of

health hazards arising from human consumption of food


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Vision of Ministry of Health, Labour &Welfare


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Healthy Japan 21

National health promotion movement in the 21st Century

Healthy Japan 21 initiated in 2000 by MHLW

This emphasizes primary prevention aiming at early

detection and treatment of diseases

The important areas targeted for improvement by 2010include:-

Improving healthy dietary habits

Promoting good exercise habits

Promoting appropriate relaxation

Promoting harmful effects of smoking & alcohol on health

The fee at healthy promotion facilities for exercise / hot

spring therapy etc. are tax deductible as medical expenses


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Media and health Promotion

With deregulation of the Medical Advertising Law in Japan (Jul96)

advertising in the areas of new treatments and information of diseases, has become very popular

Hospitals, pharmaceutical companies and health care industries can

now present and position themselves

They are now able to build trust in their

patients & have customer satisfaction


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Media and Health Promotion

Health campaigns through media focused on:

Information of medical services

Promoting the concept of informed consent

Promoting disclosure of information about

medical institutionsPrevention of medical accidents

JPMA has conducted a national newspaper &

magazine campaign aimed to educatehealthcare consumers about topics related tothe work of the pharmaceutical industry

Social Anxiety Social Anxiety Difficulty (SAD)Difficulty (SAD)

Campaign in November 2001Campaign in November 2001

focused on the clinical trials processfocused on the clinical trials process


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Health Care Markets Challanges

Market Effects of Aging Society

Home and institutional nursing care services is at US$

65.88 billion (2000)

Market for products for the elderly and the disabled, e.g.

wheelchairs, medical kits etc, is already soaring

Govt introduced Information Barrier-free Environment:

Information Network for People with Disabilities

(Normanet)

A multimedia system can simultaneously provide letter,

voice, and image data in a set via the Normanet


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Health Financing


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Japan's Health Care System

19221922

Manual WorkersManual Workers

Post World War IIPost World War II

Health Care a RightHealth Care a Right

19611961Universal Health CoverageUniversal Health Coverage

Preventive CarePreventive Care

Curative CareCurative Care

Medical services areavailable to all citizens

FinanceFinance

GovernmentGovernment

Tax DeductionsTax Deductions

FinanceFinance

Pay Roll DeductionsPay Roll Deductions

Tax DeductionsTax Deductions Patient co-payments

Employer-purchased Insurance

J H lth I


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Japan Health Insurance Background

Public Health Insurance Scheme 1927 (enterprises with 10employees or more)Regional Health Insurance Scheme 1938 (self-employed on avoluntary basis)1961- Public Health Insurance Scheme covered the whole

population1973 70 yrs or over persons were exempted from payment for health servicesHealth Service System for the Elderly 1983, includedmoderate co-payments by the elderly. In 1986 this wasextended to Intermediate Nursing FacilitiesLong-term Care Insurance System 2000, extended coveragefor:

Nursing homes and the supporting services for home care

Required contributions by the elderly themselves


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Types of Health Insurance s

Employee's Health Insurance

For regular workers

The employer handles all the paperwork and premium

payments will be deducted from salary

The National Health Insurance

For everyone who does not qualify for employee's

insurance - such as students and self-employed workers

The registration and payment procedures are done by

the individual
http://www.yokkaichi-u.ac.jp/~ushijima/my_mpeg/2002/image/020119_1_31_hokenshou.jpghttp://www.yokkaichi-u.ac.jp/~ushijima/my_mpeg/2002/image/020119_1_31_hokenshou.jpg


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How Health Insurance Works

The Health Insurance Card (hoken-shou) is one per household, which is to be presented at the clinic or hospital

This is a valuable piece of personal identification

It is also used as identification in a variety of contexts:

Proof of address when you apply for a video rentalcard

Identification at financial institutions and personal

loan companies


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All What Is Insured

Insured:

Only diagnostic and treatment services

Basic dental treatment

Not Insured

Preventive care and cosmetic procedures

Neo- and postnatal care

Normal childbirth procedures

Some doctors whose clinics specialize in English

language services

Preventive dentistry

Cleaning and whitening of teeth


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Mode of Payment

Employee's Insurance20% of medical costs to the cashier of the hospital

National Insurance

30% of medical costs to the cashier of the hospital

Family members also pay 30%


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Charges For A Typical Case

Acute AppendicitisEmergency surgery and hospital stay 7 days

Initial Consultation Fee 2500

Hospital Charge (7days) 116270

Laboratory 31690

X Ray 18760Medication 1510

IV 14950

Bandage etc 3520

Surgery (Appendectomy) 64200

Anesthesia 10680

TOTAL 264080

(patient co-payment) 63600

yen, $1=125yen


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The Need For Reforms

Problems Health Reforms 2002

Administrative

Japan's health insurance systemis "universal but fragmented"

systemUniversal guarantees that everysingle person is insured andmedical care is guaranteed toevery body

Fragmented in that there is aconsiderable inequality as to thepremium burden

The co-payment rate for employer'sinsurance raised from 20% to 30%Proposal to consolidate the presentMunicipal and the Governmentmanaged health insurance atprefectural level by 2007


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Medical Care Expenditures


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Financial

The total amount of nationalgovernment subsidies in the

FY2004 budget is 8.1 trillionIncrease in medical cost andslow increase in revenues

Growth of expenditure is not

controlled to a level that is in linewith economic growth

The co-payment rate for employer'sinsurance raised from 20% to 30%

The limit on monthly amount of co-payment raised from [63,600 yen to72,300 yen + 1% of the actual medicalcost]General outpatient drug co-payment is

abolishedThe premium rate for governmentmanaged health insurance raised from85% of monthly income to 82% of annual income


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Pharmacy

Over-prescription of drug bydoctors and hospital

There was a 15% profit margin(R-zone) in 1998 which wasreduced to 2% in 2000

Medical fees and drug pricing reducedby 1.0% in 2004


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Elderly

The annual growth rate of totalmedical expenditure for the

elderly in the past decade was8%

Expected to remain high over 5%

(The average medical cost for theelderly at and over 65 yrs old is 5 times as high as that for younger

persons)

The senior healthcare schemereformed as follows:

The eligible age would be raisedfrom 70 to 75 over a 5 year periodThe proportion of governmentsubsidies to total insuranceexpenditure would also be raisedfrom 30% to 50% over the same 5year periodThe co-payment rate unified at 10%

Transition in Source of Financing for


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Transition in Source of Financing forElderly


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The Accomplishment

The World Health Organization (WHO) announced in the report WHO 2000 thatthe state of Japanese health is ranked the first in the world, and the performance of the Japanese health care system is tenth in the world


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Heavy Investment in Preventive Care

Health Budget 2002Health Budget 2002


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The Best Solution..

Invest in Preventive Health

NOW..!!!!NOW..!!!!


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Japan Health Care