Friday, September 9, 2016

Difference of the health insurance systems in Japan and the US


Since I was studying for the pharmacy exam and learned about the health insurance system in the US, I would like to talk about the difference between the health insurance systems in Japan and the US. I thought that it was interesting. ( I will not talk about the affordable care here.)

First, the Japanese insurance system is much simpler than the Americans one, All Japanese people are provided insurance by the government, which is pretty cheap. So when they go see doctors, they just have to pay 30% of the total costs. However, only about 50% of Americans enroll in health insurance, because it is very expensive. Even though there are Medicare and Medicaid for special needs, most of insurances are private and each insurance company covers the medical cost differently. People have to pay for part of the cost as deductible, coinsurance or co-pay.

Secondly, Japanese people can go to any clinics and hospitals they like. This means, there is no primary doctors in Japan. However, Americans usually have to go see their primary doctors first (although it depends on HMOs or PPOs). Primary doctors recommend specialists for their patients, if they need more medication. Therefore, it takes more time and effort for patients to get treatments.

Finally, American insurance companies authorize for medical services. Physicians need to obtain approval from their patients’ health insurance plans to prescribe a specific medication for you. This is called prior authorization. Prior authorization is a technique for minimizing costs, wherein benefits are only paid if the medical care has been pre-approved by the insurance company. Japanese insurance does not have such a system, so people can get any medication as they want.

I think that the Japanese medical system is better, but government medical cost have been increasing, which is a big problem. Health is the most important thing in life, so we should think about medical care.

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