Pros and cons of the healthcare systems of Japan
Japan is the world leader in the healthcare system that is characterized by universal coverage, employment-based system of financing and a predominant role of private hospitals. All residents of Japan are covered either by their employer or the government without any regards to medical problems they may or may not have. The national health insurance program is compulsory and premiums of are based on income.
Japan has 15.8 hospital beds and 1.6 physicians per 1000 persons. Although Japan has lowest physician-to-population ratios, the doctors have highest number of physician contacts per capita. The Japanese doctors prefer non-invasive procedures over surgical one and the surgeries performed by them are very less as compared to other countries. The organization of medical care is centered on hospitals. Ninety percent of the Japanese hospitals are ‘general hospitals’ with 20 or more beds. The other ten percent are chronic care centers and mental health facilities. Almost all hospitals use electronic billing; however, the electronic health record systems are in a developmental stage. Majority of the hospitals are privately owned and managed by the physicians. The public hospitals are larger than private ones and are under the jurisdiction of municipal corporations, government or national institutions. Japanese hospitals are treated as recuperative centers and are well-equipped for both acute- and long-term care facilities. But, Japanese hospitals have fewer emergency rooms and intensive care units as compared to many other countries. There is an integrated system of primary, secondary and tertiary level medical care. Therefore, primary care and specialist care are not regarded as separate disciplines (Thomson, Osborn, Squires & Jun, 2013; Henke, Kadonaga & Kanzler, 2009).
The Japanese healthcare system is technologically advanced and the diagnostic equipments (such as CT scanners) are manufactured in-house. Japanese healthcare system prefers ambulatory care over in-patient hospital care and therefore, Japan has a low rate of hospital admissions. However, it has long lengths of hospital stays and low hospital staffing ratios. Further, this system is encouraged by emphasis on bed rest until complete recovery. Overall, Japan has world’s lowest infant mortality rate and longest life expectancy (Rodwin, Kawasaki & Littlehales, 1994).
Pros and cons of the healthcare systems of Canada
The healthcare system in Canada is a hybrid of public-private system in which private sector delivers healthcare and public sector is responsible for financial assistance. Canada has publicly-funded socialized health insurance plans providing coverage to all Canadians. Health coverage is provided regardless of medical history, income or standard of living. Therefore, healthcare services are provided on the basis of need and not on the ability to pay (Bernard, 2013).
The governance, organization and delivery of healthcare in Canada in highly decentralized. The health insurance in Canada is handled by provinces and territories and new residents for provinces/territories are required to apply for health coverage. The typical waiting period for the new residents is three months of less. Some of the Canadian provinces also require premiums for healthcare services. As per the Canada Health Act, the provinces should provide standard healthcare, physiotherapy, dental surgery and prescription medicines. In addition to provincial insurance, private health insurance plans are offered to employees by the companies (Marchildon, 2013).
Primary care physicians are the forefront of Canadian healthcare; however, they account for only half of the Canadian physicians. They provide basic treatment and preventive care and refer the patients to specialists for further care. In comparison to public healthcare, private clinics offer services with reduced waiting times. However, private clinics face controversy because they may favor treatments to those with higher incomes. Overall, primary care seems to be pro-poor and specialist physician services are pro-rich (Canadian Health Care, 2007; Marchildon, 2013).
Rehabilitation and long term care services and policies vary among the provinces and territories of Canada. Canada’s health system performance is better as compared the U.S. and U.K. In Canada, life expectancy has improved and mortality rates have declined in the last four decades. There are no financial barriers to healthcare in Canada and ample numbers of physicians are available per capita (Bernard, 2013).
Bernard, E. (2013). The Politics of Canada’s Health Care System. Retrieved from www.law.harvard.edu/programs/lwp/healthc.pdf
Canadian Health Care. (2007). Canadian Health Care. Retrieved from http://www.canadian-healthcare.org/
Henke, N., Kadonaga, S. & Kanzler, L. (2009). Improving Japan’s health care system. McKinsey Quarterly, Retrieved from http://www.mckinsey.com/insights/health_systems_and_services/improving_japans_health_care_system
Marchildon, G. P. (2013). Canada: Health System Review. Health Systems in Transition, 15(1), 1-179.
Rodwin, V., Kawasaki, L. & Littlehales, J. (1994). Japan's Universal and Affordable Health Care: Lessons for the United States? New York: Japan Society, 1994.
Thomson, S., Osborn, R., Squires, D. & Jun, M. (2013). International profiles of healthcare systems, 2013. The Commonwealth Fund. Retrieved from http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2013/Nov/1717_Thomson_intl_profiles_hlt_care_sys_2013_v2.pdf