Universal Healthcare Can Save Money, But Innovation Is Key: My Experiences in Japan and the U.S.

8/10/09

I was born and grew up in Japan and have first-hand experience as both a doctor and a patient in my native country—a nation that offers universal health care coverage to its citizens. I have also been a patient, an academic researcher and a biotech entrepreneur here in the United States, my home for the past 10 years. These experiences have helped me to compare and contrast and to see the advantages and disadvantages of both countries’ healthcare systems. My work as an entrepreneur has also led me to examine these systems’ effects on innovation in the biotechnology and pharmaceutical sectors.

In thinking more closely about health care, I have come to several conclusions. First, access to quality health care coverage for all people is key. Second, any health care reform implemented here in the United States should not negatively impact the high quality of care that the U.S. is known to provide and that U.S. citizens enjoy. Third, it is also very important that any health care reform not come at the expense of cutting-edge research and medical advances that could spur the next generation of safe and effective treatments.

Japan has embraced universal health care coverage and it has been relatively cost-effective for that country. We know that Japan is spending only about the half of the amount on health care compared to the United States in terms of percentage of GDP; however, it is important to note that individual out-of-pocket costs are not that different.

Also, the patient experience is vastly different. In the United States, private health insurance providers dictate which hospital you can go to and what kind of treatment you can access. In Japan, regardless of what type of insurance you have, everyone is covered. Individuals can select to see almost any doctor they would like, and their co-pay is often 30 percent but there is a cap of approximately $700 per month. However, my experience is that Japanese patients have a trade-off – they only see their doctor for three minutes (usually after three hours of waiting). I have also seen first-hand that doctors are overworked and underpaid relative to other industries. For example, currently in Japan, there is a dramatic decrease in the number of doctors who are willing to become pediatricians or OB-GYNs due to the challenging work environment. While the clear benefit is that everyone is insured in Japan, there is the downside: the average quality of medicine does not rival … Next Page »

Ryo Kubota is chairman, president and CEO of Seattle-based Acucela. Follow @

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  • Ryan McBride

    Thank you for the insights, Ryo. I hope our policymakers are reading this, because it’s so important that we get this healthcare reform done the right way.

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  • Gerry Roe

    My son spent 3 years working in Japan after a year in school there. He never experienced 3-hour waits or noticeably less time with the doctor than he gets here. If by “out of pocket” you include taxes paid to cover health care, then perhaps the costs in the two countries are not that different for some income levels, but what he paid outside of that was a pittance. Meanwhile, my daughter, who is unemployed and uninsured, was hit with a $10,000 bill for a couple of hours in the ER with no major procedures. In other words, our treatment costs constitute a much higher percentage of income for the poor. I defer your judgement with regard to quality of care, but I’m not sure you’ve identified cause and effect when you suggest that the entrepreneurial spirit in the US is a result of our approach to health insurance. It may as well be a result of other cultural factors, which evidently shape corporations differently in Japan. Would you be much less likely to pursue your research if it only made you comfortable, not wealthy? Wouldn’t more people be likely to take entrepreneurial risks if they weren’t literally gambling with their lives?