Health Care in Japan

Health care in Japan
In the Japanese health care system, healthcare services, including free screening examinations for particular diseases, prenatal care, and infectious disease control, are provided by national and local governments. Payment for personal medical services is offered through a universal health care insurance system that provides relative equality of access, with fees set by a government committee. People without insurance through employers can participate in a national health insurance program administered by local governments. Since 1973, all elderly persons have been covered by government-sponsored insurance. Patients are free to select physicians or facilities of their choice.
It is compulsory to be enrolled in a Japanese insurance program if you are a resident of Japan. The two main categories of health insurance are referred to as Kenkō-Hoken 健康保険 ([social] health insurance) and Kokumin-Kenkō-Hoken 国民健康保険 (national health insurance). National health insurance is generally reserved for self-employed people and students, where as social insurance is normally for corporate employees [1].
In the early 1990s, there were more than 1,000 mental hospitals, 8,700 general hospitals, and 1,000 comprehensive hospitals with a total capacity of 1.5 million beds. Hospitals provided both out-patient and in-patient care. In addition, 79,000 clinics offered primarily out-patient services, and there were 48,000 dental clinics. Most physicians and hospitals sold medicine directly to patients, but there were 36,000 pharmacies where patients could purchase synthetic or herbal medication.
National health expenditures rose from about 1 trillion Yen in 1965 to nearly 20 trillion Yen in 1989, or from slightly more than 5% to more than 6% of Japan's national income. The system has been troubled with excessive paperwork, assembly-line care for out-patients (because few facilities made appointments), over medication, and abuse of the system because of low out-of-pocket costs to patients.[citation needed] Another problem is an uneven distribution of health personnel, with rural areas favored over cities.[2]
In the late 1980s, government and professional circles were considering changing the system so that primary, secondary, and tertiary levels of care would be clearly distinguished within each geographical region. Further, facilities would be designated by level of care and referrals would be required to obtain more complex care. Policy makers and administrators also recognized the need to unify the various insurance systems and to control costs.
In the early 1990s, there were nearly 191,400 physicians, 66,800 dentists, and 333,000 nurses, plus more than 200,000 people licensed to practice massage, acupuncture, moxibustion, and other East Asian therapeutic methods.
Japan's suicide rate is high compared to the USA; the Yomiuri Shinbun reported in June 2008 that more than 30,000 people had killed themselves every year for the past decade. A study published in 2006, suspects that health problems were a factor in almost 50 percent of the Japan's suicides in 2006.[3] However the Yomiuri's 2007 figures show 274 school children were among those who took their own lives.
However one of the biggest public health issues in Japan is the use of tobacco, which according to Tadao Kakizoe (honorary president of the National Cancer Center) kills more than 100,000 people per year and is responsible for one in ten deaths. (Daily Yomiuri 8/9/2008)