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Japan’s medical infrastructure crumbling

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In a society aging as fast as Japan’s, a solid medical infrastructure is a minimum precondition for viability. Japan’s medical infrastructure is anything but solid, warns Shukan Jitsuwa (Oct 8).

From January to August this year, it says, no fewer than 40 hospitals went bankrupt, nearly double the 21 that failed during the first eight months of last year.

Japanese medical care still ranks among the best in the world, but can that last? In 1990, according to health ministry statistics, there were 10,096 medical facilities across the country; the current figure is 8,749.

At one time, Shukan Jitsuwa claims, if a hospital went bankrupt it was a sure sign of bad management. That may no longer be true. Hospitals today seem to operate with the deck stacked against them.

More work for less pay is the heart of the matter. Cost-cutting reforms by former Prime Minister Junichiro Koizumi led to lower fees for doctors and, as a result, fewer young people choosing medicine as a career. That, together with a surging number of patients as the nation ages, has created a situation whose most appalling symbols have been emergency patients dying in transit, turned away by hospitals strained beyond capacity.

As of 2007, 626 of Japan’s 982 public hospitals were operating in the red, Shukan Jitsuwa finds. Fewer doctors mean fewer patients and less income. Japan has two doctors per 1000 population, ranking 27th among the 30 OECD nations.

Possibly foreshadowing worse to come nationwide was the closure last May of Choshi General Hospital in Choshi, Chiba Prefecture. The hospital was severely short of doctors, and the town’s mayor, after pledging in his election campaign to keep the hospital open, ordered the shutdown, claiming to have under-estimated its plight. Angry residents demanded a recall, and got it -- only to go on to elect the deposed mayor’s predecessor, whose policies some blame for the hospital’s being in trouble in the first place. Its fate continues to hang in the balance.

Some good may come of all this yet. Shukan Jitsuwa mentions two hospitals in Sakata, Yamagata Prefecture, that finally merged last year after years of “stealing each others’ patients” and driving each other to the brink of collapse.

Another hopeful sign is the toll-free expressway policy announced by Prime Minister Yukio Hatoyama. The improved access this implies, Shukan Jitsuwa believes, could inject fresh life into hospitals in comparatively remote areas.

That won’t be enough, of course, to turn the situation around. Policies will have to be devised to deal with the chronic doctor shortage, and hospitals will need to be reorganized to meet the new kind of society -- much older than any ever known to human history -- now taking shape. As the magazine points out, the pension mess is not the only weighty issue filling, and threatening to shatter, the health ministry’s plate.

© Japan Today

©2021 GPlusMedia Inc.

25 Comments
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No surprise here. Private medical schools are going to have to bite the bullet and start letting qualified people in, not just their cronies' kids. Young people want to be doctors and qualified medical technicians, but it is extremely expensive.

Management complaining about a lack of workers (nurses and other less qualified) reveals a lack of willingness to train and pay people sufficiently.

Too bad, but we all know that the medical sector in Japan had their heyday. They should have seen this coming.

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If we take good care of ourselves, we'd rarely need doctoring. My kittens, not to bankrupt me, self-healed from strangulated legs. They rested, ate, even moved around with swollen red oozing stumps. Were they in agonzing pain. Is our pain psychological? If we have no hope of pain relief from drugs, would our brain morphine kick in?

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Klein, not all private schools let people in the back door. It's one of those urban legends that just won't die. I'd love any of the JT posters who've spouted this over the years to sit for the exams...

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I think the medical system here is great. Opening up more seats at universities would take care of the shortage.

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everyone should watch the japanese movie densen 伝染 for what can happen if a hospital does not have good upkeep.

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The medical system here is terrible, not once has a Japanese hospital actually helped me when I had an illness, they either turn me away (I have national health insurance) or don't know whats wrong with me. It's like they are scared to actually fix me or something.

I have to goto to expensive private western doctors in Japan in order to get fixed.

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Interesting...I just read the other day that Japan had the highest rating for health care out of all other developed countries.

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Don't worry Mr Hatoyama has the solution. He will rectify the crumbling medical system. Reform!

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That is interesting pointofview because a lot of organizations consider france to have the best one in the world.

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gogogo - why not try a different doctor or clinic? you cant judge the entire japanese medical system as "terrible" based on a few limited experiences surely?

i agree with yelnats - i heart the j-medical system!

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Exactly ShuFu. I had a dermatologist once that I thought sucked so I moved on to another and he was great. Same with dentists. One I have now is excellent and clean. The university hospitals although crowded are also very up to date and pretty good.

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if there's anything wrong with you, and you go to a japanese doctor or hospital, you will surely die

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Same thing going on in the US...shortage of doctors and medical personal. However, the hospitals and administrators is where the money is booming for. Maybe they need some guidance from them. Hospital administrators earning more than doctors, what a joke!

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Only 2 doctors per 1,000 people...that is a shocking statistic. Overall I am very satisfied with the treatments I get here. I had them compared with several European doctors and they agreed on it too. Go to a university hospital if you want good treatment.

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"More work for less pay"

That's what the executives in my company want from their employees.

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former Prime Minister Junichiro Koizumi led to lower fees for doctors and, as a result

Im sure he didn't take a pay cut. This is the true face of social economic engineering and politics.

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With the population getting older this is not a good sign.

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In almost 20yrs I have done good most times going to the docs here, one in fact saved my wife whose stomach cancer was quickly found & the operation done all within 10days of discovery, that was about 7yrs ago & all the follow up over the years has been top notch.

But you need to find the good ones, dentists are typically terrible & will rip you off, finally found one that seems ok but the mrs tried one when we moved & after the usual 2-4 trips he casually tells her the next visit to put in the fake tooth isnt covered by insuance & you will need another Y80,000 so needless to say she never showed & went long distance to her old dentist who finished the job to the tune of Y5,000.

As others have suggested check out the university hospitals.

What Jpn really needs to do is use quotas to get the kind of docs needed & then make sure they are guided to where they can cant practice. Maybe this takes away some of the docs freedom but as far as I`m concerned they cant expect it because we all pay into this so its US the patients who shud determine where docs can set up not the other way round

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Unfortunately, I've had a number of ailments over the years, and Japanese doctors have always managed to put me back together. I think the medical system here is good for the most part and in the long run. It was a lot worse back in the 80s (if any of you were here then).

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Don't worry Mr Hatoyama has the solution. He will rectify the crumbling medical system. Reform!

i can't tell whether or not you're being serious

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So? Increase funding for national healthcare and allow more doctors to work in Japan.. it's gov't run healthcare, so gov't can just rearrange a few numbers, and bingo.. what's the problem? Oh, the money? How about ending useless programs such as paying the "what's wrong with being naked" guy to sell new TV's? How about ending Japan's unique bureaucratic desire to stamp every form in triplicate to certify that another form has been stamped in triplicate? There are limitless possibilities to ending bureaucratic waste in Japan without resorting to the failed concept of privatization.

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Hang on! I can't understand how any hospital can go bankrupt. Don't we pay huge amounts of health insurance for this purpose? Aren't hospitals government funded? I never realised a hospital is considered a profit making business. This scenario is totally unheard of on Oz.

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I come from a city of only 140,000 people and has 2 Nationally ranked hospitals and some 60 clinics. Not to mention is among the best in the country in nursing care. Japan is supposed to be among the best in the world. Yet for all the supposed benefits of National run Health Care. It sure doesn't seen to be helping much lol. Two doctors per 1,000 is terrible. You would think we were talking about a third world country here. While medical care may be low in Japan or so I hear. That is of little constellation when hospitals can barely keep afloat. Not to mention doctors which get payed next to nothing so I can see why there is a delcine. I only see this getting worse as the population ages which could become a full blown crisis if things don't change here pretty soon. Having good doctors isn't enough if you don't have an infrastructure and the money to support it.

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Medical care in Japan is rubbish. I dread going to the doctor.

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I've seen the same thing about dentists, they're decades behind and not very good. This is based on lots of doctors and people who've gone to both Japanese and the US. On the other hand, I've heard good things about other doctors.

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