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Why is Japan's medical care system breaking down?

16 Comments

“Medical breakdown” is in the air. It’s in the media. Scarcely a day goes by without multiple references to it. Now in its second year, the coronavirus pandemic rages with renewed fury – a “third wave,” with daily infections approaching 8,000 and daily deaths near 100.

Hospitals can’t cope. Seriously ill patients are being turned away. This is “medical breakdown,” likely to get worse before it gets better.

Shukan Gendai (Jan 23) poses a question that makes us pause. Japan, it says, has more hospital beds per capita than any other country in the world. And the virus, deadly though it is, has wreaked remarkably less havoc here than elsewhere.

Why is Japan’s medical system buckling?

Other countries are under far more strain. Japan nationwide has 1.529 million hospital beds – 13.1 per 1000 people, versus 2.8 per 1000 in the UK and 2.6 per 1000 in the U.S.  Japan’s 8000 new infections per day ( 6.2 people per 10,000 population) compare with the UK’s 60,000  new cases a day (89.9 per 100) and the U.S.’s 280,000 (84.8 per 1000).

Japan, comparatively speaking, should be sailing through this viral scourge, its medical response a lesson to the world in times of crisis. The beds are there, the skills are there, the system is in place, one of the world’s best – what’s gone wrong?

The problem as Shukan Gendai sees it is not medical but economic. Some 80 percent of Japan’s 8,300-odd hospitals are private, meaning they must be run as business enterprises. Put starkly, if perhaps too simply, treating coronavirus doesn’t pay.

The magazine surveys at random 30 Tokyo-area hospitals, asking each how many of its beds are empty. The hospitals decline to answer. But an employee of one 100-bed hospital comes forward to say that 40 of them are empty. Like other medical establishments, it was hit hard by the pandemic. Cluster infections at numerous hospitals scared people into shunning the routine, non-urgent treatment that guarantee hospitals’ financial health. The employee’s hospital, like others in the same plight, began as an alternative offering PCR coronavirus tests on an outpatient basis. That filled the financial void but not the beds. Again like others, this particular institution declined to admit patients suffering heavy coronavirus symptoms.

Light and moderate symptoms are another matter. The existing infrastructure suffices for them. But heavy symptoms require heavy – and costly – medical intervention.

First, wards must be set aside for them. Often it’s the intensive care unit, which means closing it to those needing it for other reasons. Showers and toilets, too, must be separate for infected patients. And the care the situation demands – nursing, disinfecting, operators of artificial respirators and so on – is personnel-intensive, potentially straining resources to the limit of, if not beyond, current capacity.

These are difficult but not insoluble problems. China, Shukan Gendai reminds us, built in 10 days a 1,000-bed coronavirus hospital in Wuhan, the initial heart of the epidemic, symbol of a single-minded and largely successful drive to defeat the disease just where it was raging most virulently. China’s government exercises a degree of control over institutions and citizens that few Japanese would accept, whatever strength it brings to bear in a struggle like this one. Taiwan offers a model for a successful democratic response.

Given the will, Shukan Gendai suggests, Japan could do better than it is.

© Japan Today

©2024 GPlusMedia Inc.

16 Comments
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1) Because it's ridiculously inefficient. After seeing a doctor, I must wait twenty minutes to pay a ¥300 contribution that costs at least 10 times that much to process.

2) Because Medical breakdown (countries with 'conservative' administrations take note) allows the LDP to sell the system lock, stock and barrel to American insurance companies, sitting in a black ship beyond the horizon.

2 ( +6 / -4 )

The beds are there, the skills are there

This is a false assumption. First, most private hospitals are not equipped to handle infectious disease more serious than the mumps or flu. In fact, when a 'serious' case of any sort shows up, many private hospitals send the patient to a larger facility such as a university hospital.

Second, after treating colds, flu, broken bones, and stomach problems for five, ten years the doctors ability to diagnose and treat a more unique (and deadly) disease is missing. So, they send the patient to a bigger hospital. This is good; as Dirty Harry once said, "A man's got to know his limitations."

Do coved-19 patients really want to be treated in a poorly equipped, under-trained hospital for a high fee, or the opposite for less?

7 ( +9 / -2 )

Do coved-19 patients really want to be treated in a poorly equipped, under-trained hospital for a high fee, or the opposite for less?

Unfortunately the choice is increasingly becoming being cared insufficiently for a high price or not being treated at all.

These problems are not something unforeseeable that suddenly appeared nor something impossible to solve, the Japanese government had a lot of time to correct this, for example by providing funds so the hospitals would have an incentive to accept patients, maybe not to the point of becoming a good business, but at least so they would prefer to do it instead of be empty from patients. Professional health staff can also be re-trained and prepared for COVID patients relatively quickly, on the months leading to this situation it could have been done gradually without too much problem.

This only required the government to not be in denial and invest to prevent the very likely disaster instead of just expecting things to go fine without needing to do anything.

6 ( +9 / -3 )

it isn't only Japan's medical care system that brakes down ,Many countries such as italy,spain,uk,brazil,u.s,mexico's medical care system is breaking down as well.

in my opinion, Japan is doing okay..

-4 ( +4 / -8 )

Why is Japan's medical care system breaking down?

A socialized health care system in a nation with a staggeringly high national debt, a population heavily weighted towards the elderly, a relatively low paid middle and working class, and an economy that has been stagnant for a quarter century is never going to be able to hold up in the long run. The miracle is that it hasn’t collapsed already.

-7 ( +6 / -13 )

@Wolfpack

"A socialized health care system....."

You didn't read the story? The problem is that 80% of the hospitals are PRIVATE. If Japan had a true socialized health care system, like Britain's, this problem wouldn't exist. Japan needs to nationalize/socialize its hospitals now.

10 ( +13 / -3 )

@andy, no the NHS is not breaking down. It has coped admirably, to such a degree that the huge Nightingale hospitals built to cope with the initial outbreak were virtually unused and only now with the latest wave are they coming in to use to some degree. Is it under stress? Yes of course it is, the circumstances are unprecedented in at least a hundred years. Had we had a private healthcare system like the USA or the system in Japan, the death toll would have been horrendous, probably in the hundreds of thousands like the Spanish flue outbreak a hundred years ago.

As others have said, this pandemic has highlighted the structural failings of the Japanese system; whether it will now be remedied is the question going forward?

9 ( +10 / -1 )

There was more than enough time to build some corona-only hospitals , for example some connected containers as they built in Wuhan within three weeks or so, and also to use the olympic hotels and facilities , as they are not needed or still not needed, what means they were and are free to use at the moment in any scenario etc. That would have taken away most of the logistic and financial burdens of all other hospitals , also inside all hospitals themselves, and in addition many patients wouldn’t have had postponed urgent treatment of other diseases , especially cancers and cardiology ones. But you won’t get that easy common logic into their little heads, they are completely on a mental drug called ‘Games at all costs’ or stubbornly sticking to outdated pre-corona procedures.

2 ( +2 / -0 )

wolfpack:

Do you live in a society? Notice that word 'society'? Sounds pretty close to that word 'social'. That must frighten you. I hope you're not a 'social' person.

-1 ( +1 / -2 )

It isn’t in my opinion!

-1 ( +1 / -2 )

@sandybeachheaven

Who do you know with the virus?

Who do you know that works in a hospital?

Do you know the level of treatment that Covid patients are receiving now?

Can you compare that with treatment several months ago?

Do you know the illogical timely process to get a test?

Do you know the cost?

Do you know the amount of contact tracing in effect now?

If you know the answers to the above then you would surely change your opinion...

0 ( +1 / -1 )

Pukey2: Do you live in a society? Notice that word 'society'? Sounds pretty close to that word 'social'. That must frighten you. I hope you're not a 'social' person.

In a free society you can be “social” with whomever you want. In a Socialist society you are not free, you are forced by the government to do whatever 51% of the people want you to do. Notice the word “free”. That word frightens those who feel the need to control the lives of others.

-2 ( +0 / -2 )

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