Especially in the Trump era, if the Japanese government wants to ensure a healthy economic relationship with the U.S., they have to be prepared to at least talk about U.S. priorities.

Ironically, Japan's policy doesn't "contain" costs, since it discourages the most cutting edge and effective products from arriving here. Short-term cuts do not amount to long-term savings in the healthcare industry.

Do they? Trump is showing pretty conclusively he doesn't have the slightest idea what "U.S. Priorities" are and that he'll flip-flop political positions in an instant if it will get him what he wants (i.e. attention).

Japan needs to be consistently focused on what is mutually good for both allies. Trump is a bag floating in the wind- there's no way of knowing where he'll drift next and no point in bothering to predict. The more you try to accommodate him, the more he'll flutter away toward something shinier.

It is time to recognize that the US is the past (as symbolized by the election of someone like Trump as president) and China is the future.  Japan has to negotiate (hard) with China to get in on the AIIB, Belt and Road, etc.  Maybe Japan can influence China to reduce its aggressiveness.  Meet in the middle.  It is time to say good-bye to the US.  It was nice while it lasted, and thanks for all the help after the war.

A prescription product I get sometimes costs me ~$12 in Japan (after hokken) and $273 in the US (after insurance).

They are exacty the same and it's a US pharmaceutical company product.

Tell me again why I should listen to the US pharmaceutical industry? Since spending time in the US lately, I've found that there is no healthcare - only moneycare. The only interest the healthcare industry has is in the financial health of healthcare companies.

I agree with domtoidi. The medical cost system in the U.S. is ridiculous and the pharmaceutical drug companies are ripping American citizens off all with a nod and wink from the US government. The notion that any country should give two cents to what America has to say about health care costs is pretty funny.

Sorry ... JAPAN FIRST.

The notion that any country should give two cents to what America has to say about health care costs is pretty funny.

I attended a seminar given by US healthcare analysts, academics and others in Tokyo a couple of years ago. They were emphatic that Japan NOT look to the US system as a model.

They did claim that the Japan system fails to fully recognize innovation in drugs and equipment through reimbursements and other means, to the extent that companies are not bringing the world's most cutting edge products to these shores because it's not worth their time. These products actually cut costs over the long run by being more efficient and effective that the old ones.