Healthcare system in the United States vs. Japan

Debate on healthcare access is increasingly spreading across the United States. In fact, in the contemporary socio-economic policy reforms, quality and affordable healthcare has dominated global media headlines. While other developed economies have done significant changes to improve funding and access to healthcare services, Japan system is one of the best, hence preferred for comparison with the US. Japan has a healthcare policy model that is unique, relatively cheaper and reliable as compared to the United States (Wise & Yashiro, 2006). While Japan has a universal and mandatory on-job healthcare insurance system, the US uses the hybrid system that is rather complex and relatively more expensive. The overall cost of healthcare accessibility in Japan is among the cheapest among industrialized countries and by almost half of the United States.

The two countries have healthcare policy that   covers medications for the economically inactive proportion of the populations. In Japan, the unemployed, retired and children access healthcare services through cost sharing. The government covers part of the expenses through an insurance premium co-payment program. In the US, the elderly, unemployed and children are covered by the federal and local government. These vulnerable groups are therefore assured of healthcare access through government sponsored insurance.

In both countries, the patients are free to choose their own physician. The physicians undertake diagnosis, treatment, prescription, and counseling. The physician plays key role in referral of patients in the United States. The physicians have knowledge of the law and regulations that govern referrals. The physician must make the referral in writing, sign it, and include date. In both the US and Japan the primary care doctor writes an order to the patient to see a specialist for a particular medical service. The procedure requires that the patient visit the insurance firm to confirm that the coverage premium is updated and verify if the patient is visiting the correct healthcare provider for the correct medical problem. In Both countries, Failure to seek referral and following proper procedures that include confirmation with the insurance firm may make the patient lose the application of medical coverage. In such cases, the patient will incur the cost of visiting a physician to whom he/she has been referred. Besides, the  physician ensures that the referral cover only a single treatment course for each patient. In Japan, the physician write and signs referral letter to the patient that indicate cost and diseases. In that regard, in both countries physicians ensure the referral are done within the law and cost covered by the insurance.


Comparative medical coverage statistics shows Japan as leading ahead of the United States (Countries, 2013). Considering the mandatory healthcare insurance coverage in Japan, access to quality healthcare at affordable cost is wider and more reliable than that in the US. In Japan, employers pay premiums that match each employee’s contribution. All persons are covered in both countries. However, the insurance covers all medical services in the US.

In Japan, prescriptive drugs are taken for free among children while in the US, prescriptive medicine is paid for by the patients. In other words, there are additional costs in getting prescriptive drugs while in Japan there is no additional cost as insurance covers everything.

The US has the Affordable Care Act (ACA) that has played a critical role in addressing the healthcare access by people with pre-existing conditions. ACA made healthcare insurance companies cover people with pre-existing conditions. In the case of Japan, the healthcare insurers must also cover people with pre-existing conditions. It is therefore note that the healthcare systems of both Japan and the US have a legislation that compels insurance firms to offer coverage for pre-existing conditions.

In the United States, where health insurance is far more expensive, employers pay private insurers three or four times the amount contributed by each employee. However, the self-employed population in Japan pays a much expensive yearly health insurance. Besides, patients that have attained working age must enter a co-payment insurance of 30 percent to cater for drugs and treatment (Blank, 1994). This program is the most expensive globally as compared to the US hybrid and flexible system. Despite the aforementioned differences, the choice of physician is on the hands of patients. All referral are made through insurance firms. Generally, the healthcare financing mechanism in Japan makes it cheaper than in the United States.


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