Are medical costs in Japan really too high for the nation to tolerate?

Abstract

The government of Japan says that total medical service expenses via tile social insurance system should be substantially decreased to avoid bankrupting Japanese national finances. How was tiffs thesis reached a priori? The ratio of total medical costs over GDP is known in the public domain to be at the lowest among developed countries, i.e., 7.8%. That of the United States is 14.6%, Gemlany and France 10-11%, and the United Kingdom about 7.7%. The problem that the US currently faces is not the ratio itself, but rather how to ensure even coverage for the entire nation. The debt crisis that the Japanese government faces cannot be a~-ibuted merely to expanding medical costs. When UK Prime Minister Tony Blair promises to increase the social insurance budget to provide better medical services in the UK, Japanese Prime Minister Junichiro Koizumi and his financial administration appear to be on the ~wong track. Dear colleagues, as the front-line shock troops in thoracic and cardiovascular surgery, we know that further decreasing medical costs in Japan is only possible by sacrificing ourselves further to a point where work efficiency is compromised. While devoting ourselves to the highest level of service to patients, we have mostly been paid not as surgeons but as teachers at university hospitals, which are the basis for high-grade surgical service. Not only surgeons but nurses and co-medical staflg face a similar situation, because hospitals are paid essentially only through the social insurance system-in short, cheap labor to support high-level thoracic surgery. We appear, however, to be reaching the point of no return, as many thoracic surgeons fear. Again, just how did tiffs situation arise? Putting it another way, how can the prime minister propose tiffs