Naoki Ikegami – författare

The Japanese health care system provides universal coverage to a healthy but aging population. Its costs are among the lowest in the world and have remained nearly constant as a share of the economy for more than a decade. Americans concerned about runaway medical spending need to know about the successes that Japan has experienced and the problems the country has encountered in its effort to control costs while maintaining quality of care.

Offered here is an analysis of the key issues of cost-containment by specialists followed by reactions from some of America''s best-known experts on health care delivery and finance. Topics include the macro-and microeconomics of health care, technology and costs, institutions and costs, attitudinal and behavioral aspects, and the politics of health care.

This collection provides an authoritative study of successful cost-containment in the Japanese health care system---a chronicle of success that is neither a statistical illusion nor a result of sociocultural factors. Detailed here is information on the key mechanism of cost constraint: a fee schedule that covers virtually all medical services and rewards inexpensive services while making expensive services unprofitable. This system has resulted in the provision of quality health care to the entire population at roughly half the cost of American health care. Is it a single-payer system? Would the United States have to introduce a dramatically altered health care structure to benefit from the Japanese experience? No. Japan relies mainly on fee-for-service medicine financed by multiple insurers---a system familiar to Americans and one from which many lessons may be learned.

Based on conferences held in Washington, D.C., and Izu, Japan, this volume collects original chapters on the overall cost structure, how the negotiated mandatory fee schedule works, specific mechanisms for cost control, the politics of health care financing, and the impact of cost cutting on quality, among other topics. These pathbreaking studies will be a significant resource for policymakers and scholars interested in comparative health care systems as well as those interested in health care reform in the United States.

Compared to the rest of the world, Japan has a healthy population but pays relatively little for medical care. This book analyses how the health care works, and how it came into being. Taking a comparative perspective, the authors describe the politics of health care, the variety of providers, the universal health insurance system, and how the fee-schedule constrains costs at both the macro and micro levels. Special attention is paid to issues of quality and to the difficult problems of assuring adequate high-tech medicine and long-term care. Although the authors discuss the drawbacks to Japan's stringent cost-containment policy, they also keep in mind the possible implications for reform in the United States. Egalitarian values and a concern for 'balance' among constituents, the authors argue, are essential for cost containment as well as for access to health care.

Compared to the rest of the world, Japan has a healthy population but pays relatively little for medical care. This book analyses how the health care works, and how it came into being. Taking a comparative perspective, the authors describe the politics of health care, the variety of providers, the universal health insurance system, and how the fee-schedule constrains costs at both the macro and micro levels. Special attention is paid to issues of quality and to the difficult problems of assuring adequate high-tech medicine and long-term care. Although the authors discuss the drawbacks to Japan's stringent cost-containment policy, they also keep in mind the possible implications for reform in the United States. Egalitarian values and a concern for 'balance' among constituents, the authors argue, are essential for cost containment as well as for access to health care.

The goals of universal health coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. Countries as diverse as Brazil, France, Japan, Thailand, and Turkey have shown how UHC can serve as vital mechanisms for improving the health and welfare of their citizens, and lay the foundation for economic growth and competitiveness grounded in the principles of equity and sustainability. Ensuring universal access to affordable, quality health services will be an important contribution to ending extreme poverty by 2030 and boosting shared prosperity in low-income and middle-income countries (LMICs), where most of the world's poor live. The book synthesizes the experiences from 11 countries – Bangladesh, Brazil, France, Ethiopia, Ghana, Indonesia, Japan, Peru, Thailand, Turkey and Vietnam – in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways.The study examined the UHC policies for each country around three common themes: (i) the political economy and policy process for adopting, achieving, and sustaining UHC; (ii) health financing policies to enhance health coverage; and (iii) human resources for health policies for achieving UHC. The findings from these country studies are intended to provide lessons that can be used by countries aspiring to adopt, achieve, and sustain UHC. Although the path to UHC is specific to each country, countries can benefit from the experiences of others in learning about different approaches and avoiding potential risks.

The goals of universal health coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. Countries as diverse as Brazil, France, Japan, Thailand, and Turkey have shown how UHC can serve as vital mechanisms for improving the health and welfare of their citizens, and lay the foundation for economic growth and competitiveness grounded in the principles of equity and sustainability. Ensuring universal access to affordable, quality health services will be an important contribution to ending extreme poverty by 2030 and boosting shared prosperity in low-income and middle-income countries (LMICs), where most of the world's poor live.The book synthesizes the experiences from 11 countries – Bangladesh, Brazil, France, Ethiopia, Ghana, Indonesia, Japan, Peru, Thailand, Turkey and Vietnam – in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways. The study examined the UHC policies for each country around three common themes: (i) the political economy and policy process for adopting, achieving, and sustaining UHC; (ii) health financing policies to enhance health coverage; and (iii) human resources for health policies for achieving UHC. The findings from these country studies are intended to provide lessons that can be used by countries aspiring to adopt, achieve, and sustain UHC. Although the path to UHC is specific to each country, countries can benefit from the experiences of others in learning about different approaches and avoiding potential risks.

La couverture sanitaire universelle pour un développement durable inclusif synthétise les expériences de 11 pays ? Bangladesh, Brésil, Éthiopie, France, Ghana, Indonésie, Japon, Pérou, Thaïlande, Turquie et Vietnam - dans la mise en ?uvre de politiques et de stratégies d'atteinte et de maintien de la CSU.

Los fines de la cobertura universal de salud son asegurar que toda la poblacion pueda acceder a servicios de salud de calidad. Parses que han logrado la cobertura universal de salud estan demostrando c6mo estos programas pueden servir como mecanismos esenciales de mejora de la salud.

The aging of society is a growing concern in all advanced nations, and at the forefront of concern is long-term care for frail older people. Enactment of a new public long-term care insurance program by the Japanese government in 1997 provided an excellent opportunity for a conference focusing on an ideal long-term care system for frail older people. The conference was organized around four major themes: Social aspects, including family dynamics and the role of formal providers; Clinical aspects, including effective treatments for physical and mental disabilities; Macroeconomic and macropolitical settings for public policy; Program design and management issues. With contributions from the fields of medicine, nursing, social work, gerontology, political science, economics, and sociology, this volume provides an overview of key problems and possible solutions in programs for frail older people from a unique international perspective.

The aging of society is a growing concern in all advanced nations, and at the forefront of concern is long-term care for frail older people. Enactment of a new public long-term care insurance program by the Japanese government in 1997 provided an excellent opportunity for a conference focusing on an ideal long-term care system for frail older people. The conference was organized around four major themes: Social aspects, including family dynamics and the role of formal providers; Clinical aspects, including effective treatments for physical and mental disabilities; Macroeconomic and macropolitical settings for public policy; Program design and management issues. With contributions from the fields of medicine, nursing, social work, gerontology, political science, economics, and sociology, this volume provides an overview of key problems and possible solutions in programs for frail older people from a unique international perspective.