Health Care in Japan and the United States

With a population of over 130 million people, Japan is a country that boasts of above average score in its ability to provide quality health care services to its citizens. This is translated in its lowest infant mortality rate in the world and longest life expectancy levels. A comparative analysis on the health care systems between the United States and Japan reveal both similarities and differences in policies aimed at achieving higher qualities in the provision of health care. In similarities, both countries are faced with the demographic dilemma brought about by the aging population, continuous increase in the proportions of GNP allocation to medical, Japan and United States face competing demands on various choices in regard to treatment and prevention, the characteristic of a diverse mix of patients with a continuous increase in disabilities over the years and the fact that both systems receive most of their finances from employer based private insurance.

While recognizing that both Japan and the United States face similar challenges in their efforts to provide quality healthcare services to their populations, a number of differences exist (Jacobzone,1999). First, Japan’s heath care policy is characterized by a universal coverage described by many as a free for choice care providers; a system that the United States government is still struggling to achieve under the current President. In addition to this, all Japanese citizens are covered without due consideration of the kind of medical complications while the United Stats system omit a number of medical complications. According to Fahs (1990) “convenient access to healthcare, with its inherent emphasis on preventative medicine, should be the hallmark of any system.

The United States lags far behind; the well-publicized issue of millions uninsured or underinsured is only part of the story, in fact, many more with health insurance avoid doctors, disgusted by the time-consuming and often useless process”. The fact is that the Japanese system offers the best and easiest access to medical care and health information against the United States model.

The source of health care financing also remain different between the tow countries. Fahs (1990) illustrates this difference in stating that “Health insurance expenditures in Japan are financed by payroll taxes paid by employers and employees and by income-based premiums paid by the self-employed in contrast to the United States, where the federal, state and local governments finance roughly 42.9 percent of all health care expenditures and out-of-pocket payments contribute another 22 percent”.

Both countries have undertaken changes within the last 30 years in their structures of the national health insurance systems, the extent and regulation of health insurance benefits, government subsidies and cross-subsidization between plans, and provider reimbursements which all differ within both health care systems. A tabulated form that takes a comparative analysis of the health care systems between the two countries as demonstrated by Fahs ( 1990).

Comparisons of the United States and Japanese Health Systems (1990)
U.S Japan
Health Status
Life Expectancy at Birth
Males 72.00 75.90
Females 78.80 81.90
Infant Mortality Rate 9.10 4.60
Life Expectancy at 80
Males 7.10 6.90
Females 9.00 8.70
Per Capita Health Spending $2,867 $1,267
Total Health Expenditures as % of GDP 13.40 6.60
Active physicians per 1,000 2.3 1.6
Inpatient hospital beds per 1,000 4.70 15.8
Hospital staffing ratios 3.35 .79
Intensive care unit beds per million 244.50 79.20
Coronary care unit beds per million 46.30 17.80
Neonatal intensive care unit beds per million 44.70 22.40
Medical Care Use
Physician visits per capita 5.30 12.90
Hospital admissions as % of population 13.70 8.30
Average length of hospital stay 9.10 50.50
Inpatient days per capita 1.20 4.10
Number of surgical operations per 1000 91.0 22


Fahs, M.C. (1990). Japan’s Universal and Affordable Health Care. Web.

Jacobzone, S. (1999). The Interplay of Health Policy, Incentives and Regulations in the Treatment of Ageing-Related Diseases. Web.

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