The Japanese health care system presents a tantalizing puzzle.On the positive side, universal health insurance has been achievedat relatively low cost and the health indexes of infant mortalityand life expectancy at birth are among the best in the world.However, the system has been criticized for lack of good management,quality control, and attention to consumers.1 In this articlewe will discuss the link between the positive and negative aspectsof the Japanese system by describing the use of a universalfee schedule to define much of the health care system. We willthen describe current efforts . . . [Full Text of this Article]
Principal Features of the Japanese System
Costs
Structure
National Fee Schedule
Private Practice versus Hospital Care
Dispensation of Drugs
Role of the Fee Schedule
Recent Attempts at Reform
Source Information
From the School of Policy Management and the Department of Hospital and Medical Administration, School of Medicine, Keio University, Tokyo, Japan (N.I.); and the Department of Political Science, University of Michigan, Ann Arbor (J.C.C.).
Address reprint requests to Dr. Ikegami at the Department of Hospital and medical Administration, School of Medicine, Keio University, 35 Shinanomachi Shinjuku, Tokyo 160, Japan.
References
Related Letters:
Survival after Age 80
Preston S. H., Elo I. T., Hughes-Davies T.H., Sallar A. M., Hogg R. S., Schechter M. T., Manton K. G., Vaupel J. C.
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N Engl J Med 1996;
334:537-538, Feb 22, 1996.
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