8 Health Care Costs in the U.S. Health Care Costs in Japan Diff erence in medical consultation proceduresThe basic flow of a visit to a medical institution in Japan is It is the same regardless of the type of room and is the same amount throughout Japan, based on the medical fee scoring table. If you stay in a “four-person room or less,” which is used in many hospitals, the hospitalization fee is included in the basic hospitalization fee without any additional charge.(2) Bed diff erential (special care environment room charge)This is an additional charge for a room with a special environment,such as a private room or a two-person room. This is not coveredby insurance and is charged only when the patient requests oragrees to it.For example, the 30% copayment is applied, so in the case ofan acute care hospital (17,000 yen per day), the copaymentwould be approximately 5,100 yen. In the case of a communitycomprehensive care ward (14,400 yen per day), the cost would beapproximately 4,320 yen.”Healthcare spending as a percentage of GDP” is a measure of how much a country spends on healthcare as a percentage of its gross domestic product (GDP). It is an indicator of how much resources a country invests in areas related to health and medicine relative to the size of its economy (GDP).This indicator has an impact on the economy. Excessive healthcare spending puts pressure on public finances, while insufficient spending can harm the health of the population. It also serves as a basis for policy decisions: healthcare reform, budget allocation, insurance system design, etc. It is also useful for international comparisons. Moreover, it can serve as a basis for judging whether healthcare spending is appropriate compared to other countries, which is helpful for international comparisons.In 2019, Japan's healthcare expenditure to GDP is estimated at 11.0% of GDP (Estimated value), ranking 5th among 38 OECD member countries. In contrast, the U.S. ranks first with 16.8%. Therefore, the U.S. invests a lot of resources in healthcare.as follows. First, the patient presents a health insurance card at the reception desk and fills out a medical questionnaire. Thereafter, the patient is examined by a doctor, and tests are performed if necessary. A treatment plan will be determined based on the examination results, and a prescription will be issued for medication. Finally, the patient pays the bill and leaves In contrast, Japan's per capita national health care expenditure in 2020 (national health care expenditure divided by the country's population) was 358,800 yen. There are regional disparities in health care costs in Japan as well. The highest in Japan is Kochi Prefecture at 471,100 yen. On the other hand, the lowest is Saitama Prefecture at 318,100 yen, a difference of 1.48 times between Kochi, the highest, and Saitama, the lowest. Although the amounts differ in magnitude, there is a disparity in medical expenses by region in Japan, as in the U.S. Figure 2 below shows the difference in per capita national healthcare expenditure by prefecture.Figure 2. Nat ional Medical Expenditures by Prefecture and Per Capita Nat ional Medical ExpendituresMedical costs in the U.S. are extremely high compared to Japan. For example, in the Manhattan boroughs, an initial general examination costs $150 to $300, a visit to a specialist costs $200 to $500, and a day of hospitalization costs about $2,000 to $3,000 for room and board alone. A day's inpatient room charge alone is equivalent to one month's salary (including tax) or more for a middle wage earner in the New York area. Medical bills are often sent separately by doctors, laboratories, hospitals, etc., and it is not uncommon for them to arrive at a time when you have forgotten about them.In Japan, all people are covered by public medical insurance under the universal health insurance system. In principle, 30% of the medical expenses are paid over the counter (with some reductions for the elderly and children). There is also a high-cost medical care reimbursement system, under which medical expenses exceeding a certain amount are subsidized by the government. In Japan, for example, the fee for an initial medical examination is set uniformly throughout the country based on the medical fee system (with insurance coverage). It is approximately 860 yen for both general clinics and hospitals (outpatient care).In addition, there are two types of book room charges for hospitalization.(1) The basic hospitalization fee (covered by insurance) is coveredby health insurance.
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