1.3 The Fundamental Challenge: A Shortage of Experts1.4 Infrastructure Challenges: Enormous Costs and Regional Disparities2.1 The United States: "Is It Really Effective?" An Evidence-Based, Meritocratic System2.2 Germany: A Government-Led, Integrated System of "Treatment, Research, and EducationChapter 2: International Comparison - The Approaches of the U.S. and Germanysystematically training these professionals. This personnel shortage is a fundamental obstacle to the stable and continued provision of this therapy in the future. Also, while Japan has more facilities than any other country in the world, their distribution is not necessarily even. They tend to be concentrated in urban areas, creating geographical access disparities where patients may have to travel long distances for treatment depending on where they live. Insurance companies strictly demand that for expensive treatments like particle beam therapy, there must be evidence of superiority over conventional therapies. This pressure has become a major catalyst for advancing large-scale comparative research on treatment efficacy in the U.S. The American style is to prioritize evidence and rigorously evaluate the value of technology.to fuel further research, making it easier to develop new technologies and therapies. Furthermore, these centers do not operate in isolation; they serve as core hubs within research and training networks funded by the European Union (such as ENLIGHT), functioning as European centers that transcend national borders. The German style is for the state to take the lead in advancing treatment, research, and education in an integrated manner. Another serious problem is the lack of specialists. Particle beam therapy requires a team of many experts, including not only physicians but also "medical physicists" who create treatment plans and engineers who manage the massive equipment. However, Japan still lacks a sufficient system for A major factor hindering the spread of particle beam therapy is its enormous facility cost. The world's first medical heavy-ion facility cost over 30 billion JPY to build, and even with today's advanced technology, constructing a single facility requires an investment on the scale of tens of billions of yen. Furthermore, the annual operating costs run into the hundreds of millions of yen, making facility management far from easy. The U.S. healthcare system is complex, characterized by a multitude of private insurance companies. Within this system, the decisions of "Medicare," the public insurance for the elderly, have a significant influence and effectively set the industry standard. What is emphasized here is scientific evidence (data) that demonstrates, "Is this treatment truly more effective than existing methods?" Germany, on the other hand, takes an approach with more active government involvement. Particle beam therapy is positioned as a key national science and technology, and the government invests in facility construction. A major feature of Germany is that treatment facilities are operated as an integrated part of university hospitals and cutting-edge research centers. This creates an "innovation ecosystem," a virtuous cycle where research findings are quickly applied to clinical practice and clinical data is used 11
元のページ ../index.html#12