Comment by graemep
11 hours ago
> The US spends ~$14,570 per person on healthcare. Japan spends ~$5,790 and has the highest life expectancy in the OECD. That gap is roughly $3 trillion per year.
The difference in life expectancy will be influenced by multiple factors and may have more to do with diet and lifestyle than with healthcare.
Japan also spends less per capita than the UK, France or Germany. The US spends a lot more than any of those so the US system is bad value for money.
But also age-related care is by far the largest share of medical care costs, and Japan has no lack of very old people. Being unhealthy also often reduces the amount of procedures someone is eligible to receive. Despite the blame people throw on unhealthy people for medical costs, they ironically often cost less because of the reduced care and lower lifespan which cuts out a significant amount of age-related healthcare costs. One could argue dieing at 60 instead of 90 is a big loss socially and personally, but overall financially it is a benefit.
The US also has GDP per capita of $90k and Japan has a GDP per capita of ~ $35k.
Put another way, in both countries a hip replacement surgery is almost exactly 1/8 of someone's per capita GDP.
The median salary in the US is around $61k a year and in Japan is around $42k a year. Salary-wise the difference is not as big as GDP per capita
The difference that using percentage of GDP instead that Japan moves close to the European countries. The US remains a very expensive outlier.
https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locat...
Too bad Walmart greeter isn't making "per capita GDP".
Some quick googling suggested cashiers at Seiyu in Japan earn $7-9/hour USD while Walmart is about double that.
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They make more than they would in Japan. But people can make $0 in any country. Regardless, part-time Walmart greeters are fortunately not paying full price for health insurance in the US.
“someone” in this case is in the 73rd percentile in the USA and ~40th in JP.
So the USA is still significantly more expensive as a portion of actual income. “GDP per capita” is a relatively useless figure
This feels like a misleading ratio, it's just saying the cost is the same in per capita terms but says nothing about the absolute cost or more importantly cost as a percentage of income, which matters for the majority of people in the denominator of the GDP per capita calculation.
Japanese Americans have a slightly higher life expectancy in the US (87 years) vs Japanese living in Japan (85 years).
I suspect you would see the exact same trend comparing Japan and the U.S. in transit, education, and many other services. The U.S. spends more per capita to get less.
The US is a wealthier country and wages are higher here than Japan.
The median equivalised household disposable income of a US household is over twice that of a household in Japan.
This is one of many reasons why it’s so misleading to compare prices across countries in a vacuum. All of the people doing the work for those education, transportation, and other services and all of their inputs aren’t going to work for Japan-equivalent pay when they’re living in the United States.
In domains like healthcare, education and transportation, the cost is primarily labour. A wealthier country pays its workers more, which gets passed down in higher prices to its consumers. And, while healthcare and education do not benefit from economies of scale, transportation does, so the denser population gets cheaper transportation per capita.
Not in iPhones!
It "may be other than health care" but most (all?) other modern nations on multiple continents in multiple cultures spend less percent GDP on healthcare with longer life expectancy than the US
Japan also has the "Metabo Law" (aka fat tax). Do you think Americans would go for that?
"Obesity costs the US healthcare system almost $173 billion a year."
So that's about 6% of the difference? I'm not immediately saying no, but it sounds like that's not the real problem.
That 6% number isn't even close to accurate. There are many other very expensive chronic conditions that are downstream of obesity including type-2 diabetes, heart failure, hypertension, MSK injuries, etc. We are digging our graves with our teeth.
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Social reasons it would never work. I hate to mention anything race related online but simple truth is America has complicated history and African Americans are 30% more likely to be obese than White Americans and also earn approximately 60% of income that whites earn. A fat tax, especially one that properly allocated the cost burden to the individual, would erode race relations.
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Fat shaming! ... It makes me sad whenever I hear that response to any mention of the health problems associated to obesity.
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Try seeing a doctor in Japan as a foreigner. Just a simple consult costs $300 USD or so, and it goes up from there. It's actually a rather expensive system.
This is absolutely not true. I pay the equivalent of about $40 for X-rays and blood tests. A simple consultation is about $15, if that. I recently got diagnosed with asthma, and the whole set of tests plus a month of medicine came out to about 6000 yen, which I suppose is $40.
The only reason you would pay that much is if you're visiting a private no-insurance clinic and not using insurance. And private clinics pretty much only exist to prey on people who identify as expats and make zero attempt at learning non-English languages, aside from a few exceptions (certain speciality dentists, plastic surgery, anonymous STD treatment, some cancers).
That doesn't seem more expensive to what I generally pay in the US.
> Japan also spends less per capita than the UK, France or Germany
These have to be purchasing power adjusted.
The Japanese system is amazing. Cheap drugs, cheap dentistry, no wait times and reimbursements for all kinds of things (government covered more than 100% of childbirth cost - yes we got more back than we paid). But the best part IMO is the emphasis on preventative medicine. My wife and I get annual checkups which cover a whole range of things including screening for various kinds of cancer.
We in Germany copied a lot of the stupid stuff from America (including the stupid billing system for inpatient stays), so it's not that surprising that our system is also bad value for money.
PS: Outcomes here are not worse than those of rich people in the US, because I know some idiots will claim this to cope
https://jamanetwork.com/journals/jamainternalmedicine/fullar...
Germany didn't copy the US - they just happen to share similar roots.
Both historically had private hospital systems, and just so happen to implement pension/employer-based insurance programs very early on. German's just evolved in one direction and the US evolved in the other.
We copied the DRG reimbursement System from the US.
And no, we didn't had a historically significant share of private hospital systems, those came with the introduction of the DRG System, which forced many city/church owned hospitals into privatisation.
Before that, they had a "Fixed Price per Night" System, which also was a bit stupid, before that they got reimbursed their cost.
Actually Germany is a lot better value for money than the US. The cost (either absolute or as a percentage of GDP) is similar to the UK or France, and from what I have been told by people who have lived in both countries, the German system is better than the British.