The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care

Dr. Nakamichi Noriaki is one of the best-known orthopedic surgeons in Japan and runs a clinic in the Orthopedic Surgery Department of Keio Daigaku Hospital in Tokyo. To treat Reid’s shoulder, Dr. Nakamichi recommended acupuncture and steroid injections, though he also offered to perform the total shoulder arthroplasty that Reid’s American doctor had recommended. Japanese health insurance would cover all treatments. For his consultation, Reid paid only $19, though the doctor’s charge is $64 dollars; insurance covers 70% of the fee. If Reid had chosen to have the surgery, insurance also would have mostly covered the surgery and a five-day hospital stay. The cost would have been around $10,000—a quarter of the price in the US.

In Japan, doctors and hospitals are privately-operated and insurance plans pay their fees. The Japanese visit the doctor far more often than both Americans and Europeans and make house calls at least once per week. When Japanese patients enter hospitals, their average stay is 36 nights. In the US, patients, on average, remain hospitalized for six nights. New Japanese mothers also stay hospitalized with their infants over a week longer than new American mothers. Japan has the world’s highest rate of life expectancy. Other factors, in addition to outstanding health care, also impact longevity, including lower rates of violent crime, less drug use, and less obesity.