Japan is facing a public health catastrophe. Thousands killed and injured from the earthquake, aJand many drowned by the tsunami. Thousands more may be poisoned by radiation from damaged nuclear reactors.
And that is just the start. Severe traumatic injuries may take years to heal, and rare infections from tsunami-contaminated water may resist antibiotics. Life in shelters may spread disease, malnutrition, and mental despair. The longer term holds the prospect of spikes in thyroid cancer and other radiation-related conditions.
Some things are impossible to control, like movements of the earth. Others are in the power of man, like the response. So far, Japanese officials have reacted to the radiation risk with evacuations and distribution of sodium iodide for thyroid protection. It is not yet clear if that will be enough.
Whether Japan successfully copes in the days and weeks ahead remains to be seen. But the country has one strong factor in its favor - one of the best health care systems in the world.
A bit of background on Japanese health care may be helpful.
Every citizen is guaranteed coverage. Employers provide it for workers at large and medium size companies. The government arranges it for workers at small firms, the unemployed, the elderly, and the poor. While the government oversees the system and picks up much of the tab, it doesn’t actually provide insurance. That is done by private companies – about 5,000 of them (see this Kaiser Family Foundation site).
Japanese patients choose their own physicians and can see them whenever they want. The vast majority of physicians are in private practices. Most hospitals are private, as well, and most are well equipped with the latest technology.
The health outcomes for the Japanese are startling. Japan has the longest life expectancy in the world. Men, on average, live to age 79 and women to age 86. The country also boasts one of the lowest rates of infant mortality and of heart disease.
What do the Japanese pay for their system of universal coverage with excellent health outcomes? Less than half what we do in the United States. Japan spends about 8% of its gross domestic product on health care. We spend over 17%. (Full statistics are available from the World Health Organization here).
For all its strengths, Japanese health care will be severely tested by the recent disasters. It will take years to deal with the effects. But the country starts with one of the best foundations in the world. That will likely be a major asset as events unfold.
You never know when disaster will strike. When it does, you want to have the best health system you can. Let’s hope America’s politicians have the wisdom to make ours as strong as possible. That should start with providing sufficient funding for public health infrastructure and letting health reform’s promise of guaranteed health coverage see fruition. Good health care is not something that any country should take for granted.
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