Friday, November 16, 2012

Trilemma of medical care

Yesterday I caught a heavy cold and broke down. Now I still have a headache.

Medical care is a big issue in every country. Administration of a hospital is similar to other business but actually far from normal business. Purpose of medical care is to normalizing human, whereas purpose of business is to enrich human life. Therefore, medical care tends to deal with poor people. So if medical care system declines to business too much, it would changes to so call “poverty business.”

It is said that the system of medical care have trilemma. The three elements are cost, access, and quality.

In US, the level of medical skill is so high that many famous persons move to US to be treated. But it costs quite high. Recently Obama administration decided to apply health insurance for all citizens. I feel this policy quite natural but it is criticized by several states.
In UK, all citizens become a member of national health insurance. So they can be treated for free. But they have to wait quite long time before consulting specialized doctors.

On the other hand, Japan has also national health insurance. So Japanese can be treated for not so high cost. And Japanese can consult any doctor as they want to do. Cost and access is guaranteed in Japan.
Quality of medical care is not so low in Japan. Infant mortality and life expectancy are first classes of the world. WHO also set a high validation on medical care in Japan. The Lancet, one of leading medical journals, made a special issue for medical care in Japan
(Wikipedia about infant mortality rate and life expectancy)
(THE LANCET Japan: Universal Health Care at 50 years)

However Japanese people are not satisfied to medical care. Some researches show that satisfaction level to medical care in Japan is the worst of the world. I do not know the reason. Perhaps level of demand for service of Japanese is too high. I often feel this matter in other fields.

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