Anyone ever notice how it is when Japan’s health care system is discussed there are always increasing costs involved going from ¥2 trillion in 1970 to ¥37 trillion in 2009, to a current estimate of ¥40 trillion today, but never if rarely are total figures given on salaries for professionals including doctors and nurses working in the healthcare industry including their pensions? The amount paid in salaries and pensions for nurses and doctors in Japan is enormous and continues to climb yearly.
What also needs to be factored into these enormous expenses for healthcare in Japan, are the yearly bonuses paid twice a year on thousands of doctors and nurses working in the healthcare industry in Japan. It is well known too that there are loopholes doctors are aware of they take advantage of to avoid paying income taxes. Currently, the largest group of overseas tourists, buying motorcycles in Japan and who have money for entertainment are the thousands of nurses who work in the healthcare system in Japan. Turns out a large percentage of Japanese females visiting Hawaii taken from a close source in the tourist industry in Hawaii, are Japanese female single nurses who have the large amount of disposable income often living with their parents.
Total amounts for bonuses and salaries paid to doctors and nurses throughout Japan’s healthcare system is in the trillions of Yen. The figures are available but they would have to be sourced from many different reports and documents. The total tax revenue in Japan for 2013 was around ¥46 trillion ($457 billion). In 2013, Japan spent 10.3 percent of its GDP on healthcare and will expect to move to 13 percent by 2030 (worst case scenario 19 percent) mainly because of Japan’s aging population. Since Japan has socialized healthcare, the Japanese government controls the health care workforce with enrollment quotas for all medical schools throughout Japan. Because of this quota system into medical schools, the competition is rigorous and education expensive with fewer doctors per population than in other OECD (Organisation for Economic Co-operation and Development) countries. There are roughly 2.2 doctors for every 1,000 Japanese people in the population with 13.4 beds per 1,000 people. The average hospital stay is 18.2 days.
Whenever reforms are introduced into Japan’s healthcare system to reduce costs, never are the salaries and pensions of workers in the healthcare system placed under scrutiny. If anything, the salaries and pensions increase incrementally from year-to-year. Policy options to curb health spending growth are classified into three broad categories:
“Macro-level controls to cap spending or to regulate the price and quantity of services; micro-level reforms to improve the functioning of the health system to increase spending efficiency; and demand-side reforms to curb health care demand by increasing cost sharing by patients.”
Never are salaries and pensions discussed in official policy papers at least from reports that I have read regarding healthcare reform in Japan. And if they are it is minimal suggesting only nominal small percentage points in salary and wage increases. One aspect not looked at and only briefly mentioned, is disease prevention. But that has its downside since cancer is a major money-maker for hospitals in Japan. From a business stand point, cancer is good for business, so it won’t be anytime soon that aggressive prevention policies will be put in place to encourage Japanese people to educate themselves on cancer prevention as a part of any healthcare reform.