The Japanese Healthcare System
While the pressure on Prime Minister Abe to declare a state of emergency is mounting, there continue to be baffling statements like the one from the Japan Medical Assocation, as reported in Kyodo News:
JMA President Yoshitake Yokokura said in the same press conference that the number of beds available for infected patients is nearing its capacity.
“So that the health care system doesn’t collapse, I ask people to refrain from going out and to enforce basic health practices, such as washing hands and gargling,” he said.
The association also indicated that guidelines for discharging patients, such as those with mild symptoms who can recuperate at home, also need to be reconsidered in the future.
It does not need a rocket scientist, never mind a doctor, to come to the conclusion that one should discharge the mild cases if there is a risk that capacity is reached.
However, it is also worth taking a further look at data that is available from the OECD that characterizes the Japanese healtcare system pretty well.
Japan has the highest number of hospital beds per 1,000 inhabitants
That is good.
Japan has the longest hospital stays
It is not even close. All these beds need to be filled. And it teaches you a pattern of longer-than-necessary stays and hospitalization-when-not-needed that is hard to overcome even in the current crisis, leading to such statements as quoted from the JMA above.
Japan has the second-most doctor consultations
The population is pre-disposed towards seeing a doctor for any little ailment. To some extent, they have no choice as quite a few of medications that are available over-the-counter in other countries, require a prescription in Japan. Have a cold in the US? Buy some DayQuil/NyQuil. Have a cold in Japan? See a doctor.
Japan has surprisingly few doctors per 1,000 inhabitants
Can you find Japan? It’s eighth from the bottom. Also, Korea, which exhibits even more doctor consultations, has slightly less doctors per 1,000 inhabitants. Similar health care systems, similar culture? Dunno.
In any case, if you try to square the number of doctors with the number of doctor consultations, then either there is little time for each consultation (some argue that is true in the case of Japan), and/or many of the procedures are actually performed by nurses (next chart).
In any case, going to speculate a little bit here, if you have a relatively low number of doctors, and a population that is pre-disposed towards seeing a doctor for every little symptom, what would you do in the face of a pandemic? Likely, you would try to focus your resources on serious cases, and tell everyone that they should seek out a doctor only once there is some likelihood that they have contracted the virus, like four days of symptoms. Kind of makes sense if you look at it that way.
Compared to doctors, Japan has a relatively high number of nurses
Bonus chart.
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