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Japanese Healthcare.
When you start looking at birthing options, you'll notice
that most of the hospitals work with mid-wives. In the
USA, mid-wives are virtually synonymous with "natural
delivery." But that's not necessarily so in Japan.
In most hospitals, mid-wives work with mothers prior to
the delivery (mainly making them comfortable), but doctors
delivered all the babies. Many mid-wives have confirmed
that doctors monopolize control of the birth process in
most situations. The lack of empowerment can really weaken
the role (and, in some cases, the abilities) of mid-wives. |
The nurses in Japan also work under the
doctor's firm authority. Once you check into the hospital,
and ask the nurses questions about the birth process,
some of the answers could be alarming, because they could
completely contradict what you hear from the doctor. Despite
their confident show of authority, it does prove how little
the nurses are actually empowered.
Through its universal health insurance program, Japanese
bureaucrats are charged with the responsibility and power
to ensure a "minimum standard of care for all."
Rules of the game, and in particular what is covered and
how doctors get paid, are mainly set by the central government
in Tokyo. Sound familiar? It should, as this is the direction
we would be headed in within the U.S. if recent state
level universal coverage proposals and federal prescription
drug purchases for Medicare beneficiaries are enabled.
The Journal article lists many of the downsides to the
system, particularly in light of cancer coverage: * "Japan
saves by requiring less training of doctors and paying
them less" * Japanese "doctors say they have
little time for patients" * Until recently, many
Japanese cancer patients weren't even told that they had
the disease--family members "often felt it was cruel
to burden the patient with information" about the
cancer diagnosis. The Journal article further indicates
that new classes of chemotherapy drugs and the spread
of the Internet have "spawned a new class of activist
cancer patients." This patient activist movement
has grown largely in response to the central government's
reluctance to embrace and approve a new class of promising
cancer drugs. The article mentions that "a movement
for more drugs and better care culminated in May 2005
when 2,000 patients and family members packed a hall in
Osaka for the first national convention of cancer patients."
Now is the time to consider how this type of system would
play out in the United States. People need to ask themselves
how they would feel about the state or federal government
telling them that a promising new cancer drug is, by law,
simply not available to them or their loved one who is
dying of cancer.
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