Health care reform in Japan: The virtues of muddling through
Health care reform in Japan: The virtues of muddling through
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DOI：
10.1377/hlthaff.18.3.56
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发表时间：
1999-05-01
期刊：
影响因子：
9.7
通讯作者：
Campbell, JC
中科院分区：
文献类型：
--
作者：
Ikegami, N;Campbell, JC
日本的全民和平等的医疗保健制度有助于以极低的成本保持其人口的健康。多年来，其筹资和交付系统以保持平衡的渐进方式进行了调整。特别是，其强制性收费表已被证明是有效的，通过操纵价格来控制支出。如今，由于严重的财政问题，要求进行更激进改革的压力越来越大。然而，这些建议攻击错误的问题，是不切实际的。真实的问题包括不公平的健康保险筹资和对医院护理质量的重视不够。我们建议进行渐进式改革，以改善这些情况。
Japan's universal and egalitarian health care system helps to keep its population healthy at an exceptionally low cost. Its financing and delivery systems have been adapted over the years in a gradual way that preserves balance. In particular, its mandatory fee schedule has proved to be effective in controlling spending by manipulating prices. Today, with severe fiscal problems, pressures are mounting for more radical reforms. However, these proposals attack the wrong problems and are impractical. Real problems include inequitable health insurance financing and insufficient regard for quality of hospital care. We suggest incremental reforms that would improve these situations.