Universal Healthcare Can Save Money, But Innovation Is Key: My Experiences in Japan and the U.S.

I was born and grew up in Japan and have first-hand experience as both a doctor and a patient in my native country—a nation that offers universal health care coverage to its citizens. I have also been a patient, an academic researcher and a biotech entrepreneur here in the United States, my home for the past 10 years. These experiences have helped me to compare and contrast and to see the advantages and disadvantages of both countries’ healthcare systems. My work as an entrepreneur has also led me to examine these systems’ effects on innovation in the biotechnology and pharmaceutical sectors.

In thinking more closely about health care, I have come to several conclusions. First, access to quality health care coverage for all people is key. Second, any health care reform implemented here in the United States should not negatively impact the high quality of care that the U.S. is known to provide and that U.S. citizens enjoy. Third, it is also very important that any health care reform not come at the expense of cutting-edge research and medical advances that could spur the next generation of safe and effective treatments.

Japan has embraced universal health care coverage and it has been relatively cost-effective for that country. We know that Japan is spending only about the half of the amount on health care compared to the United States in terms of percentage of GDP; however, it is important to note that individual out-of-pocket costs are not that different.

Also, the patient experience is vastly different. In the United States, private health insurance providers dictate which hospital you can go to and what kind of treatment you can access. In Japan, regardless of what type of insurance you have, everyone is covered. Individuals can select to see almost any doctor they would like, and their co-pay is often 30 percent but there is a cap of approximately $700 per month. However, my experience is that Japanese patients have a trade-off – they only see their doctor for three minutes (usually after three hours of waiting). I have also seen first-hand that doctors are overworked and underpaid relative to other industries. For example, currently in Japan, there is a dramatic decrease in the number of doctors who are willing to become pediatricians or OB-GYNs due to the challenging work environment. While the clear benefit is that everyone is insured in Japan, there is the downside: the average quality of medicine does not rival

Author: Ryo Kubota

Ryo Kubota is chairman, president and CEO of Seattle-based Acucela. He is an ophthalmologist by training who has performed more than 1,000 eye surgeries. Before founding Acucela in 2002, Dr. Kubota spent his early career performing ocular research at Keio University, where he earned his M.D. and Ph.D. In the course of his work there, he discovered the glaucoma gene, myocilin, a discovery that earned him the Suda Award for his contribution to the field of neurodegenerative retinal disease. Dr. Kubota continued his research at the University of Washington and later licensed his findings from the university as the core technology on which he founded Acucela to develop novel and safe therapies for patients with blinding eye diseases. Dr. Kubota is a member of the American Academy of Ophthalmology, the Association for Research in Vision and Ophthalmology, the Japanese Ophthalmological Society and the Japan Glaucoma Association. He serves on the Foresight Group of the Department of Pharmacology at Case Western Reserve University and on the board of the Japan-America Society.