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Why is Japan's medical care system breaking down?

Medical breakdown is in the air. Its in the media. Scarcely a day goes by without multiple references to it. Now in its second year, the coronavirus pandemic rages with renewed fury a third wave, with daily infections approaching 8,000 and daily deaths near 100.
Hospitals cant cope. Seriously ill patients are being turned away. This is medical breakdown, likely to get worse before it gets better.
Shukan Gendai (Jan 23) poses a question that makes us pause. Japan, it says, has more hospital beds per capita than any other country in the world. And the virus, deadly though it is, has wreaked remarkably less havoc here than elsewhere.
Why is Japans medical system buckling?
Other countries are under far more strain. Japan nationwide has 1.529 million hospital beds 13.1 per 1000 people, versus 2.8 per 1000 in the UK and 2.6 per 1000 in the U.S.Japans 8000 new infections per day ( 6.2 people per 10,000 population) compare with the UKs 60,000new cases a day (89.9 per 100) and the U.S.s 280,000 (84.8 per 1000).
Japan, comparatively speaking, should be sailing through this viral scourge, its medical response a lesson to the world in times of crisis. The beds are there, the skills are there, the system is in place, one of the worlds best whats gone wrong?
The problem as Shukan Gendai sees it is not medical but economic. Some 80 percent of Japans 8,300-odd hospitals are private, meaning they must be run as business enterprises. Put starkly, if perhaps too simply, treating coronavirus doesnt pay.
The magazine surveys at random 30 Tokyo-area hospitals, asking each how many of its beds are empty. The hospitals decline to answer. But an employee of one 100-bed hospital comes forward to say that 40 of them are empty. Like other medical establishments, it was hit hard by the pandemic. Cluster infections at numerous hospitals scared people into shunning the routine, non-urgent treatment that guarantee hospitals financial health. The employees hospital, like others in the same plight, began as an alternative offering PCR coronavirus tests on an outpatient basis. That filled the financial void but not the beds. Again like others, this particular institution declined to admit patients suffering heavy coronavirus symptoms.
Light and moderate symptoms are another matter. The existing infrastructure suffices for them. But heavy symptoms require heavy and costly medical intervention.
First, wards must be set aside for them. Often its the intensive care unit, which means closing it to those needing it for other reasons. Showers and toilets, too, must be separate for infected patients. And the care the situation demands nursing, disinfecting, operators of artificial respirators and so on is personnel-intensive, potentially straining resources to the limit of, if not beyond, current capacity.
These are difficult but not insoluble problems. China, Shukan Gendai reminds us, built in 10 days a 1,000-bed coronavirus hospital in Wuhan, the initial heart of the epidemic, symbol of a single-minded and largely successful drive to defeat the disease just where it was raging most virulently. Chinas government exercises a degree of control over institutions and citizens that few Japanese would accept, whatever strength it brings to bear in a struggle like this one. Taiwan offers a model for a successful democratic response.
Given the will, Shukan Gendai suggests, Japan could do better than it is.


Japan Today
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