Sunday, December 21, 2014

The USA Is Not Japan!

The following chart shows the 10-year moving average of the Japanese life expectancy minus the United States life expectancy.

Click to enlarge.

The Japanese have figured out how to live more than 4 years longer than us.

The next chart shows the 10-year moving average of the United States infant mortality rate divided by the Japanese infant mortality rate.

Click to enlarge.

The Japanese have also managed to keep their babies alive much, much better than us.

Infant Mortality

The infant mortality rate correlates very strongly with, and is among the best predictors of, state failure. IMR is therefore also a useful indicator of a country's level of health or development, and is a component of the physical quality of life index.

Health care system in Japan

Hospitals, by law, must be run as non-profit and be managed by physicians. For-profit corporations are not allowed to own or operate hospitals.

See? Nothing like us.

While some countries like the U.S. allowed costs to rise, Japan tightly regulated the health industry to rein in costs.

Nothing like us at all! Tightly regulated? Where's free market capitalism? Somebody needs to do something!!

[I]n the U.S. an MRI of the neck region could cost $1,500, but in Japan it cost US$98.

Not even comparable! How are they going to generate higher inflation rates when an MRI only costs $98? WTF are they thinking!!

Japan has about three times as many hospitals per capita as the US and, on average, Japanese people visit the hospital more than four times as often as the average American.

And yet they spend far less than we do overall! How can they possibly hope to create inflation, lower life expectancies, and higher infant mortality rates without the help of an extremely inefficient and greedy for-profit free market capitalism health care industry? It's insanity I tell you!

Source Data:
St. Louis Fed: Custom Chart #1
St. Louis Fed: Custom Chart #2


mab said...

Fantastic post! Don't tell the free market faithful though.

Texas Railroad coMISHion anyone?

whydibuy said...

Oh,here we go with the utopian state health care.
We would need a lot more info about the baby care. Because many systems don't even consider a baby to be a live berth until the baby is 4 weeks old whereas we consider pre term births to be live births. This apples to oranges stuff came up with H Clinton telling us that jungle people in thatch roof structures had a better survival rate than our sophisticated medical technologies provided.
Well only when a baby there reached 6 weeks old was it classified as a live birth. Ours are about 6 weeks premature to be considered a live birth.
So this state health care stuff is great if you live. Then they tell the world how great they do at healthcare management.

Stagflationary Mark said...


I'll try not to tell the free market faithfull unless one shows up.

Oh, look! One did!

Stagflationary Mark said...

Let me tell you a little story about our "Dystonian" free market health care system.

My girlfriend has Dystonia. It is an extremely painful condition. Picture a charley horse in your leg that never goes away. Hers is in her neck.

Under her free market insurance plan, she is entitled to receive a series of very expensive and very painful shots to treat her condition every three months. She hasn't had any treatments in the last year though. And why might that be?

Her free market insurance company finally figured out a more cost effective solution (for them). Their pre-authorization now comes with a 30 day expiration.

Since the waiting list is 60 days at her provider, her provider cannot actually schedule her for treatments. This means that it now costs her insurance company nothing. For all intents and purposes, all of her treatments are now permanently denied. She can get all the 30-day pre-authorizations she wants, but they don't actually do her any good at all. Her provider cannot schedule her without a valid pre-authorization for the time of service. That can no longer happen.

Since you are a free market faithful, I hope for your sake that you never have a serious chronic medical condition. A free market insurance company's ability to deny is directly proportional to the cost of the procedures. Funny how that works out.

Take this one, for example.

November 24, 2014
My Insurance Company Killed Me, Despite Obamacare

Malcolm MacDougall, a prominent speechwriter and creative director, was diagnosed with prostate cancer earlier this year. Even after the passage of the Affordable Care Act, his insurance company delayed and denied cancer treatments despite MacDougall paying his premiums. This is his story, in his own words, written five days before he died.

And from within a link found within that link:

“[T]he bottom line is that insurance companies make money when they don’t pay claims…They’ll do anything to avoid paying, because if they wait long enough, they know the policyholders will die.” — Mary Beth Senkewicz, former senior executive at the National Association of Insurance Commissioners (NAIC)

Free market health care prosperity, baby. That's what I'm talking about.

Stagflationary Mark said...

An analysis of the reasons for Japan's low infant mortality rate.

Japan's infant mortality rate in 1991 was four per 1,000, the lowest in the world. Contributing factors are the universal use of the Boshi Kenko Techo (maternal-child health handbook) and universal access to care. Most births occur to women aged 25-29 years and there are few unmarried mothers. Ninety-nine and seven-tenths percent of births are attended by qualified professionals either in hospitals or private clinics, with an average stay of one week postpartum. Abortion is available when contraceptives fail. There are government subsidies for medical, obstetric, and pediatric complications. Japanese citizens are highly literate and seek out medical advice, and their society is organized to support children. Efficient systems of community support, public health education, and excellent medical care encompass events from conception to school age.

It really doesn't take a rocket scientist to believe that if every baby has access to excellent health care, then more babies will survive.

But hey, if you wish to take the other side of the argument, more power to you.

Nathan said...


I think your frustrations are more with American culture and what market behaviors are rewarded than "free markets" per se. The Federal government is responsible for about half of all healthcare spending in US, and the other half generally passes through one or more private intermediaries, so it's hard to blame the problems on free market forces since there is no price discovery at work.

Take those barriers away and it's likely that the insurable health care market would more closely resemble the non-insurable health care market (e.g. cosmetic surgery) which has actually experienced negative cost inflation. People who advocate increasing the Federal portion to 100% (i.e. single payer) ignore the fact that giving the government complete pricing power doesn't mean that power will be used effectively. The Federal government has a complete monopsony in the defense industry, but that power is subverted politically.

So, I think your complaints are better characterized as an indictment of private enterprise in fundamentally broken markets. Those criticisms are valid, but they aren't tied to capitalism, they're tied to the fact that providing value for money is not important in the health care market right now. The same goes for education - people really dislike for-profit schools, but those organisations are only responding to the incentives created by the government via student loans.

Re: Japanese health care

I think in Japanese ethics and cultural norms are what make their market work effectively. I don't think those forces work in the US though.

Stagflationary Mark said...


My frustration is 100% centered on the for-profit health insurance industry.

I have no faith that my insurance claims will be paid if I ever experience a catastrophic change in my health. As is the case with my girlfriend, they will make every effort to deny and delay.

She has had many different insurance carriers since I have known her, and this happens repeatedly.

Keep in mind that I have also seen the perils of for-profit greed first hand. My former employer was involved in the biggest accounting scandal in US history (at the time it happened).

That said, our current health care system is almost the worst of all worlds. Government bureaucracy working as a team with corporate greed? Oh, joy. Sigh.

I say almost because I can picture Congress itself administering a plan (hands on approach) that Haliburton implements. Cluster@#$%.

I do agree that ethics are a problem in this country. I'd be tempted to let my local fire department run my healthcare over the alternatives. I strongly suspect that most firefighters aren't doing it for personal greed, but instead truly want to help people.

As a side note, I am not opposed to market capitalism in a properly regulated restaurant industry (meaning health standards are met for my own safety). As in many industries, I think it thrives. There is a fine balance between for-profit greed and customer value.

dearieme said...

It's truly impressive that the Japanese live four years longer in spite of attending hospital four times more often. Just think how much their lifespan advantage would increase if they cut back on the hospital visits.

Stagflationary Mark said...


live four years longer in spite of attending hospital four times more often

@#$%! They've got a fountain of youth in each hospital and they aren't sharing with us!

Greedy nonprofit bastards! ;)