Monthly Archives: November 2014

Week 11: セルフメディケーション (Self-Medication) and CONCLUSION

As of 2009, there are four levels of over-the-counter drugs sold in Japan under the Pharmaceutical Affairs Law.
-Class 1: new OTC drugs or those with potentially serious side effects, which usually require a consultation with a pharmacist before they’re given to you
-Class 2: OTC drugs that have some side effects, but are not as serious as Class 1
-Class 3: OTC drugs with minimal/low side effects
-Quasi-drugs: products like cosmetics or energy drinks that have effects similar to drugs, but which can be sold outside of pharmacies
The system has a fair amount of regulation, and basically serves as another example of how Japanese healthcare is based around preventative or symptom-based care.

This week’s vocabulary:
医薬品 (いやくひん): medicine
That thing that looks like jelly is not food, it’s medicine.

新薬 (しんやく): new medicine
My grandmother’s stomach cancer has gotten worse. Is there a better and new drug?

薬店 (やくてん): drugstore (often with a more limited selection than a 薬局)
A “yakuten” does not usually have prescription drugs.

服用 (ふくよう): dosage
This medicine’s dosage is 3 times a day, 1 tablet each time.

医薬部外品 (いやくぶがいひん): quasi-drug
Soap, hair color, and energy drinks, among other things, are considered quasi-drugs.

Other sources on the subject:

The Japanese healthcare system is based around low-cost, publicly available healthcare with plenty of emphasis on preventative care. Healthcare is universal, insurance is taken out by the government or employers, and the Ministry of Health, Labour and Welfare sets prices for drugs and procedures, in a system similar to the UK’s National Health Service. Compared to other Western powers, though, Japan spends much less on healthcare than its contemporaries. This approach has some upsides, such as an emphasis on Chinese traditional medicine, self-medication and personal responsibility, but also some downsides, especially with regard to important aspects of care like hospital stays and the treatment of diseases like obesity and mental illness. Ultimately, the system will need to change in some areas in light of Japan’s increasing elderly population and decreasing workforce. In spite of some measures of personal responsibility being put into place, like the tokuho program and an emphasis on self-medication, there are still several problems with the system. The reforms from current prime minister Shinzo Abe’s “Abenomics” economic policies are one way that the government is readjusting the system, but it will take much more than this in order for the government to truly find a solution.

Week 10: 日本の健康的の食事 (Japan’s Healthy Diet)

This time, I’ve got two articles discussing one part of Japanese healthcare that I’ve overlooked up to this point: the traditionally healthy diet of the Japanese population. Although some foods (for example, miso and soy sauce) are high in sodium, and the staple of the Japanese diet—rice—is a simple carbohydrate, there are many different foods in the average Japanese diet, some of which are considered to be very healthy. The Japanese love soy, vegetables and fish, and on the whole eat less red meat and dairy than other Western societies, although their specialties in that regard are well-known. Green tea, a staple drink, is rich in antioxidants. On the negative side, also, many processed foods in Japan have MSG and high fructose corn syrup, but they make up for that by eating a variety of foods in small quantities.
Yet, unlike other Western countries, processed foods which can possibly provide beneficial effects are specifically certified as such through the government program 「特定保健用食品」or simply 「特保」(Foods with Special Health Qualities). These include things such as the beneficial microbes in Yakult, the fiber in Kirin’s Metz Cola, and certain kinds of tea. The labeling program was introduced in 1991, and now, over 1,000 products have the designation. There have been some controversial designations, though, including the Econa brand of cooking oil, which was found to have a carcinogen. In response, new rules were put in place in 2009.

This week’s vocabulary:
特保 (とくほ): food with a special health use designation
Look, that oolong tea has a tokuho label on it. It’s healthy!

タンパク質 (たんぱくしつ): protein
For the purpose of making your muscles stronger, you must eat protein.

脂/油 (あぶら): fat/oil
Recently, the fat content in the Japanese diet has increased.

炭水化物 (たんすいかぶつ): carbohydrates
Because you’re a diabetic, please be careful when eating carbohydrates.

繊維質 (せんいしつ): fiber
For my stomach and heart, I eat lots of fiber. For example, I think we should eat things like vegetables of wheat.

It’s interesting to see the impact of Japan’s diet on their healthcare. In all honesty, this system seems to place an emphasis on preventative care instead of going to the doctor for every single ailment, and the government stresses healthy eating through methods such as the Tokuho label. While not perfect, as the Econa scandal shows, it’a still fairly good on that front, and I wonder what it would be like if similar labeling systems are implemented in the West. For my last post about this topic, I think I’m going to discuss self-medication, another aspect of preventative care.

Other sources on these subjects:

Week 9: 人口減少 (Population Decline)

Another recent trend in Japanese society that will change healthcare is the population decline. This paper discusses several implications that come with the continued use of a low-expenditure healthcare system in a country experiencing a fairly steep population decline. According to the paper, there will have to be a 9-14% increase in taxpayer funding for the healthcare system by 2050 in order to compensate for the lower number of workers and accommodate the higher elderly population. Unfortunately, the potential reform policies, such as an increased consumption tax (which, after this was published, is starting to happen with Abenomics) and lower co-pays for some individuals, are not proving to be exceptionally popular to people over 35. This is disheartening, but something does need to be done about this, especially because the impact of Japan’s inverse population pyramid is so great.

This week’s vocabulary:

国民健康保険 (こくみんけんこうほけん): government-mandated health insurance
America has recently introduced a government-mandated health insurance system.

人口減少 (じんこうげんしょう): population decline
As Japan’s population decline increases, so, too, will the price on things like health insurance.

免責額 (めんせきがく): deductible
I had a car accident. But, because my insurance deductible is high, I’m fine.

自由診療 (じゆうしんりょう): treatment not covered by insurance
Drugs you buy at the pharmacy are one example of treatment not covered by insurance.

薬価 (やっか): drug price (under government-mandated health insurance)
The price of brand-name drugs is high, so please be judicious in prescribing them.

This is another political topic, but one that raises a point of contention. Indeed, the low-cost healthcare in Japan has been good and sustainable for quite some time, but I really do think there are quite a few changes that could be done. I knew the aging population could be a big factor, but the amount of labor tax needed to compensate is certainly high. This, as well as the low spending on healthcare anyway, provides a good reason as to why Abenomics is transforming the healthcare system in Japan. I still, however, have not looked much at the cultural factors behind how Japan views health, so that will be next week’s topic.

Other sources on the subject: