6 ms·

> The US spends ~$14,570 per person on healthcare. Japan spends ~$5,790 and has the highest life expectancy in the OECD. That gap is roughly $3 trillion per yea

• hermanzegerman 8mo ago
  We in Germany copied a lot of the stupid stuff from America (including the stupid billing system for inpatient stays), so it's not that surprising that our system is also bad value for money. PS: Outcomes here are not worse than those of rich people in the US, because I know some idiots will claim this to cope https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2774561 https://jamanetwork.com/journals/jamainternalmedicine/fullar...
  • legitster 8mo ago
    Germany didn't copy the US - they just happen to share similar roots. Both historically had private hospital systems, and just so happen to implement pension/employer-based insurance programs very early on. German's just evolved in one direction and the US evolved in the other.
    • hermanzegerman 8mo ago
      We copied the DRG reimbursement System from the US. And no, we didn't had a historically significant share of private hospital systems, those came with the introduction of the DRG System, which forced many city/church owned hospitals into privatisation. Before that, they had a "Fixed Price per Night" System, which also was a bit stupid, before that they got reimbursed their cost.
  • graemep 8mo ago
    Actually Germany is a lot better value for money than the US. The cost (either absolute or as a percentage of GDP) is similar to the UK or France, and from what I have been told by people who have lived in both countries, the German system is better than the British.
• legitster 8mo ago
  The US also has GDP per capita of $90k and Japan has a GDP per capita of ~ $35k. Put another way, in both countries a hip replacement surgery is almost exactly 1/8 of someone's per capita GDP.
  • JKCalhoun 8mo ago
    Too bad Walmart greeter isn't making "per capita GDP".
    • cj 8mo ago
      Some quick googling suggested cashiers at Seiyu in Japan earn $7-9/hour USD while Walmart is about double that.
      • bandofthehawk 8mo ago
        If the Japanese cashier makes half the amount, but spends only 1/3 on healthcare that still seems to favor Japan
        • bloppe 8mo ago
          Well sure, then you're kinda cherry picking data that could easily be considered within a margin of error to make a rather unconvincing point
          • kakacik 8mo ago
            Whats your point, US healthcare is ridiculously expensive to detriment of all US citizens sans those working for health insurance conglomerates. Any objective data you pick will show this, no need for strawmen.
            • twoodfin 8mo ago
              It’s really good for clinicians and their paychecks, too.
• rayiner 8mo ago
  I suspect you would see the exact same trend comparing Japan and the U.S. in transit, education, and many other services. The U.S. spends more per capita to get less.
  • Aurornis 8mo ago
    The US is a wealthier country and wages are higher here than Japan. The median equivalised household disposable income of a US household is over twice that of a household in Japan. This is one of many reasons why it’s so misleading to compare prices across countries in a vacuum. All of the people doing the work for those education, transportation, and other services and all of their inputs aren’t going to work for Japan-equivalent pay when they’re living in the United States.
    • rexroad 8mo ago
      The wage adjustment is worth testing with data. Japan's GDP per capita on a PPP basis is roughly $47,000 versus the US at $80,000, a 1.7x income gap. The per-capita healthcare spending gap is $14,570 vs $5,790, a 2.5x ratio. Healthcare costs outpace the income gap by a meaningful margin even on PPP terms. The outcome data is what makes the adjustment argument hard to sustain. Japan has the highest life expectancy in the OECD (84 years) and the lowest infant mortality (1.7 per 1,000). If higher spending were buying proportionally better outcomes, the wage argument would carry more weight. The US spends 2.5x more and gets worse population health statistics. PPP narrows the gap, it doesn't close it.
      • shimman 8mo ago
        Median salary in the US is barely $45k a year: https://www.ssa.gov/oact/cola/central.html https://www.ssa.gov/oact/cola/central.html So what you're describing is even worse.
        • rayiner 8mo ago
          The above was comparing the average in Japan to the average in the US. If you want to compare medians, it’s about $43,000 in the U.S. (2023) versus 3.96 million Yen (2025). See: https://e-housing.jp/post/average-salary-in-japan-2024-insights-on-tokyo-and-beyond https://e-housing.jp/post/average-salary-in-japan-2024-insig.... At current exchange rates that’s about $25,000. So that’s the exact same 1.7x ratio as for the averages.
• nradov 8mo ago
  Japan also has the "Metabo Law" (aka fat tax). Do you think Americans would go for that?
  • Dylan16807 8mo ago
    "Obesity costs the US healthcare system almost $173 billion a year." So that's about 6% of the difference? I'm not immediately saying no, but it sounds like that's not the real problem.
    • nradov 8mo ago
      That 6% number isn't even close to accurate. There are many other very expensive chronic conditions that are downstream of obesity including type-2 diabetes, heart failure, hypertension, MSK injuries, etc. We are digging our graves with our teeth.
      • epicureanideal 8mo ago
        Although I tend to think we overwork the working class such that they have no energy to keep up their health, so this would basically be taxing them because they're poor in many cases.
      • AngryData 8mo ago
        Except all those things reduce peoples lifespan, and age-related care is by far the most expensive medical care.
    • conductr 8mo ago
      Social reasons it would never work. I hate to mention anything race related online but simple truth is America has complicated history and African Americans are 30% more likely to be obese than White Americans and also earn approximately 60% of income that whites earn. A fat tax, especially one that properly allocated the cost burden to the individual, would erode race relations.
      • 8mo ago
• JumpCrisscross 8mo ago
  > Japan also spends less per capita than the UK, France or Germany These have to be purchasing power adjusted.
• tjpnz 8mo ago
  The Japanese system is amazing. Cheap drugs, cheap dentistry, no wait times and reimbursements for all kinds of things (government covered more than 100% of childbirth cost - yes we got more back than we paid). But the best part IMO is the emphasis on preventative medicine. My wife and I get annual checkups which cover a whole range of things including screening for various kinds of cancer.
• glitchc 8mo ago
  Try seeing a doctor in Japan as a foreigner. Just a simple consult costs $300 USD or so, and it goes up from there. It's actually a rather expensive system.
  • AngryData 8mo ago
    That doesn't seem more expensive to what I generally pay in the US.
    • glitchc 8mo ago
      Exactly, it's roughly on par. The OP was claiming it was significantly cheaper.
  • kdheiwns 8mo ago
    This is absolutely not true. I pay the equivalent of about $40 for X-rays and blood tests. A simple consultation is about $15, if that. I recently got diagnosed with asthma, and the whole set of tests plus a month of medicine came out to about 6000 yen, which I suppose is $40. The only reason you would pay that much is if you're visiting a private no-insurance clinic and not using insurance. And private clinics pretty much only exist to prey on people who identify as expats and make zero attempt at learning non-English languages, aside from a few exceptions (certain speciality dentists, plastic surgery, anonymous STD treatment, some cancers).
    • glitchc 8mo ago
      The whole debate is about what insurance companies are paying for those services, right? It's when one walks in without insurance that you see the true cost of the service. > The only reason you would pay that much is if you're visiting a private no-insurance clinic and not using insurance What alternatives does a tourist have? If Japan truly had cheaper procedures, it would see a huge uptick in medical tourism. There's no doubt that Japan has state-of-the-art facilities and treatment options, comparable to the US. It's no surprise that costs are comparable too.
• AngryData 8mo ago
  But also age-related care is by far the largest share of medical care costs, and Japan has no lack of very old people. Being unhealthy also often reduces the amount of procedures someone is eligible to receive. Despite the blame people throw on unhealthy people for medical costs, they ironically often cost less because of the reduced care and lower lifespan which cuts out a significant amount of age-related healthcare costs. One could argue dieing at 60 instead of 90 is a big loss socially and personally, but overall financially it is a benefit.
• dv_dt 8mo ago
  It "may be other than health care" but most (all?) other modern nations on multiple continents in multiple cultures spend less percent GDP on healthcare with longer life expectancy than the US
• phyzix5761 8mo ago
  Japanese Americans have a slightly higher life expectancy in the US (87 years) vs Japanese living in Japan (85 years).
• pjc50 8mo ago
  Japan has an age fraud problem which inflates its life expectancy: https://en.wikipedia.org/wiki/Sogen_Kato https://en.wikipedia.org/wiki/Sogen_Kato "The discovery of Kato's remains sparked a search for other missing centenarians lost due to poor recordkeeping by officials. A study following the discovery of Kato's remains found that police did not know if 234,354 people over the age of 100 were still alive".
• bojangleslover 8mo ago
  The US has a high variance population. Aggregating the US into a single mean or median for that matter is a fool's errand.
• helsinkiandrew 8mo ago
  > The difference in life expectancy will be influenced by multiple factors and may have more to do with diet and lifestyle than with healthcare Less than 5% of Japanese are obese (BMI >30) compared with 36% of Americans, additionally 1 in 10 Americans are severely obese (BMI>35) whereas the number in Japan is negligible. https://theworlddata.com/us-obesity-rate-compared-to-other-countries/ https://theworlddata.com/us-obesity-rate-compared-to-other-c...