Wednesday, November 19, 2008
Japan
1. It encourages physicians to be part of this field for its intended purpose of aiding the health of others, thereby discouraging those who feel that they should enter medicine for the money. If you want to fly on private jets and own a yacht, well then, go into business.
2. Advancement of science cannot take place unless it is well funded. A great example of this is the number of available treatment options for breast cancer patients. B/c organizations such as the Susan B. Komen foundation have been so successful in raising money, scientists have been able to use this money toward advances in the field.
3. Health care in general will improve in Japan if physicians are willing to contribute to a fund that's sole intention is to advance the medical care of the country. This not only sets a precedent for younger physicians to follow but also instills a mindset that change is a necessary part of the system and that the only way to keep moving forward in a positive direction is by altering pieces of the system that are lacking.
I do have a hard time mandating someone to contribute their profits beyond a certain point. What if one physician works very long hours while another keeps normal business office hours? Shouldn't the physician who puts in long hours be compensated appropriately? Well, I guess that there would be less incentive to work very long hours and in a sense, this may be damaging to the field. But overall, I think that the medical reinvestment fund would be more advantageous.
Japan
Japan
Overall it seems un-fair that they have to do this, a suggestion would be to have it be a percentage of their profit and not all of it. More like a set fee that all Japanese doctors pay a month. that way its not seen as "taking their profit", but more of a contribution!
Japan's Mandatory Medical Reinvestment Fund

[ I tried to look "Medical Reinvestment Fund" up on Japanese sites (and English ones) to find out more about it but I couldn't find anything about it. Do you know what its called in Japanese? ]
I think that this is a great idea! Doctors already get paid so much so I think putting a little percentage into medical research wouldn't hurt (although it depends on what percentage of their paycheck is mandatory). The doctors are the ones using the medical technology anyway, so why not have them contribute a little toward the cause. I think it will make doctors more appreciative of these technologies they use, and maybe even more interested in what they are paying for and maybe get involved in the research.
Since Japan has officially declared an economic recession a couple of days ago, I think that this fund is even more important. When the government and economy are not doing good, money towards research on medical technologies are probably going to decrease. If there is a constant contribution from doctors, who are unlikely to see a huge decrease in their paychecks, then this can help maintain the pursuit of new technologies. I can imagine that this sort of system would work in places like Singapore as well, but NOT the United States (everyone would start talking about their rights as an individual who has earned that money and why they should have to pay for the benefit of all others).
Japan Re-Invvestment
Having a Medical Re-Investment Fund seems like a great way to have funds for medical advancements and investments, especially so that the government has less of a burden to cover these expenses. I think the issue is how willing the physicians are to contribute their own profits and what kind of margin they are allowed before they are required to invest. So, if the doctors are allowed to keep a certain percentage (like 20%) and then invest anything over that, it seems more feasible than if they are required to give everything over a small base salary. I guess it all just depends on the stipulations that are imposed with this kind of policy. So, what is exactly considered profit, how much is required as investments, if the investments can be directly allocated to each region or practice, and how much the patients actually benefit from this.
This system, like many others we have discussed, would not be possible to implement in the United States. The economy, physicians, personal perspectives, and many other barriers would prevent this sort of policy from being implemented here. I could guess that physicians here already feel they give up a large portion of their pay (which they probably feel is too low, even though its higher than most other countries) for things like malpractice insurance and taxes. I find it hard to believe that they would be willing here to give an even larger portion for investments they feel the government and private funders need to pay for.
Tuesday, November 18, 2008
The Doctor Tax!

Uncertainty in Russia
After break down of USSR, many countries have declared independence from Russia. It is an indication of weakness in government and instability in the states. Russia might still have universal health care, but does the government provide enough for people to get proper treatment? Are there enough clinics in every corner like in Cuba? Is there price regulation like in Japan?
As far as I know Vladimir Putin had helped the nation rebuild stability and economic growth. The question of healthcare is still uncertain if the Russians birth rate is not stable. But, I believe that with such a strong central government system, Russia can make a major transformation easily.