Japan

I think that the medical reinvestment fund is a very noble but physicians should only have to contribute to this fund if they are attaining a certain profit level. For example, there should be a cap set and if the physician earns more than that cap, then excess profits can be distributed to this fund. This type of reinvestment does a few things:

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

I think it is a great idea to reinvest their money toward medical cares. We are able to see that Japan has a much different mentality than people in the United States. It is difficult for us to think that hard-earned money would go to a fund instead of our pockets. The sense of community is clear in other countries but not so much in the US. We have accepted the notion that doctors are supposed to have expensive cars, houses on the beach, and expensive vacations. But, it is difficult for us to imagine what it would be like to have some of their income go to a Medical Re-investment fund. It makes sense for those people that took on this career to want to put some of their resources into medical cares. On the other hand, those who went to medical school for the income would not be so excited about this fund. I would still would like to know what is meant by "medical cares". Do this medical cares benefit the whole population or just those who have resources.

Japan

My first reaction is "WHAT?!", but after much thought it does not seem like such a bad idea. If it is solely profit, that is after reaching their maximum amount of earnings per year then I see no problem. That money will be going back into their practice, they to will benefit from the contributions. It is an investment that may cost them at first , however in the long run it works out for them. They will have better medical equipment to use, and continued research on disease will allow for changes in medications and treatment of disease.
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.

The Doctor Tax!

First of all, I would need to know what proportion of the doctors' paychecks are mandatory. For example, anything up to 3% of a doctor's annual salary seems reasonable as long as they are able to utilize the reinvestment in some shape or form (ie physicians working in certain hospitals contribute to buy new medical diagnostic equipment). It seems unfair that doctors would have to pay this extra tax and I hope that everyone is paying a little more as well or pay a little extra on a sliding scale based on income. And though I would consider mandatory contributions from doctors as increasing a society's solidarity and an increasing willingness to share risk, I disagree that this has to be mandatory. I feel like each person should be able to do what they want with their money. From what I can remember, Japanese already pay premiums and out-of-pocket costs, so why should doctors have to pay more? That is, unless they benefit in some way, by reducing their diagnostic times, improve health outcomes or quality and efficacy issues. It's almost like they're being taxed for being doctors...which is definitely annoying if it's a significant mandatory tax.

Uncertainty in Russia

Russia’s fluctuated life expectancy at birth might contribute to its higher income inequality and socioeconomic status. I have known a woman moved from Russia because of their harsh economic situation. What she told me about Russia does not have many good things, in terms of economy, jobs, and even health care. She brought her mother to US because she can get the kind of treatment she needs. Birth rate is also declining that the government is giving large amount of money incentives to family to produce more children. (I even heard they don’t know what seafood is, something I didn’t expect from a country like 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.

The Fall of Health Care

It is quite evident that the transition into a market economy has been difficult for Russia in maintaining the health of its people. As a result of the collapse of the Soviet Union and rapid decline of their GDP, leaving them with fewer funds available for health care, there was nowhere to go but down for the Russian people with regards to their health.

“With the fall of Soviet power, health standards continued to deteriorate and citizens of the Former Soviet Union (FSU) were treated to the complete collapse of the health system that had already been in bad shape.” http://chnm.gmu.edu/1989/exhibits/soviet-health-posters/essay

Also, keeping the communist ideology of providing universal medical care did not help with being able to deliver quality care in their time of political and financial reconstruction. With less money circulating in the economy, health care advancements did not occur, which led to the high increase of mortality rates and other indicators of the decline of Russian health.

The down turn of Russia’s health care system worked in conjunction with the depletion of lifestyle habits leading to complex circumstances where bad habits were treated with minimal resources. I think that much of their poor health can be attributed to the despair the populations were experiencing due to the fall of the Soviet. As a result of the chaotic status of the time, there was an increase in mental health problems, increased substance abuse, more violence/crime, and an increase of infectious diseases, etc.

Total commitment

The Japanese Re-investment Fund is a very interesting idea. It forces doctors to put all of their profits into investments to further medical technologies. As the tital of my blog suggests this imposition by the the Japanese government represents a total commitment on the part of the Medical Practicioner to function as a healer both physically and financially. The Japanese physician spends all day healing and then any extra money goes to that same end. It would be interesting to find out whether the Japanese physicians support or impose this regulation but I suspect they would embrace it as long as the money is being used for a good purpose. I am very moved by this idea that the physician makes just enough to get by and that any excess goes toward the patient.

This mentality would never work in the United States, too many doctors are in it because it provides a good paycheck and can support someone in a lifestyle which they are accustomed. Were would Beverly Hills be without the plastic surgeons pulling in 8 figure paychecks? Arguably we would end up with no skilled physicians. This arguement is valid because the profit motive is a good way of advancing the medical field. Still there is something to be said for contributing all of your profits toward medical advancement and while this could never be legislation in the U.S, I wouldnt mind that becoming a practice endorsed by the AMA

Japan

I am a little confused on what exactly the medical re-investment fund entails. Do ALL the profits that doctors make go into the fund? or does a percentage of their total salary go into the fund? The goal of the fund is great--however, since Japan offers a universal health care system..it is important that all people using the system pay into this fund as well..not just doctors. The fact that a fund exists solely for the advancement of medicine probably contributes to the high life expectancy and high medical technology found in the country--and thus, enhances the overall health of Japan's citizens.

Japan

I think the medical re-investment fund is a great part of the Japanese health care system and well aligned with their cultural values. The fund improves the quality of care the Japanese are able to provide and plays into their communal cultural values to provide the best care to their community. It will be interesting to see the Japan group elaborate on this on Wednesday and the benefits the Japanese people have seen as a result of this medical re-investment fund.

Japan

I am a bit confused with the posted question: are the physicians the only profession to contribute to this Fund? If so, then it isn't justified. Since the Japanese society is egalitarian, wouldn't other professions (and every member of society) have to contribute proportionately?

Or, would it be better to have this funded through general sales tax? Granted, it's a medical advancement fund; however, all members of society will be benefiting from the innovations/services produced through this fund. As a result, it should be an equal playing field for contributions.

Now, would it be justified that physicians pay more than the average? Is it part of their occupational duty?

Japan

Like Sonny, I am torn on this issue, but am leaning more towards agreement.  I think that this is fully supported by their culture and makes it less of a problem for them.  And the goal of every medical society of a country should be technical advancement and betterment of the country's health.  I think Japan is doing exactly this. Is it really necessary for doctors to have yachts and such! Isnt this the problem with our system, the fact that doctors wont accept a paycut?

Got Your Money? (Japan)

Like from the classic Ol'Dirty Bastard's "Got your Money" song, Japan is telling the doctors to "gimme that money." I am torn apart by two views with this "Medical Re-Investment Fund." With global persepective, I think it is great that Japan identified that they should be saving up money for the latest/future technology in medicine. Cures and devices are around the corner for this world and at any moment, a breakthrough can happen. The other view is that it is unfair on the Doctors' to lose their luxary money to use as they see fit. I mean, who doesn't love hanging out (or partying) on a yacht especially in the beautiful Pacific Ocean? Though I see two stances within me, I will have to say I am for this fund because the fund if it stays true with its purpose is the BEST for the overall Japanese population. The sacifice of the few in order to extend the life of the masses is okay in my eyes.

Song of Blog: Christina Milian - Us against the world

Blog Question

Japan:

What do you think about the mandatory Japanese "Medical Re-Investment Fund" in health care delivery? "Medical Re-Investment Fund" is the fund required by Japanese government to ask all Japanese doctors to contribute their profits into such funds and used for medically related investments only, NO personal usage such as yachts, vocations etc. but only advancement toward medical cares.

Russia:

In 1991, the Russian Federation was formed after the fall of Communist USSR. Russia continued the tradition of universal free medical care from the Soviet era, even as GDP declined about 50% by 1995. In the years preceding and following Russia's declaring independence, the population's life expectancy at birth has fluctuated dramatically, and the elderly comprise an ever-increasing percentage of the population. Please comment on the relationship between these facts, health financing, and Russia's sudden and difficult transition to a market economy.