According to the results of a recently conducted survey by the Ministry of Health and Welfare entitled "A Survey of the General Public's Views on Health," more than 60% of Japanese believe health care should be handled in the same way as other service industries, and over half are generally satisfied with the quality of health care currently provided. Conducted by interview in January 1995, the survey was designed to gather a broad spectrum of opinions concerning health care in Japan. It was directed at a sample group of men and women aged 20 years or over, excluding those who are currently hospitalized; the effective response ratio was 70.6%. The following is a summary of the survey's results.
What Constitutes Good Health?
Asked to describe what they considered to be good health, one-third (33.3%) of respondents indicated that they considered good health to consist of "never becoming ill." The most widely selected response (45.3%) was that good health can be defined as "not having an illness that requires medical treatment." The third most common response (21.0%) was the view that good health constitutes "being able to work or participate in everyday life even if one has a chronic illness requiring consistent medical attention."
Asked to pick one or two factors important for the sake of good health, over two-thirds of the respondents (67.6%) cited "maintaining a personal regimen of temperate living." This was followed by "actively following what you personally believe is a healthy lifestyle" (50.1%), "improvement of the government-administered health examinations and other aspects of the health care system" (27.5%), and "receiving health-related advice from doctors" (16.1%).
Administration of Health Care
A great number of respondents gave a favorable evaluation of the current system for the payment of health care costs under government-run or mandated insurance schemes, with 76.5% giving a positive response (26.1% indicated high approval, while a moderate approval rating was given by 50.4%). Negative responses accounted for only 6.3% of the answers (with 0.7% indicating severe disapproval and 5.6% indicating they were somewhat critical).
Favorable responses also were in the overwhelming majority concerning the current setup for the provision of health care services, with 86.7% giving a positive evaluation of the accessibility of health care services (39.4% gave a high grade to the current system, while 47.3% gave a moderately good rating). Negative evaluations were given by only 3.2% of the total survey participants (0.4% of this group gave a strong negative response, while 2.8% gave a somewhat critical evaluation).
Asked to cite the most important factor in determining which health care facility they would select, the highest proportion of respondents replied that nearby medical clinics or hospitals would be their first choice (55.4%). This was followed by those who answered that they would seek treatment from a clinic for a light illness and a major hospital for a serious illness (19.0%), those who would go to a relatively large local hospital from the beginning of treatment (14.8%), and those who would look for a hospital or medical clinic that they thought had good doctors (6.8%), and only a few who stated they would go only to a major hospital from the start (3.4%).
Looking at Health Care as a Service Industry
When asked to consider whether health care should be provided to patients in the same way as customers are treated in other service industries, the most common response (33.0%) was that "the health care industry is a service industry, but it is difficult for it to treat patients in the same way that is, with the same courtesy as customers are treated in other service industries." This response was followed by those who answered "health care is a service industry, and so it should treat patients as valued customers" (29.4%), bringing the total of respondents who believed that the health care system is a service industry to 62.4%. By comparison, only 28.9% agreed with the view that "the health care system is not a service industry, and patients are best off placing themselves in their doctors' hands."
Asked to cite up to two factors they believed medical practitioners should be attentive to in providing care, the most common point noted was that they should provide patients with explanations of illnesses and treatments that the latter can understand and accept (49.9%); this was followed by "providing accurate diagnosis and treatment to assure recovery" (45.3%), "treatment with empathy for the patient" (29.5%), "not just administering examinations and prescribing medicine, but also offering advice on healthy lifestyles" (15.7%), "providing consultation not just on disease but also on how to build good health" (14.7%), and "creating a hospital environment in which patients can receive care comfortably" (13.3%).
The Current and Future State of Medical Treatment
Concerning the current overall state of health care, favorable responses were given by over half of the survey participants (of the 50.9% who gave favorable responses, 2.4% stated they were extremely satisfied with current treatment, and 48.5% responded they were generally satisfied) while 22.1% gave an unfavorable response (3.0% expressed extreme dissatisfaction with the quality of treatment while 19.1% expressed slight dissatisfaction).
Asked to cite one or two areas where the health care system will face increased demands in the future, two responses given by respondents stood out from the rest: "Hospitalization for elderly persons and others requiring long-term medical attention" (45.5%), and "emergency assistance and lifesaving" (42.0%). Other responses included "medical treatment for those with chronic illnesses such as high blood pressure and heart disease" (25.3%), "treatment for the preservation of mental health" (24.2%), "treatment to ease the suffering of patients diagnosed with terminal cancer" (23.2%), and "in-home medical treatment by doctors, nurses, and other health practitioners" (21.2%).
(The above article, edited by Japan Echo Inc., is based on domestic Japanese news sources. It is offered for reference purposes and does not necessarily represent the policy or views of the Japanese Government.)