K Maeda Jared Lane
Health Analysis Division, Congressional Budget Office, U.S. Congress, USA.
Inquiry. 2025 Jan-Dec;62:469580241310757. doi: 10.1177/00469580241310757.
The Japanese health care system provides universal coverage with relatively low cost sharing and patients have a free choice of providers. Although Japan's government price controls have helped to restrain the growth in health care spending, the country's rapidly growing elderly population and adoption of new drugs and technologies have placed increased fiscal pressures on its health care system. Additionally, the Japanese health care system does not have the infrastructure in place to restrain utilization, which may be a key driver of increases in health care spending. Although the US health care system has many shortcomings, such as the highest health care prices among developed countries and a significant uninsured population, it has been able to manage utilization by using various tools, such as prior authorization and gatekeeping. The US health care system might be able to offer Japan some lessons on ways to reduce unnecessary utilization and supply to create greater value in its health care system.
日本的医疗保健系统提供全民覆盖，成本分担相对较低，患者可自由选择医疗服务提供者。尽管日本的政府价格管制有助于抑制医疗保健支出的增长，但该国迅速增长的老年人口以及新药和新技术的采用给其医疗保健系统带来了更大的财政压力。此外，日本的医疗保健系统缺乏限制医疗服务利用的基础设施，这可能是医疗保健支出增加的一个关键驱动因素。尽管美国的医疗保健系统有许多缺点，如在发达国家中医疗保健价格最高以及大量未参保人口，但它能够通过使用各种工具，如事先批准和把关，来控制医疗服务利用。美国的医疗保健系统或许能在如何减少不必要的医疗服务利用和供应以在其医疗保健系统中创造更大价值方面给日本一些启示。
