Regarding Shawn White's Jan. 17 letter, "Health care closer to U.S. system": I share the writer's disquiet about recent changes in the Japanese health-care system, but his accusations go way too far.
First, increasing the co-pay to 30 percent for everyone except the elderly (previously co-pays ranged from 10 percent to 30 percent) does not mean out-of-pocket costs are nearing American levels, as people who have gotten treated in both countries will attest.
One reason is that the fees themselves are far lower in Japan; another is that there is a monthly cap on co-pay costs. And of course everyone in Japan is covered by public insurance, quite unlike the situation in the United States.
Second, the reforms are not political payoffs to insurance companies. Most "cancer insurance" is sold by foreign firms, hardly political darlings. The move was part of a broader effort to constrain spending, which has been successful -- health-care costs have gone up quite gradually in Japan, despite the aging population.
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