I was driving home the other day and I was sitting at a street light watching someone pull out a cigarette and unabashedly light it up. It’s sad that people in this country still smoke I thought as I literally drove by a billboard on Santa Monica Boulevard that counts the Tobacco related deaths each year (~100,000 so far). 100,000 and its only March! But then I started thinking some more. There was an all out war against the tobacco industry in the 90s and early 2000s which resulted in significant changes in the tobacco industry and also tobacco related deaths, but during that time we started seeing the USA slip further and further down the WHO ranking of healthcare systems in the world. I’m not saying that when more people smoke our healthcare does better, but I am saying that if we changed a social staple that was killing so many people, shouldn’t our healthcare ranking reflect that? I automatically picked a developed country I wanted to compare the USA with. Japan was the winner.

Japan is very developed socially, economically, and within their healthcare system. The Japanese government covers 70% of all healthcare costs for all of its citizens and the citizens are responsible for the other 30%. There is universal healthcare in Japan. There is not in the United States. And even “Obama-care” will not be a single payer system. This is not a political blog, and the reason for this post is about healthcare outcomes, not systems per-se.

Here is where my mind gets blown. And I know this doesn’t relate to physical therapy but I felt these stats needed to be shared:

People might argue that because Americans probably still smoke more there are worse healthcare outcomes but the average cigarettes per adult per year: USA 1200     Japan 2025 (link)

Okay, so if it’s not cigarettes that are killing americans it must be that we are overworked but Work Hours per week USA 34     Japan 35 so there’s no real difference there. (link)

So it must be the awful diet of the Americans that leads to a worse healthcare rating. I mean over 60% of the people in this country are overweight or obese but the Percentage of diet made up of carbohydrates: USA less than 50%     Japan 55-60%. (link)

But Americans eat more! Well, because of the difference in statures of Americans and Japanese it has been calculated that there is about a 200 calorie difference to maintain baseline metabolic function per day. On average an American adult eats 2170 calories while a Japanese adult east 1930 calories per day. Let’s call this one a tie. (i’ll include my reference here. the other stats are really easy to find)

Okay fine, we all know that the USA spends the most world-wide when it comes to healthcare but Japan must be up there too with such good rankings. In reality, among 13 industrialized countries in 2008, Japan spent the LEAST per capita on healthcare out of all of them. USA spent the most    Japan spent the least (link)

Also, I’ll let you know that stress levels are reported roughly the same between the two countries as well.

So, the Japanese smoke more, work more/same, are just as stressed, eat more carbs and roughly the same calories for basic functioning, and spend significantly less on healthcare per year than the Americans but –

Life Expectancy – America 75.9 (CDC)     Japan 79.5 (W.H.O.)

A difference of four years! That’s a lot of life to be lived.

Here are some other numbers that I found interesting and may play a part in this

Average steps per day USA 5100 (liars)     Japan (7100) – 2000 steps a day makes a huge difference! (link)

Average doctor visits per year USA (3-4)     Japan 14.5 – there is value in taking care of yourself in Japan, but Japan has twice as many hospital beds as the USA and the average hospital stay is six times longer in Japan (link). This is likely due to costs being regulated by the government so this can happen, and with all this regulation there must be stunted growth in the Japanese economy, but that just was not true over the past year. Japan’s economy grew about twice as much as the USA’s in 2012.

I could car less about the regulations, or the smoking, or the steps per day or carbohydrates when it comes to healthcare. There is difficulty getting access to healthcare regardless of having health insurance in this country, and it’s being reflected in our outcomes. By the way ,the World Health Organization ranked our healthcare system 37th and Japan’s 10th. Some other notables that were ranked ahead of the USA were Costa Rica, Columbia, Malta, and Italy.

Always Evolve,

Mike