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Discussion 1

China “is the most populous country in the world, with a population of over 1.3 billion” (Johnson et al., 2018). Its healthcare system has gone through three phases, with the result of universal health care and reform, which was inspired by the SARS outbreak in 2003 (Johnson et al., 2018). They have three public insurance schemes and “in 2011, approximately 95 percent of the Chinese population was covered under one” (Tikkanen et al., 2020). A reform strategy China needs to consider is they need to make their insurance plans more affordable and encourage those insured to use their insurance. In Comparative Health Systems: A Global Perspective, it says that the “benefit of the NRCMS [the New Rural Cooperative Medical Scheme] has been quite narrow and shallow, with a focus on inpatient cost…its protection against the financial burden of its enrollees is quite limited [and so]…the utilization of the NRCMS has been low” (Johnson et al., 2018). There is no point in citizens being insured if they are not benefitting from it. Second, they need to focus on the portability of their insurance. Since “there is no cross-country subsidizing…millions of migrant workers…have fallen through the insurance cracks” (Johnson et al., 2018). They need to protect those who are moving and ensure they are being insured regardless of location. A third reform strategy China should take into consideration is focusing on preventive services since they “are not covered by the URBMI [the Urban Resident Basic Medical Insurance]” (Johnson et al., 2018). With this, they could provide better care to their citizens and have them have better health.

Japan’s “population as of July 2016 was…approximately 126.7 million” (Johnson et al., 2018). Looking at the statistics provided in Comparative Health Systems: A Global Perspective, we can see that “an aging population has become a persistent concern for today’s Japan” (Johnson et al., 2018). In Japan, “the national and local governments are required by law to ensure a system that efficiently provides good-quality medical care” (Tikkanen et al., 2020) and have established a comprehensive social insurance program. Some reform strategies Japan needs to consider are programs that educate in risky behavior due to “the greater tendency among men to engage in risky behaviors such as tobacco and alcohol” (Johnson et al., 2018). Then the older men will be educated and learn how these activities negatively affect their health. Next, they need to make sure that this older population gets vaccinated. Our textbook says that “Japan’s influenza vaccination rate in people aged 65 years and over is not very high” (Johnson et al., 2018). This would help protect them against communicable diseases and increase longevity. Another reform Japan should consider is educating their doctors more. After checking patient satisfaction it is learned that “[doctors don’t provide patients with sufficient opportunity to ask questions” (Johnson et al., 2018. Lastly, and most importantly, they need more beds; “considering Japan’s fast-growing elderly population, demands for beds…were expected to rise” (Johnson et al., 2018).

Word Count: 497


Authors Roosa Tikkanen, Authors, Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton, G. A. (2020, June 5). China. Home. Retrieved March 4, 2022, from

Authors Roosa Tikkanen, Authors, Tikkanen, R., Osborn, R., Mossialos, E., Djordjevic, A., & Wharton, G. A. (2020, June 5). Japan. Home. Retrieved March 4, 2022, from

Johnson, J. A., Stoskopf, C. H., & Shi, L. (2018). Comparative health systems: A global perspective. Jones & Bartlett Learning LCC.

Discussion 2

China has one of the highest populations and Japan has one of the highest older populations. Both counties are being faced with a large aging population that pose a threat to their healthcare system. The older population tends to face chronic illnesses that can cost more to treat and might require more time for treatment. China has a population of 1.3 billion people and in comparison to Japan’s 126.7 million people population, to the naked eye it might not seem like they’d have the same healthcare concerns. However, about a third of Japan’s population is over the age of 65, forcing both countries to have to deal with the increases in healthcare services. China provides healthcare to more people and Japan provides healthcare for chronic issues more often.

Public-funded healthcare covers most of the population in both countries currently. But it seems like the current system can not keep up with demand. Both countries could benefit from advancing in technology to create a more centralized system that can communicate information quickly and efficiently between different providers and to add more funding towards healthcare in general. Many of these patients would not be able to afford healthcare without the public funding and when it comes to paying out of pocket many would be able to pay for added services.



Income poverty in old age – United Nations. United Nations Department of Economic and Social Affairs. (2015). Retrieved March 5, 2022, from