Containing Health Care Costs in Japan

Conventions and Usages

Conventions and Usages Japanese names are given in the Western order, with family name second. Our rule in translating names of Japanese agencies and programs is to follow the Ministry of Health and Welfare's most common usage. The major exception is Kokumin Kenko Hoken, the health insurance program for the nonemployed, which is usually but misleadingly translated National Health Insurance. We use the term Citizens Health Insurance as a better expression ofits nature and a legitimate gloss on the Japanese word Kokumin. We also generally translate shinry6jo as "office" rather than "clinic," and kaigvoi as "office-based physician." Conversions of yen figures into dollars are only to give the reader a sense of the order of magnitude of the amount. In general the conversions have been calculated at the rate of$1 =¥180, as a rough approximation ofpurchasing power parity (PPP) throughout the period, rounded off to two significant digits. We consider this convention preferable to using annual estimates of PPP, such as those calculated by the Organization for Economic Cooperation and Development (OECD) and used in its Health Data File, because, for example, our procedure does not make a yen amount that has actually been stable to appear to change over time. The exceptions are: chapters 6 and 16, comparing specific costs in a single year between Japan and the United States, in which the OECD estimate ofPPP for that year is used; and chapter I I on pharmaceutical charges, where one table uses the same PPP rate as was employed in the original source. It should be emphasized that all PPP estimates are always somewhat arbitrary , since the "market basket" ofgoods and services used for comparison cannot be identical. More generally, quantitative cross-national comparisons should always be viewed with considerable skepticism, since discrepancies in definitions and ways of counting creep in at many points. In this volume we have tried to be realistic about the limitations as well as the considerable payoffs of comparative analysis. 7 Conventions and Usages Japanese names are given in the Western order, with family name second. Our rule in translating names of Japanese agencies and programs is to follow the Ministry of Health and Welfare's most common usage. The major exception is Kokumin Kenko Hoken, the health insurance program for the nonemployed, which is usually but misleadingly translated National Health Insurance. We use the term Citizens Health Insurance as a better expression ofits nature and a legitimate gloss on the Japanese word Kokumin. We also generally translate shinryojo as "office" rather than "clinic," and kaigvoi as "office-based physician." Conversions of yen figures into dollars are only to give the reader a sense of the order of magnitude of the amount. In general the conversions have been calculated at the rate of $1 = ¥ 180, as a rough approximation of purchasing power parity (PPP) throughout the period, rounded off to two significant digits. We consider this convention preferable to using annual estimates ofPPP, such as those calculated by the Organization for Economic Cooperation and Development (OEeD) and used in its Health Data File, because, for example, our procedure does not make a yen amount that has actually been stable to appear to change over time. The exceptions are: chapters 6 and 16, comparing specific costs in a single year between Japan and the United States, in which the OECD estimate ofPPP for that year is used; and chapter lIon pharmaceutical charges, where one table uses the same PPP rate as was employed in the original source. It should be emphasized that all PPP estimates are always somewhat arbitrary , since the "market basket" ofgoods and services used for comparison cannot be identical. More generally, quantitative cross-national comparisons should always be viewed with considerable skepticism, since discrepancies in definitions and ways of counting creep in at many points. In this volume we have tried to be realistic about the limitations as well as the considerable payoffs of comparative analysis. 7 ...