2 May 2020, NIICE Commentary 4429
Dr. Mahendra Prakash
Japan, no doubt is a prodigious country with world class facilities for all its citizens. It is also one of the largest economies in the world. However, its impressive standards of living and long life expectancies have been challenged by the COVID-19 outbreak, since early January 2020. The healthcare service system is facing criticism from the Japanese community on its approach to fight the novel Coronavirus cases. The Prime Minister of Japan has declared an emergency in the country and has created a task force to control the dire situation that has emerged due to the Coronavirus. Nonetheless, the health sector is well prepared to deal with the COVID-19 Pandemic effectively. Conventionally, Japan is known to be one of the best health service provider to its citizens and workers under the health insurance scheme, which was started in the country in 1922.
The existing Japanese National Health Insurance Law was endorsed in 1958, and this ensued the world standard of universal healthcare for Japan in 1961. Now, in Japan, the enrolment in public health insurance is obligatory, just like citizenship. For all those who have lived in Japan for more than three months, public health insurance schemes are chosen according to the service standing, age and residence. Approximately 3,500 insurers are providing insurance services to the citizens according to Employer-based health insurance, residence-based National Health Insurance (NHI), and the health insurance specifically meant for people aged more than 75 years old. Internationally, Japan spends comparatively less on healthcare; nevertheless, the total budget for healthcare in the country is higher than that of the member countries of the Organisation for Economic Co-operation and Development (OECD). Japan also increased its health care spending from 7.8 percent to 10.9 percent of its Gross Domestic Product (GDP) in the late 2010s, which is much higher than any of the developing countries.
In present times, the outbreak has changed the way medical and health care systems operate in Japan. Apart from a general disinclination to embrace social distancing and stay at home, professionals are also disparaging government competence. It was also perceived that the personal protective gears and equipments are available in lesser numbers in Japan. Tests are being conducted in limited numbers due to the rules requiring the patients to be hospitalised. Hospitals in Tokyo are filled with hundreds of patients, who were infected aboard the infamous cruise ship ‘Diamond Princess’ in February 2020. Till now, people infected with the novel Coronavirus are being looked after at hospitals nominated for treating infectious viruses. These hospitals are equipped with airtight facilities to prevent contamination outside.
COVID-19 infections continue to grow by more than hundreds each day, which has amounted to more than 14,500 cases all over Japan up to late April 2020. Tokyo and the Kanagawa prefecture of Kanto region have the largest number of infections, while Osaka prefecture in Kansai is on the number two spot in Japan. These areas are observing hundreds of cases every day. This condition has amplified the stress of medical care units. Moreover, the situation might get more complicated in remote areas, where the medical facilities are less specific.
The continuing number of positive COVID-19 cases has particularly changed the stand of the Ministry of Health, Labor and Welfare into softening the rules and moving patients with slighter indications to hotels, and freeing the emergency rooms in hospitals for old and serious patients. The Japanese government has made available more than 210,000 hotel rooms nationwide to accommodate patients who are asymptomatic, or with mild Coronavirus symptoms, after the ruling coalition partner Komeito pressurised the Liberal Democratic Party (LDP). There are several patients staying outside of hospitals in Japan because they have no choice but to look after their small children, even in sickness. Social distancing has not worked well enough in packed cities like Tokyo and Osaka, as citizens are traveling to offices in crowded trains, even though the Prime Minister declared emergency in the country. Now the government has planned to exempt tax on brews with high alcohol concentration, with expectations to make such products available at lower prices in the current situation, wherein there is a scarcity of alcohol-based sanitisers. The exemption would remain effective, if the Ministry of Health, Labor and Welfare approves the use of alcohol as a substitute. Further, the Ministry has issued a notice that alcohol with a concentration percentage in between 70 to 83, not containing methanol, could be used for decontamination at medical institutes and other places to control COVID-19.
Everyone has a role in Japan to avert the spread of COVID-19. For example, individuals who are only feeling that they might be infected, and do not possess serious symptoms, should avoid going to the hospitals. COVID-19 in Japan has not only disturbed the livelihoods of the Japanese people, but has also made the economy and education system susceptible to losses due to the unprecedented emerged situation. Students in schools are dropping out due to the fact that their parents suffered loss of incomes at the hands of the Coronavirus. American business and financial service provider Moody’s Analytics recently announced that Japan is likely to face an economic crisis in coming months.
Earlier in April 2020, the Bank of Japan (BOJ) said that it would try to stabilise the Japanese economy through various resources. Yet, the economy worldwide would suffer its worst slump in mid-2020 due to the virus-driven collapse of fiscal activity. The economy of Japan is facing sluggishness due to its export dependence and soft internal consumption occurring since March 2020, and such economic conditions amid COVID-19 would cost Japan heavily, later this year. Meanwhile, the Japanese government is helping the citizens and foreign nationals registered as residents who are earning no income due to the COVID-19, with the payment of ¥100,000 each from a part of the ¥12.8 trillion economic package allotted for pandemic sustenance. However, the long registration process and paperworks for every resident might affect the indigent families, who are in urgent need of such valuable assistance from the government.
The Government of Japan is trying to normalise the situation through various other fiscal measures. Japanese Prime Minister Shinzo Abe approved ¥117 trillion economic package to manage the economic uneasiness emerging from the new dangerous disease – this package is larger than the 2020 annual budget of the government and would further push the Japanese GDP down by 4.4 percent. It is required that the economic package be revised and updated as per the necessity of citizens, to accomplish provision of medical facilities, management of unemployment and helping of small businesses, airlines, etc. side-by-side. Japan is aiming to stimulate consumption with an allotment of ¥1.6 trillion for tour campaigns for citizens, which would subsidise the travel expenses and tickets for entertaining events. Nevertheless, the uncertainty of COVID-19 situation in coming months has exposed the opportunity for opposition political parties to criticise the initiatives of the ruling government.
The Japanese government has already postponed the Tokyo Olympics 2020 event to July 2021, till the situation gets normalised in all over Japan, and the world. The national emergency is likely to extend for more weeks, with slight liberties. The workers in Japan are facing uncertainties due to the outbreak, and they are willing to return to work to lighten their economic burden. Based on research findings by the country’s leading newspaper The Japan Times, the social distancing measures might be essential until 2022 to reduce persistent outbreak following the initial wave. Whatever situation arises during the Coronavirus phase, Japan has enough competence to manage it at national level. However, it can be said with some certainty that in the future, COVID-19 would damage the Japanese position of being advanced country, internationally.
