Structural and historical aspects of the healthcare delivery systems

HCA 4303, Comparative Health Systems 1

Course Learning Outcomes for Unit III

Upon completion of this unit, students should be able to:

1. Identify the strengths and weaknesses of Eastern and Western style medicine by comparing and
contrasting the historical and structural aspects of two country’s systems.

Reading Assignment

Chapter 4: The Healthcare System in the United States

Chapter 6: The Healthcare System in Japan

Unit Lesson

Imagine going to your family physician’s office after several weeks of unexplained lower back pain. Although
you were hoping to heal naturally with rest, analgesics, and perhaps a heating pad, you finally admit defeat
and decide you must see a provider. You anticipate being x-rayed, receiving a diagnosis that sounds Latin,
and a prescription—perhaps a strong muscle relaxant and physical therapy. Your only real hope is that
surgery will not be required to cure the pain. After being checked in by the receptionist and screened by a
registered nurse, your vital signs are measured and recorded, and you are escorted to an examination room
where you are instructed to remove your clothing and put on the loosely fitted gown to await the physician’s
arrival.

As you look around the room, you notice diplomas from several schools of medicine at Ivy League
universities, a current state license, and evidence of Board Certification. You feel very confident in the
physician’s capabilities and rest assured that you are safe medically. When he arrives, he greets you warmly
and asks to examine your back. He palpitates numerous areas in various ways. Then, he asks you to sit up
on the edge of the exam table. His response is stated quietly and confidently, “you have lower back strain
caused by stress. You need to begin to pray and medicate for at least 30 minutes each day. Make an
appointment to come back and see me in two weeks. I’m sure you will feel better by then.” As he leaves the
room, a number of emotions begin to surface: disbelief, confusion, uncertainty, frustration, and even anger.
This would be descriptive of the average American’s response to the situation.

In the United States, we practice “Western medicine.” We anticipate a prescription pad and feel somehow
cheated if there is no complex explanation for our anatomical discomfort. However, if you lived in Japan and
had that same situation, you might very well be grateful for the positive news, thank the physician profusely,
and begin to follow his or her instructions at your earliest opportunity. Physicians trained and practicing in
Japan practice a combination of Western medicine and “Eastern medication.” In this unit, we will discuss the
numerous similarities and differences between the two approaches, and you will use this comparative
analysis to write a 300-word paper comparing three strengths and weaknesses of the history and structure of
both the United States and Japan.

According to Suzuki (2004), the use of Complementary and Alternative Medicine (CAM) is increasing rapidly.
Based on the research, more people worldwide are using CAM than are those practicing Western medicine.
This is significant for those of us in the United States. We tend to believe that the rest of the world
experiences health care very much in the same way that we do here. However, as we will see throughout this
course, that is not the case.

Unlike Western countries, part of Kampo medicine (Japanese herbal medicine) and acupuncture are covered
by the public health insurance (Suzuki, 2004). This is significant since 100% of Japan’s citizens are covered
by a public insurance (Lovett-Scott, 2014). The United States has only recently began to contemplate a form

UNIT III STUDY GUIDE

A Comparison of Both Current
Structure and Historical Perspectives:
The United States and Japan

HCA 4303, Comparative Health Systems 2

UNIT x STUDY GUIDE

Title

of universal health insurance, and it is not likely to include CAM. As you know from previous courses,
chiropractic care is only now being covered by major third party payers in the United States primarily because
it is not a perfect fit into Western medicine. Although approximately 50% of Americans use some type of
CAM, it will likely be a few more years before techniques used in Eastern medicine are covered.

Suzuki (2004) classifies CAM into four basic groups. The first is alternative medical systems. These include
traditional Chinese medicine, as well as a variety of homeopathic and naturopathic medicine techniques. The
second group is mind-body interventions. This includes meditation, prayer, mental healing, art, dance, and
music therapy. Third, the manipulative and body-based methods include chiropractic or osteopathic
manipulation and massage. The final category is energy therapies that include Qi (the body’s natural energy)
therapy, therapeutic touch, and the use of electromagnetic fields. Other popular techniques include
acupuncture, acupressure, reflexology, and aromatherapy.

Below, you will find a chart that describes other commonly accepted differences between Eastern and
Western medicine. Use it as a guide while reading Chapters 4 and 6 as well as when you are writing your
assigned paper for this unit.

TOPIC EASTERN VIEW WESTERN VIEW

1. Origin of the
Approach

Chinese medicine
can be traced back
many centuries and
is often credited for
developing much of
the knowledge and
many of the
techniques.

Knowledge and
techniques are
typically credited to
European medical
schools that sprung up
inside the United
States in the 1800s.

2. The Definition
of Being
Healthy

A balance between
mind, body, and
spirit

The absence of pain,
symptoms, discomfort,
physical, or mental
defects

3. The Definition
of Being
Unhealthy

An imbalance or
disharmony of the
natural body energy
known as “qi”

A defect of the bodily
(including mental)
structure with a cause
and symptoms

4. Meaning of
Symptoms

The body’s way of
showing that it is
healing

A sign of illness to be
eliminated or at the
very least suppressed.

5. The Cause of
Illness

Any action that will
cause disharmony
of the qi

A foreign pathogen or
force from outside the
body

6. Patient’s
Responsibility

To prevent illness
and live a healthy,
harmonious lifestyle

Personal lifestyle
beginning to receive
attention (diet,
exercise, smoking,
alcohol, etc.,) but
focus is still on
healing, not on staying
healthy

7. The
Physician’s
Role

An assistant to help
people stay healthy
and harmonious

A mechanic to find
and fix what is broken
or not working.

8. Goal of
Treatment

To restore balance
through lifestyle
changes and other
natural means

To suppress
symptoms–usually
through medications,
treatments, or surgery

HCA 4303, Comparative Health Systems 3

UNIT x STUDY GUIDE

Title

9. Major
Strength

The recognition of
lifestyle’s impact
and a focus on
prevention

Ability to treat
structural defects as
well as life-threatening
illnesses through
trauma care and
surgery

10. Major
Weakness

Often seen as
“second best” within
the medical
community

An overreliance on
pharmaceuticals and
an inflated cost that
burdens the economy

Hopefully, you enjoy this unit and gain several important insights that you can use to prepare your personal
manifesto in Unit VIII. There is much that Westerners can learn from studying and embracing the centuries-
old Eastern medicine techniques!

References

Lovett-Scott, M., & Prather, F. (2014). Global health systems: Comparing strategies for delivering health

services. Jones and Bartlett Learning.

Suzuki, N. (2004). Complementary and alternative medicine: A Japanese perspective. Evidence-Based

Complementary and Alternative Medicine, 1(2).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC516460/

Key Terms

1. Complementary and alternative medicine (CAM)
2. Cultural competence
3. Gold plan
4. Managed care
5. Primary care
6. Universal coverage