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The US also has GDP per capita of $90k and Japan has a GDP per capita of ~ $35k.

Put another way, in both countries a hip replacement surgery is almost exactly 1/8 of someone's per capita GDP.

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Too bad Walmart greeter isn't making "per capita GDP".
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The Walmart greeter also isn't paying for the bulk of their healthcare expenses because Walmart provides subsidized health insurance to all employees who work at least 30 hours per week. All US employers with at least 50 employees are required to do so under the ACA. If the greeter worked fewer than 30 hr/wk, they wouldn't get insurance through Walmart, but they would likely qualify for an ACA subsidy that covered close to the entire cost of a health insurance plan on the marketplace.

The statement, "The US spends ~$14,570 per person on healthcare. Japan spends ~$5,790" is about the average amount that the country as a whole is spending per person on healthcare, not what any given individual is paying. Per-capita GDP (i.e. the average economic output per person) is the most relevant comparison.

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Some quick googling suggested cashiers at Seiyu in Japan earn $7-9/hour USD while Walmart is about double that.
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If the Japanese cashier makes half the amount, but spends only 1/3 on healthcare that still seems to favor Japan
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Well sure, then you're kinda cherry picking data that could easily be considered within a margin of error to make a rather unconvincing point
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It is not cherry picking to respond to presented data
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It's cherry picking to describe the typical worker experience? You do realize that vast majority of Americans don't make more than $100k right?
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Whats your point, US healthcare is ridiculously expensive to detriment of all US citizens sans those working for health insurance conglomerates. Any objective data you pick will show this, no need for strawmen.
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It’s really good for clinicians and their paychecks, too.
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They make more than they would in Japan. But people can make $0 in any country. Regardless, part-time Walmart greeters are fortunately not paying full price for health insurance in the US.
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put another way, they're so poor that the US gov has to subsidize their healthcare since they couldn't get insurance or care otherwise.
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I'm curious what you're implying. Is there a country where the poorest person is so rich they can get all the insurance and care they require without government subsidy?
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The median salary in the US is around $61k a year and in Japan is around $42k a year. Salary-wise the difference is not as big as GDP per capita
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This is called "purchasing power parity". There's an official index for it, as well as ad hoc measures like the Economist Big Mac Index.

To some extent it's circular: the US has a higher number of GDP because it spends more on healthcare. The broken leg version of the broken window fallacy.

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This is an excellent point. Another comment pointed out that the gap in median salary is not as great as the gap in per capita GDP. Depending on the causes this and lower prices may mean Japanese are better off then Americans - e.g. if there is greater self-supply within households that would not be captured by GDP.
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The difference that using percentage of GDP instead that Japan moves close to the European countries. The US remains a very expensive outlier.

https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locat...

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The important question is: which fraction of people can afford it in either country?
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“someone” in this case is in the 73rd percentile in the USA and ~40th in JP.

So the USA is still significantly more expensive as a portion of actual income. “GDP per capita” is a relatively useless figure

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This feels like a misleading ratio, it's just saying the cost is the same in per capita terms but says nothing about the absolute cost or more importantly cost as a percentage of income, which matters for the majority of people in the denominator of the GDP per capita calculation.
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But also age-related care is by far the largest share of medical care costs, and Japan has no lack of very old people. Being unhealthy also often reduces the amount of procedures someone is eligible to receive. Despite the blame people throw on unhealthy people for medical costs, they ironically often cost less because of the reduced care and lower lifespan which cuts out a significant amount of age-related healthcare costs. One could argue dieing at 60 instead of 90 is a big loss socially and personally, but overall financially it is a benefit.
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Japan has an age fraud problem which inflates its life expectancy: https://en.wikipedia.org/wiki/Sogen_Kato

"The discovery of Kato's remains sparked a search for other missing centenarians lost due to poor recordkeeping by officials. A study following the discovery of Kato's remains found that police did not know if 234,354 people over the age of 100 were still alive".

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I suspect you would see the exact same trend comparing Japan and the U.S. in transit, education, and many other services. The U.S. spends more per capita to get less.
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The US is a wealthier country and wages are higher here than Japan.

The median equivalised household disposable income of a US household is over twice that of a household in Japan.

This is one of many reasons why it’s so misleading to compare prices across countries in a vacuum. All of the people doing the work for those education, transportation, and other services and all of their inputs aren’t going to work for Japan-equivalent pay when they’re living in the United States.

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The wage adjustment is worth testing with data. Japan's GDP per capita on a PPP basis is roughly $47,000 versus the US at $80,000, a 1.7x income gap. The per-capita healthcare spending gap is $14,570 vs $5,790, a 2.5x ratio. Healthcare costs outpace the income gap by a meaningful margin even on PPP terms.

The outcome data is what makes the adjustment argument hard to sustain. Japan has the highest life expectancy in the OECD (84 years) and the lowest infant mortality (1.7 per 1,000). If higher spending were buying proportionally better outcomes, the wage argument would carry more weight. The US spends 2.5x more and gets worse population health statistics. PPP narrows the gap, it doesn't close it.

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Median salary in the US is barely $45k a year:

https://www.ssa.gov/oact/cola/central.html

So what you're describing is even worse.

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The above was comparing the average in Japan to the average in the US. If you want to compare medians, it’s about $43,000 in the U.S. (2023) versus 3.96 million Yen (2025). See: https://e-housing.jp/post/average-salary-in-japan-2024-insig.... At current exchange rates that’s about $25,000. So that’s the exact same 1.7x ratio as for the averages.
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In domains like healthcare, education and transportation, the cost is primarily labour. A wealthier country pays its workers more, which gets passed down in higher prices to its consumers. And, while healthcare and education do not benefit from economies of scale, transportation does, so the denser population gets cheaper transportation per capita.
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Not in iPhones!
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> The difference in life expectancy will be influenced by multiple factors and may have more to do with diet and lifestyle than with healthcare

Less than 5% of Japanese are obese (BMI >30) compared with 36% of Americans, additionally 1 in 10 Americans are severely obese (BMI>35) whereas the number in Japan is negligible.

https://theworlddata.com/us-obesity-rate-compared-to-other-c...

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Japan also has the "Metabo Law" (aka fat tax). Do you think Americans would go for that?
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"Obesity costs the US healthcare system almost $173 billion a year."

So that's about 6% of the difference? I'm not immediately saying no, but it sounds like that's not the real problem.

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That 6% number isn't even close to accurate. There are many other very expensive chronic conditions that are downstream of obesity including type-2 diabetes, heart failure, hypertension, MSK injuries, etc. We are digging our graves with our teeth.
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Although I tend to think we overwork the working class such that they have no energy to keep up their health, so this would basically be taxing them because they're poor in many cases.
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Except all those things reduce peoples lifespan, and age-related care is by far the most expensive medical care.
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Social reasons it would never work. I hate to mention anything race related online but simple truth is America has complicated history and African Americans are 30% more likely to be obese than White Americans and also earn approximately 60% of income that whites earn. A fat tax, especially one that properly allocated the cost burden to the individual, would erode race relations.
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Is that controlled for income / poverty levels?
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It doesn't matter as the cited numbers will be cherry picked.
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fwiw the “tax” in Japan is not paid by the individual, and generally taxing the behavior via e.g sugar taxes rather than the outcome has worked better without much public outcry after the fact
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Not sure that would play the same in US though.

Black population in the US is still concentrated in neighborhoods formed by overt racism and segregation and same neighborhoods tend to be food desert where no healthy or even fresh options exists. Even if we taxed just the bad food, the lack of options and mobility that higher income might provide, basically means it’s something that would be seen as targeted. Not to mention, people will draw the most racist perception no matter how carefully you crafted the tax because race relations are always unfortunately weak and these correlations are being forced/drawn.

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Fat shaming! ... It makes me sad whenever I hear that response to any mention of the health problems associated to obesity.
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It’s what all of Asia does and it’s very effective. Make people’s weight their primary problem until they resolve it. It’s not like it is some unchangeable attribute that can’t be fixed through self control and discipline. The shaming is just unsolicited motivation that works. I feel sad if people are made fun of for attributes they can’t change.
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If everyone could control their weight via simply willing themselves to have more self-control, then nobody would be fat.

Self-control is, ironically, not usually within one’s self control.

Most people don’t contemplate very deeply about the gap between their will and their behavior. I’m extremely focused on self-determination and it’s absolutely astounding (and irritating) to me how little control I have over my actions relative to the control that circumstances have over me.

Your attitude about the matter is common, and seems like plain old common sense. It’s also dead wrong.

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> Self-control is, ironically, not usually within one’s self control.

Problem solved. Next!

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Companies make a fortune from creating that lack of “self control”
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No, they didn’t create it. They created the circumstances where it causes certain types of purchasing and consumption behaviors. The lack of self control was always there, just waiting for those circumstances to bring out the effects of the lack of self control.

Most people vastly overestimate how much they are actually in charge of their life.

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Metabo is a saw producer, so cut fat in half should be their motto. /JK
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The US has a high variance population. Aggregating the US into a single mean or median for that matter is a fool's errand.
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Japanese Americans have a slightly higher life expectancy in the US (87 years) vs Japanese living in Japan (85 years).
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Try seeing a doctor in Japan as a foreigner. Just a simple consult costs $300 USD or so, and it goes up from there. It's actually a rather expensive system.
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This is absolutely not true. I pay the equivalent of about $40 for X-rays and blood tests. A simple consultation is about $15, if that. I recently got diagnosed with asthma, and the whole set of tests plus a month of medicine came out to about 6000 yen, which I suppose is $40.

The only reason you would pay that much is if you're visiting a private no-insurance clinic and not using insurance. And private clinics pretty much only exist to prey on people who identify as expats and make zero attempt at learning non-English languages, aside from a few exceptions (certain speciality dentists, plastic surgery, anonymous STD treatment, some cancers).

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The whole debate is about what insurance companies are paying for those services, right? It's when one walks in without insurance that you see the true cost of the service.

> The only reason you would pay that much is if you're visiting a private no-insurance clinic and not using insurance

What alternatives does a tourist have? If Japan truly had cheaper procedures, it would see a huge uptick in medical tourism. There's no doubt that Japan has state-of-the-art facilities and treatment options, comparable to the US. It's no surprise that costs are comparable too.

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That doesn't seem more expensive to what I generally pay in the US.
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Exactly, it's roughly on par. The OP was claiming it was significantly cheaper.
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The Japanese system is amazing. Cheap drugs, cheap dentistry, no wait times and reimbursements for all kinds of things (government covered more than 100% of childbirth cost - yes we got more back than we paid). But the best part IMO is the emphasis on preventative medicine. My wife and I get annual checkups which cover a whole range of things including screening for various kinds of cancer.
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It "may be other than health care" but most (all?) other modern nations on multiple continents in multiple cultures spend less percent GDP on healthcare with longer life expectancy than the US
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> Japan also spends less per capita than the UK, France or Germany

These have to be purchasing power adjusted.

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We in Germany copied a lot of the stupid stuff from America (including the stupid billing system for inpatient stays), so it's not that surprising that our system is also bad value for money.

PS: Outcomes here are not worse than those of rich people in the US, because I know some idiots will claim this to cope

https://jamanetwork.com/journals/jamainternalmedicine/fullar...

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Germany didn't copy the US - they just happen to share similar roots.

Both historically had private hospital systems, and just so happen to implement pension/employer-based insurance programs very early on. German's just evolved in one direction and the US evolved in the other.

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We copied the DRG reimbursement System from the US.

And no, we didn't had a historically significant share of private hospital systems, those came with the introduction of the DRG System, which forced many city/church owned hospitals into privatisation.

Before that, they had a "Fixed Price per Night" System, which also was a bit stupid, before that they got reimbursed their cost.

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Actually Germany is a lot better value for money than the US. The cost (either absolute or as a percentage of GDP) is similar to the UK or France, and from what I have been told by people who have lived in both countries, the German system is better than the British.
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