The Truth of Healthcare 2030–2040: The End of Healthcare as Seen by a Downtown Hospital Director

"Your stories are interesting." This book was born from that single comment made at a cross-industry networking event. There are many books where medical professionals defend their own positions. The Ministry of Health, Labour and Welfare also releases a vast amount of data. However, I believe there are few books told from the perspective of those receiving medical care.

In reality, democracy and theater are closely interrelated, and this connection has been discussed in Western philosophy and political theory from ancient times to the modern era, as represented by the theories of Plato and Rousseau. Furthermore, recent research examines various characteristics of theatricality with the aim of developing egalitarian ideas suited to a diverse modern society, improving the aesthetic judgment of citizens in evaluating politics, and encouraging more active political involvement by citizens.

In Chapter 1, I discuss what the aging society looks like based on the dementia patients I have encountered. Please imagine a daily life where the town is overflowing with people with dementia. In Chapter 2, I describe a future where ambulances cannot find destinations, the elderly and those with dementia are refused admission, and even healthcare in the Tokyo metropolitan area is paralyzed. I list numerous challenges facing the medical field and express concern that young people, unable to envision a bright future under these conditions, will flee abroad. In Chapter 3, I use my own hospital as an example to describe a dead-end situation where, due to medical cost reduction policies as well as a declining birthrate and aging population, labor shortages and deficits occur, making it impossible to rebuild or implement IT systems at a time when modernization is necessary. In Chapter 4, I explain the reasons why small and medium-sized private community hospitals are disappearing—just as greengrocers, fishmongers, and old small factories have vanished from towns—based on legal systems and policies.

Furthermore, I point out that the cause also lies with the citizens who are the users. In other words, "Is it enough for healthcare to just be cheap?" Just as the rice shortage problem arose, patients must also become wiser. Now that the success of the National Health Insurance system has backfired and caused systemic fatigue, we must seek fundamental solutions.

In Chapter 5, I introduce the medical situations abroad and explain their pros and cons. Both the American-style free-market economy model and the Nordic/British-style advanced social welfare model are at a standstill. Where should Japan aim? In Chapter 6, I present a prescription to save us from a disastrous future. To resolve regional disparities and labor shortages, it is necessary to thoroughly utilize IT to improve operational efficiency. This requires fundamental legal reforms, expansion of scale, and the introduction of business sense.

It is no longer possible to manage through the self-help efforts of small and medium-sized private hospitals alone. I took up my pen because I want the public to understand how serious the situation is.

The Truth of Healthcare 2030–2040: The End of Healthcare as Seen by a Downtown Hospital Director

Yoriyoshi Kumagai

Chuko Shinsho La Clef

248 pages, 1,155 yen (tax included)