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 healthcare 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 considers various characteristics of theatricality to aim for egalitarian thought suited to a diverse modern society, the improvement of citizens' aesthetic judgment in evaluating politics, and more active political involvement by citizens.

In Chapter 1, I discuss what the aging society looks like through the dementia patients I have experienced. 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 transport destinations, the elderly and those with dementia are refused admission, and even healthcare in the Tokyo metropolitan area becomes paralyzed. I list numerous challenges facing the medical field and express concern that young people, unable to see a bright future at this rate, will flee abroad. In Chapter 3, I use my own hospital as an example to describe a dead-end situation where, as a result of not only a declining birthrate and aging society but also medical cost reduction policies, labor shortages and deficits occur, making it impossible to rebuild or implement IT 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 there are causes on the side of 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 smarter. Now that the success of the National Health Insurance system has backfired and caused institutional fatigue, we must seek fundamental solutions.

In Chapter 5, I introduce the healthcare situations abroad and explain their pros and cons. Both the American-style liberal 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 legislative reform, 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)