| Invited Lecture(JGES) |
| Sat. November 2nd 11:30 - 12:00 Room 7: Portopia Hotel South Wing Ohwada C |
| Positive and negative aspects of American medical system | |||
| Makoto Nishimura | |||
| Memorial Sloan Kettering Cancer Center | |||
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| The American healthcare system is often regarded as advanced in various aspects. In the field of gastroenterology, while the endoscopic equipment itself shows little difference between Japan and the United States, the disease profiles shaped by racial differences are notably distinct. In Japan, the focus on early detection of gastric cancer has been a national priority, leading to a significant emphasis on mucosal lesion detection and treatments like Endoscopic Submucosal Dissection (ESD) in endoscopic practice. In contrast, gastric cancer ranks 11th in overall cancer incidence in the U.S., where the absence of routine gastric cancer screening often results in late-stage diagnosis. Consequently, the U.S. lags behind Japan in terms of the diagnosis and treatment of mucosal lesions. On the other hand, significant advancements have been made in the U.S. in the diagnosis and treatment of advanced cancers, particularly Barrett's esophageal cancer, with the development of various ablative devices, cryotherapy, and photodynamic therapy (PDT). The structural differences surrounding medical care are also substantial between the two countries. One notable example is the presence of Advanced Practice Providers (APPs) in the U.S., which allows physicians to focus more on their specialized tasks. For instance, the process of scheduling endoscopic procedures involves multiple roles, such as appointment coordination, patient communication, insurance verification, and preoperative medication checks, all of which are handled by different personnel. This division of labor reduces the burden on physicians, enabling them to concentrate on their clinical duties. Another significant difference lies in the healthcare insurance systems of the two countries. Unlike Japan, which has a universal healthcare system, the U.S. relies on private insurance, with public insurance available only to some elderly individuals. This system leaves many, particularly immigrants, without adequate coverage, creating a significant social issue. Although the rising cost of healthcare is a major challenge in the U.S., the healthcare industry itself remains a thriving sector. In 2023, healthcare expenditures in the U.S. exceeded $4.8 trillion, surpassing the growth of GDP, with per capita healthcare costs reaching approximately $13,000, far exceeding Japan's per capita healthcare cost of around $2,400. |
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