Comparing Healthcare Systems - A View from Japan

Visiting anthropologist Daiki Ayuha from the University of Tokyo reflects on his time at the Centre

Firstly, I would like to state my appreciation to all the people at Centre for Biomedicine, Self and Society (CBSS), for supporting me during my stay. I especially would like to express my gratitude to Dr Martyn Pickersgill and Dr Sarah Chan for accepting me as a visitor and for coordinating my visits. I am also grateful to ESRC and AHRC, which have funded the bursary for UK visits.

My research subject is a qualitative or anthropological understanding of welfare states, especially healthcare service systems. So far, I have been engaged in fieldwork on the Indonesian healthcare system is co-shaped by regulations, practices, and technologies from many disciplines. After the fieldwork, I have realized the importance of comparative viewpoint for a deeper understanding of how unique trajectories of healthcare systems in different countries have engendered unique ways of how our health, bodies, and behaviours are managed and controlled in each context.

Japan's National Health Insurance is characterised by free access to healthcare providers including hospitals and fee-for-service payment to healthcare providers. Indonesia's National Health Security scheme has similar healthcare providing scheme to UK's NHS, such as capitation funding to its primary healthcare providers and referral system to higher healthcare providers, apart from its funding is based on social insurance premium. Comparing the UK's NHS to Japan and Indonesia's health service schemes provides insights into the conceptual question of what it means for us to be enrolled in health service systems.

During my stay, I have met and discussed with several staffs at Usher Institute, who work as academic staffs but have backgrounds as clinical practitioners. Because they are sat somewhere between academism and clinical practice, discussions with them have been quite helpful to understand what is it like to work inside NHS as general practitioners or nurses.

Last but not least, joining the workshop, which was handled by Dr Sarah Chan, and sharing and discussing research interests with CBSS researchers and other Japanese researchers, who also have visited UK under the same ESRC/AHRC bursary, has been a quite exciting experience. Discussions during my stay in Edinburgh are insightful not just for my future research plans of comparative work but also for deepening the analysis of data I have collected so far.