Since we’ve spent the last month discussing the problems existing in the American healthcare system as well as possible reforms, I thought it might be useful to consider the highly successful Japanese healthcare system as a model. While Japan spends 5.4% less of its GDP per year on healthcare than the Unites States, unlike the US, Japan provides universal coverage to Japanese citizens. The Japanese system requires all citizens to purchase health insurance. Insurance companies pay privately owned service providers directly at rates set by the government. All employees in Japan are provided health insurance by the Social Insurance System (SIS). Employers shoulder between 50-80% of the cost of insurance, while the remainder is covered by premiums paid by employees based on their financial ability. The average worker’s premium is 4% of their salary. Citizens who are not employed are covered by National Health Insurance (NHI). A third insurance agency caters specifically to the healthcare needs of the elderly. Patients are allowed to choose their own doctors and preferred facilities. This system seems to integrate private healthcare providers with government subsidy quite effectively in a way that might appeal to insured American voters preoccupied with maintaining the freedom of choice they have with private insurance companies. While the Japanese system is highly successful on a whole, primary problems include long waits to see doctors and a shortage of doctors and medical facilities in rural as compared to urban areas.