Speech on Healthcare Policy

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My reports are somewhat delayed than usual, but I have returned home on October14th from a slightly long travel which started on 5th.

Next day in the morning, at the Denmark Embassy in Tokyo, I gave speech on ‘Healthcare Policy for the Aging Society’ to the audience of about 30 or so of legislators and other members of Denmark’s delegate visiting Japan.  I was told that  Ambassador Melbin  (Ref.1) and the audience enjoyed my speech.  (by the way, around April or so, I went to see the Ambassador to talk about the World Cup; and, of course, the Japan-Denmark match….)  The discussions in Seattle turned out to be very helpful in preparing my speech.

After leaving the Denmark Embassy, I headed to Haneda airport to fly to Matsuyama.  The Panasonic Shikoku in Matsuyama is focusing on healthcare and they asked me to speak on topics on ‘Healthcare Policy for the Aging Society’.

I was being so focused on this theme for these days, so I was able to learn much from these events, and also was able to develop new ideas.
 
Developed countries share common challenges; ‘1. Continuing growth of the aging society, 2. Chronic diseases as a major disease burden, and 3. Public funding for healthcare being hard to increase’.  I have written about the framework of my ideas in many occasions, and my view remains essentially the same as of today.  What I think is uploaded in recent On-line article of Nikkei (in Japanese), so please have a look.

These are without doubt one of the top priorities of political issues today.

 

The 100th Anniversary of the Swedish Hospital in the beautiful City of Seattle

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Recently, I have posted a series of reports from Seattle. The distinguished Swedish Medical Center (SMC), one of the oldest organizations in Northwestern America, invited me to participate in their 100th Anniversary celebratory Symposium (Ref.1)at the Bell Harbor Conference Center.  Since I have been interested in their activities for quite some time and the proposed program was quite impressive, I thought this was a good opportunity to experience SMC first hand. The overall theme was local health care systems, particularly in the Northwest regions of America. Experts in various fields joined to speak about their experiences so that they might apply their findings to the ailing American health care system.

The Symposium opened with these videos (Ref.1). I had the pleasure of being seated at the same table as Ms. Lisa Cohen, the Executive Director of the Washington Global Health Alliance and who appeared in the latter video. We spoke and found we had several friends in common. I enjoyed our conversation immensely and discovered that apparently she began her career as a journalist.  

Each person was wonderful in his or her own way. Aside from those in my field of medicine and health care, I was particularly impressed by Mr. Jeffrey Immelt, CEO of General Electric. There were also two congressmen from Seattle who appeared in the panels, Dr. Jim McDermott (Ref.1,2) and Mr. Jay Inslee(Ref.1). Their speeches were very inspiring and innovative.

I found the lectures so intriguing that I ask the organizers of the Symposium to let me know when the rest of the lectures are available on the web.  I would very much like to share them with my friends and the visitors of my web site.   The photos from the Symposium is uploaded on the web already.

There were many debates and conversations had throughout the Symposium, and though there were many things discussed, there were twelve ideas that seemed to be more or less ubiquitously agreed upon. 

Because the Symposium was located along the waterfront of downtown Seattle, I was able to take short walks between sessions. Luckily, the weather was bright and sunny. I enjoyed the views of the Puget Sound, and of the Olympic Mountains. I also stopped by the original Starbucks in Pikes Place Market. I also stopped in at the Seattle Aquarium and saw a variety of fish (I happen to quite like aquariums).  Also, as reported in my previous postings, I met several Japanese students (Ref.1,2) who took leave of absence from school and are currently studying in Seattle. Over the course of two evenings we had a wonderful time together during dinner.   In closing, I found Seattle a beautiful and tranquil city.

From Singapore

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Click here for photos of Marina Bay Sands Resort

I left STS Forum in Kyoto early in the morning of October 5th, made a brief stop at my home, and arrived at GRIPS early in the afternoon.  There, I had a good conversation over various topics with Dr. Han Seung-Soon, the former prime minister of Korea, whom I have met in Seoul just recently.  Then, I took a train from Tokyo Station to Narita Airport, arriving at Singapore at around midnight.

IMG_0008 (2)

Next morning was a board meeting of A*STAR . The discussion was heated from beginning to the end until the meeting closed after lunch.  This board is working quite vibrantly actually.  Budgets are allocated to make Singapore more competitive in science, technology and research, to build new opportunities ? very constructive and active.  A*STAR is also planning a collaboration with Universities in Iran, in order to develop further exchanges of talented students.  Another project is the Liberal Arts course that has a full boarding system which will be offered in collaboration with Yale University.  In short, they are so dedicated to nurturing global talents.  It is a common sense, so to say, that ‘Nurturing Human Talents is the Base of Building of a Nation’ (in Japanese), but it seems quite different in a country who knows where. The problem is that adults, the grown-ups, are ‘closed minded’, and that will make it difficult for our nation to address problems we are expected to face in this rapidly ‘flattening age of globalization’.

Late in the afternoon, we visited the ‘Marina Bay Sands Hotel and Resort’.  First thing to do was to see the fantastic view from the top of the building, looking down the course of F1 autorace track that took place just recently, Marina Barrage  where I had been not so long ago, and right beyond the ocean lies Malaysia and Indonesia so closely.  The premise is a combination of three 57 stories high buildings, with hotel, condo, major convention facility, casino, etc. and a 150 meters swimming pool on the top of the building. The view is just breathtaking.  Elevators moves up and down in high speed ?very fast- but motions are almost unnoticeable.

Its grand scale, however, is not the only thing that impresses us.  Prices are also soaring high; Hotel, Condo (still some vacancy…), Casino (sheer admission cost 85 dollars), and practically anything.  After the tour, I had a nice cheerful dinner with other members of the board.

I recommend that you visit this Sands Hotel and Resort if you have an opportunity.

After returning to the Hotel, I spent about 2 hours with Professor Ito, who has been working vibrantly at Singapore for about 10 years, Professor Yamamoto, new member of NUS faculty, and Dr. Steve Chu, a member of the board of UCLA.  I have known Professor Ito since he was at Kyoto University, but he moved to Singapore after retirement from Kyoto, and was awarded President’s Science Award this year.   I congratulate him for this great achievement.  We are so proud of him.

Why don’t more professors of Japanese universities broaden their world and go out to spread their field of activities instead of sticking around universities even after their retirement, I wonder?  Recently, it seems that many accomplished professors stay at universities taking advantage of their uiversities being Independent Administrative Institutionization (Dokuritsu Hojinn).  This would cause less room availabilities, and I feel sorry for young people.  Yet, more ‘adults’ and ‘professors’ complain that youths today are not passionate about going abroad.  This is a problem.  Mind you, young people are quite aware that their seniors are not being consistent in their words and actions.

Tomorrow, a car will pick me up at 5:15 am to take me to the airport.  I will fly for Toronto from here.

 

Participating in Variety of Projects, and Once Again, About Armchair Quarterback

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On September 28th and 29th, Asia Innovation Forum, as you have read in my website last year, was held again.  It is its fourth year and several small ‘satellites’ were set up.  The sizes of the rooms were smaller, in fact that contributed to making the discussions to be more engaging and participatory, and people seemed to like them.

I joined in the last two panels on the 2nd day (in Japanese).  Panelists in the first panel (in Japanese), besides myself, were Dr. Ishikura and Ms. Ishiguro whom I worked with a week ago at the ‘Marunouchi Career Juku’, as I have reported recently, and with Ms. Kaori Sasaki and Ms. Magsaysay Chou, a business leader from the Philippines.  Here, I was again the only male panelist as was the case at the ‘Juku’ last week.  However, this time, the audience consisted mostly of middle aged or senior men and I somehow could feel the difference clearly from a week ago as I participated in the discussions.

The latter panel was hosted by the same host as last year, Mr. Kusunoki, welcoming Mr. Idei (former CEO of Sony) of Quantum Leap, the organizer of this Forum.  I stayed rather quiet this year.  Many views were presented to answer the question ‘One Thing That Would Bring Changes to Japan’, and many panelist pointed more than one Thing; but I had nothing else to say besides ‘Recommendation to Take Leave of Absence from School’, that would give youths broader choices for their future career.  Traditional system of Japan Inc failed to change for more than 20 years even after the burst of bubble economy in 1990, because of the strong opposing power of the establishments. Whatever things that are said have been said many times in the past, but nothing changed as of today.  I sincerely wish to give hope to youths who have long future ahead of them.  To my regret we have seen hardly any changes during these 10 to 20 years, regardless of many policy recommendations made in terms of legislation or budgets.  What matters is ‘execution of plans’!  I think this problem has become basically ‘a battle between generations’, ie, ‘the past vs the future’ generations.

We may need to think differently when we plan our next Forum.  Since Mr. Idei is a wonderful leader in the business sector, together with him, let us craft plans with even stronger impacts for the next year.

On October 2nd, I joined in the ‘Global Agenda Seminar’ (in Japanese) (Ref.1), hosted by Dr. Yoko Ishikura.  Our guest was Dr. Kano, who now works at the World Bank in Washington DC – such youth like him working in global arena has power to easily connect with the hearts of young people who join this very interesting Seminar.

After the Seminar, I headed for Kyoto in the afternoon of October 2nd to participate in the STS Forum.  This Forum gathers so many leaders from all parts of the world, so I enjoy seeing many friends as well as their interesting panels.

Reports will be uploaded on the web sites of each event, so please keep eyes on them.

My schedule is quite tight, I have to admit, but on the other hand I am also concerned about how slow Japan is in its changing.  I think the Democrat Party administration has to face numerous difficulties lying ahead of them.  They are not yet experienced enough in handling the process of politics and legislative processes.  Will it take another 1 to 2 years for them to work effectively?  Also, it is not good that each minister comment on recent China- Japan problems separately and not consistently as one Cabinet.  Diplomacy must have a good, stable leadership in the government.  Even if the ministers think they are speaking to Japanese only, their comments will quickly be translated and be sent out to the people of the world, in particular, to the governments of nations which are interested in Japan affairs.  Current style of press coverage of these Ministers will serve only to give impression that Japanese government has no governance.

I have once written about the effect of ‘Armchair Quarterback (Okame Hachimoku)’  (in Japanese) in my web site, and in that sense, the mail magazines (in Japanese) and twitter (in Japanese) by Mr. So Bunshu are very thought provocative.  Mr. So has deep knowledge about the way people think and feel both in China and Japan, reflecting his own background and real experiences in both countries.

 

Mr. Jun Kurihara of Harvard Kennedy School

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I have introduced to you for a couple of times in my blog postings Mr. Jun Kurihara, Senior Fellow at Harvard Kennedy School (Ref.1).

He is also a research director of The Canon Institute for Global Studies , hops around the world, and issues ‘The Cambridge Gazette’ in nearly monthly bases.  As you have read in my previous posting about him,  this Gazette is quite good in a sense that you can intuitively sense his broad human network as well as his intellects.

Mr. Kurihara dropped by at my office when he visited Tokyo recently and we had a good time together.  I felt honored to find his comments on our meeting in his latest issue of ‘The Cambridge Gazette’.  As always, this Gazzette is also filled with evidence of his deep knowledge and broad human network.

‘A person like myself would be difficult to be accepted in Japanese institutions.  I think that is why things are like this…’ says Mr. Kurihara, but clearly he is a very valuable asset.  I am sure that if we had more of people like him in Japan this nation would be more lively and active.  If ‘Unique human capital’, ‘Nails that stick out (Deru kui)’ are given more and more places to flourish, organizations will gain energy and youths will have good ‘Role models’ which eventually will make them more positive and active. For organizations, it is important to give right person the right place so as to optimize the talents giving them more chances to flourish.

Domestic and international broad connection based on ‘credibility as individual’, like Mr. Kurihara’s, is a huge asset.  The Canon Institute for Global Studies chose a good member.  Without doubt Mr. Kurihara is one of our precious ‘Human capital’ (similar but not the same as the ‘Human resource’) whom no one can exchange with any amount of money.

From ‘Healthcare System’ Reform to ‘Health and Healthcare System’ Reform: My Basic Idea

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Healthcare system reform is a huge political issue not only in developed countries but also in emerging or developing countries and in global society.  This is because of the rapid changes taking place in the structure of major diseases based not only on the progress of healthcare technologies but also on the enhancement of life expectancy, changes in social structure and in lifestyle.

In addition many societies share the problem of aging population.  Since public funding for healthcare expenditure is already pretty much to its limit even in developed countries this is another big challenge.  Also it is clear that income inequality within and across the countries continue to expand in this global world.

So, Japan is not the only nation that faces problems related to healthcare.  However, there are some reasons particular to Japan that make system reforms particularly difficult here.

This is one of the main themes that we work on at the Health Policy Institute, Japan.

However, in view of such major changes in our society, it is clear that healthcare system must be structured with more attention to social aspects.  In other words, we must take into consideration ‘Social Determinants of Health’ (Ref.1) in our policy, thus we must create not ‘Healthcare (Medical, in principle) System’ as it is but rather ‘Health and Healthcare System’. Otherwise I suspect that winning public support for policy or its implementation would be difficult.

Here, I will introduce to you my recent interview (in Japanese) reflecting such thoughts.

Same perspective is also expressed in my book ‘University Hospital Reform (Daigaku Byoin Kaikaku)’ (in Japanese).

Ohya Stone Underground Mining Pit Remain, Teleconference with Canada, and To Mishima

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In the afternoon of September 24th (Fri.), I headed to Utsunomiya to give a lecture at the Japanese Society of Nephrology Eastern Regional Meeting.  Nephrology had been my main background, so it was nice to see Dr. Kusano, the President, and many colleagues at the venue.

Reception was held at a huge underground hall about 15 minutes’ travel by car from downtown Utsunomiya which was originally remain of a mining pit of Ohya stone (Ohya Ishi).

The place actually had quite a good atmosphere.  I found many photos at the blog site of a person who had been here before. (in Japanese)

Underground was quite cool (around the year average temperature is ８℃ (46F)).  Gyoza, the local specialty, beer, wine were served at the reception as well as the special flamenco show.  We spent a good time.
 
The schedule of events at this underground space, as I saw it, seemed to have room for more variety of activities.

I suggest that you visit here when you have an opportunity to go to Utsunomiya area.

After returning to the hotel, I participated in a teleconference on Grand Challenge Canada  for two hours from 10pm to midnight.  Toronto served as the hub for this telecommunication.

On the next day, September 25th (Sat.), I returned home briefly and then headed to Mishima city in Shizuoka Prefecture.  This trip was to give a lecture at the Japanese Telemedicine and Telecare Association (JTTA) (in Japanese) organized by Professor Nakajima, who created telemedicine and telecare training program at Tokai University School of Medicine mainly for international students.  I owe Professor Nakajima for his presence at the Pacific Science Association in which I am part of, in Okinawa  and Tahiti  (Ref.1, 2, 3).  By the way, although this meeting displayed a number of interesting corporate exhibitions they seemed somehow to be intended only for Japanese audience (users) from the start.   I think this is a pity since the world is broad and there must exist great needs.

Giving lectures at annual meetings of scientific societies was something I have done less for a while.  I enjoyed and appreciated these opportunities of two days in a row.

‘Beautiful’ Resume

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‘Hitotsubashi Business Review’  (in Japanese) is a quarterly magazine read broadly by business people in Japan. Edited by Hitotsubashi University Institute of Innovation Research (Director, Professor Seiichiro Yonekura),  the magazine’s fall issue recently organized a special feature on ‘the 10th anniversary’ of the magazine.  It was my honor to write some of my thoughts to congratulate, together with Mr. Fujio Mitarai, Chairman and CEO, Canon; Professor Ikujiro Nonaka; and Mr. Takuya Iwasaki, Editor in Chief, ‘Diamond Harvard Business Review.

The title of my article is “‘Beautiful’ Resume ("'Utsukushii' Rirekisyo no Jidai")” (in Japanese) . The wording was quoted from a book by Ms. Michi Kaifu  ‘Paradise and Closed Country ? Japan, a Forgotten Great Power (in Japanese, original title ‘Paradise Sakoku- Wasurerareta Taikoku Nippon)’  (Ref.1) (in Japanese). 

Besides the book, Ms. Kaifu is sending out messages actively from Silicon Valley through her blog (in Japanese). What this title means is explained in her book, and by the way, her book is one of my recommended readings because it is filled with good catchy words reaching to the core issues of Japan. 

I borrowed this wording because I thought by this expression Ms. Kaifu beautifully described almost the same idea as what I have been saying, i.e. “build your career by seeing yourself better in the global world through spending some time and competition with peers outside”- you can see your strength and weakness self better and more objectively.

How to build such ‘beautiful’ resumes ? is also the core message of my book with Professor Yoko Ishikura ‘How to Build a Global Career (Sekaikyu Kyaria no Tsukurikara)’.

And examples of how to start this kind of career are to ‘Take a Leave of Absence from School’ , one of my major messages, or the ‘Asian Youths Exchange Program’ in Okinawa.

Our current system of one track career, being promoted step by step within the same organization, starting a career right after university graduation, employment being informally decided at junior year in collage ? the society which take these facts for granted and ‘norm’ should be regarded as ‘outrageous (tondemo)’ career in global and flattening world.  Working lifetime for the same organization must be a choice for ‘the employees’.  However, in government offices and big companies, this single career remains the standard for most people.  Even in universities, where more autonomy and mobility is expected, we see quite a number of ‘Four Lines Biography Professors (yongyo kyojyu, i.e. professors who need only 4 lines for their academic resume staying and being promoted in the same institution)’ (Ref.1) (in Japanese)

Why is it that I (originally in the field of science, an MD) was asked to write for such a ‘business’ magazine?  To be frank I hesitated a bit when I thought about the readers of this magazine, but on the other hand was also pleased.  Perhaps the idea came from Professor Yonekura.  It may be because my philosophy is that whether in business, education, health services, or government, the basics is always ‘B to B’ for all, and ‘how much you are able to see and feel the change’.  In short, my ‘B to B’ is ‘Back to Basics’. The person who continuously emphasizes this principle of ‘Back to Basics’ in business and innovation is Peter Drucker, whom you all know very well.

 

Hayman Island, ADC Leadership Retreat -2

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Please click here for the photos.

The 2nd day at Hayman Island was beautiful.  We should be outdoors in such day.

However, the program was quite packed.  I was scheduled to be at the ‘Kailis Oration’ (Session 6) (cf. the program).  This opening session of Day 2 was again hosted by Nik Gowing.  It was an exciting session starting with questions raised by Bjorn Stigson, the photos linked above which I appear are of this panel (also included are the 2 photos of Nick Stern (facing backwards), myself, and Bjorn Stigson after the panel).

Clyde Prestowitz, whom I met in Tokyo a few weeks ago, is also participating in various discussions starting today.

For lunch session, I joined session 9.5, a panel surrounded by beautiful greens.  Somehow the discussion focused on the issues of Australia.  My colleague William Saito was also on the panel with me.  Chris Selth said that there were few targets for VC, was quite critical in that sense pointing out how dependent Australia was on its rich natural resources for its economic growth…. Then followed the plenary lecture by Richard Wilkinson  (right after session11).  I think that producing such type of academics as Dr. Wilkinson represents one of the strengths of British academic community.
 
Another session was ‘Cybersecurity’ (session 12.2) hosted by Nik Gowing.  William Saito did a very good job here.

On the 3rd day, 29th, I was especially impressed, among many, by Stephan Bungay in session 16.3, and Bror Saxberg of Kaplan (I felt that the power of the US lies in the fact of having quite a volume of extraordinary, brilliant and ‘crazy’ people like him) in session 17.3 ‘Education futures’ whom I have introduced to you in my last report , and my old friend Jeff West (another brilliant and ‘crazy’) in session 20.3.   These sessions were all very moving and thought provoking.

There were of course many other sessions that I would have liked to join, but as you see from the program, doing so was not easy.

My last appearance in the afternoon was with William Saito at ‘Japan -Perspectives on Change’ (session 19.3).  Australia, the host country, has just gone through the federal election which ended in an unexpected result and people here were talking about it excitedly.  On the other hand our story is; ‘Japan?  Well, we had 5 prime ministers in these 4 years.  Maybe the 6th is coming soon?’ ? isn’t this a bit sad?  I tried to include many comparisons and metaphors to make my points of Japan clearly understandable to non-Japanese intellects; perhaps, I somewhat succeeded since after the session I was told by several people that my discussion was ‘very persuasive, clear, and easy to understand’.  I do think that the current (and even the last 50 years') situation of Japan is difficult to understand if we do not present them in a sound logical manner, focusing to the basic issues and from outside perspective.
 
The closing ceremony ended by a very moving speech by Michael Roux, the host.

We enjoyed a nice dinner reception in the evening.

I would say that this 3 days’ retreat was a very nice event of a good size which made it possible to share much more intimate time, even more than the World Economic Forum in Davos (which I posted for many years), with truly wonderful participants to exchange different and common views and share new ideas. I was able to see my old friends, make new friends, see ‘great’ people such as those whom I have introduced to you in my report postings ‘1, 2’ and Gita Wirjawan  (Ref.1) of Indonesia.  I learned a lot from each of them.  Also, I was lucky enough to be asked to join in many good sessions in earlier phase (opening panels of day 1 and day 2) so many new friends noticed me from early of this three days Retreat  I sincerely thank Michael Roux for his invitation and thoughtsfullness.

 

The Economist, Sarcastic But Honest: ‘Food For ‘Zombies’, ‘The Civil Service Serves Itself’

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I would say that ‘The Economist’ competes for the 1st or 2nd position as the most widely read weekly magazines in economy.  This magazine even picks up the issues of its home country, Great Britain with plenty of sarcasms, to report to its people and the world what they need to know.  This precisely is the most important and basic mission of journalism, the foundation for its credibility.  The Economist has its own ‘unique, cool’ style in writings, titles, figures and charts which makes it so special and unsurpassable.

Those, I think, are the reasons why The Economist or Financial Times are so highly evaluated, being read by business people throughout the world.  In short, their works are professional.

Japanese journalism is quite different here.  Basically it is rather on the establishment side as you see for example by the system of members only ‘Press Club (Kishya Kurabu)’ and their reports are in large part targeted to Japanese only, i.e. mere 2% of the population of the whole world.  It is a matter of course then that journalism of the ‘global age’ will not develop in such circumstance. I doubt that they (Japanese journalists) have such ambition to be global in the first place.

I have recently introduced to you in my blog one of the articles of The Economist and here I would like to call your attention to a good sarcasm in the article (1) and another in the ‘On-line’ edition (2).

Please refer to the original for the full text but:
In (1), the subtitle is striking; ‘Food for zombies’(click here for Japanese translation of the article). They write how Japanese government endlessly supports not well performing big companies, and new enterprises hardly emerging, so many no-good companies survive, thus only to become ‘zombies’. This is a keen observation which I totally agree.
In (2), the title is; ‘The civil service serves itself’ describing the irresponsible current mechanism and governance of Japanese bureaucrats or civil servants; they enjoy ‘Descent from Heaven (Amakudari).’ Spending huge amounts of public money for themselves.

The world is noticing the reality of Japan.  What will become of our national credibility?

These days politics seems to be occupied with nothing but their struggles within the party.  Our country is having 5 prime ministers in 4 years – an outrageous nation (Tondemo Kokka) – are we going to have the 6th prime minister beginning later this month?

What has become of the elites of ‘intellect’ of this nation (Ref.1); ‘legislators, governments, industries’ and ‘academics’, I wonder?

Don’t they care any more about the people of Japan?

Does Japan now have to head for the crises ?