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.

“‘Recommendation to Take Leave of Absence from School’, Seeing Students….”, A Follow Up from Seattle

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In my last posting, I have reported to you about seeing and having dinner with three Japanese students in Seattle.

Two of them posted columns about our dinner on their blogs.  They even had photos uploaded.

I will introduce to you their blogs here for you to take a look; Ms. Tomo and Mr. Miyamoto  (both blogs are in Japanese).

I could see from the students’ comments  (in Japanese) that Japanese universities, probably because of lack of experience, are having a bit of difficult time trying to organize the procedures for student’s taking leave of absences.  However, if more students go on to file in the applications, I think university administrations will eventually learn to handle them more efficiently.

By the way, it seems that quite many private universities charge considerable amount of tuitions even while the students are on leave.  This is stupid.  Universities are halls of education more than anything else.  I strongly wish such weird thing as putting the cart before the horse to be stopped.

The objective of education is, after all, to encourage the youths to seek their potentials, and to support their future.  It is a pleasure and a vitalizing experience for me to read the writings of the students who are currently on leave of absence, as those whom I have introduced to you today.

 

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).

Meeting of Enthusiastic Youths Who Heard Their ‘Inner Voice’ and Jumped on to Action

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Considering how difficult it is to find jobs today, the future of youths seem to be quite unpromising.  There are, however, a small number of grown ups and entrepreneurs working actively to support young people.  The ‘Fresh Career Course’ by Pasona (Ref.1,2)(in Japanese) designed to support new graduates is one of those examples.  I think these actions are wonderful.  I, too, participate as one of the supporting members for such right and compassionate actions.

On the other hand, there are increasing number of young people who have found what they really want to do through ‘on the site experiences’, in search for ways to reach the goals, and stepping forward towards the goal with great effort.  I wish to support them sincerely in my own capacity as I have introduced to you more than several times in my site (Ref.1,2).  
 
Two days ago I had guests at my office who gathered in spite of the heavy rain we had that day; Ms. Kanae Doi of Human Rights Watch, Mr. Shigeyuki Jo  (in Japanese) of Joe’s Lab, Mr. Yuske Matsuda and Mr. Kota Fukazawa, working hard to get on track their recently founded ‘Learning For All’ (in Japanese) (a group set up in preparation of the Japanese version of ‘Teach For America’ which I have introduced to you in this site 2 years ago ), Mr. Naoto Miyahira  of Soket and his colleague (Dr. Arai of D-Lab Japan).  My intention was to introduce them to each other to have them tell their ‘stories (monogatari)’ so that they may ‘connect’ and ‘expand horizontally’ as they see fit.  I am quite positive that many future-looking enprepreneurial activities will emerge and expand through them.

Youths hear their ‘inner voice’ through their ‘first hand experience’ and then be awakened, filled with passion.  Good examples include Mr. Saisyo and Miyoshi, students of Waseda University (on leave) and their colleagues who are currently working hard in Bagladesh (I have introduced them to you a number of times here (Ref.1) ), senior students who responded to my message of ‘Take Leave of Absence from School’, suspended their job hunting activities, took leave of absence from school and went to Moscow or is going to Ghana next week.

These students have much stronger ‘gut’ or ‘deep inner' feeling of the essence of important matters than most of the grown ups who always respond with ‘Reasons Why Something Cannot Be Done’.

We, the grown ups, should support and encourage those youths, but never interfere or obstract their paths.  This world is changing in a great speed.  The future of the young generation is the top priority for human resource development and the future of Japan.

 

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 ?

Hayman Island, ADC Leadership Retreat -1

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Please click here for the photos.

After attending two conferences from the morning on August 27th, I returned home to pack my baggage and be at Narita late in the afternoon.  This was the reason why I was unable to attend the lecture of Professor Sandel.

The plane took off from Narita shortly after 9pm arriving at Brisbane Airport at 7am after a 9 hours’ flight.  The cabin was not too spacious although I was in the business class, the seats did not become near-flat, so I did not get much sleep.  At Brisbane airport I spent 4 hours for transit to JQ (JetStar) for an 1hour and 40 min. flight to Hamilton.  Then finally I got on a cruiser to Hayman Island. At last I am here to join the  ‘ADC Forum Retreat’.  Regretfully I have been unable to accept their kind invitation for a few years because of my schedule elsewhere.

Most of the people on the cruiser were those who came for the meeting.  Inside the cruiser was very comfortable, cruising moved smoothly on the quiet surface of the sea, we enjoyed the nice view of many islands that the boat passed by.  A whale was seen along.  We were told that we were cruising along the route of the whales.  The weather was not too wonderful but was not too cold either.  I think it was about 70?.  A bit cloudy, rain might be falling any minute.

As we were enjoying glasses of champagne and conversation for about an hour, the boat arrived at the Hayman Island.  We wasted no time to check in to the hotel and were guided to our rooms by 4pm.  It took quite a while for my baggage to be delivered to my room, however.

The time flew quickly and the ‘ADC Form’ (Ref.1) started at 4:45 pm.  Since I was scheduled to be on ‘Opening Plenary: Australia ?Big questions and new unknowns’ I had no choice but to go to the venue and on the stage in my jeans (to my relief everybody was dressed casually, no one had ties on…)

The federal election of 6 days ago resulted in both Liberal/National coalition (Mr Abbott) and Labor (Ms Gillard) parties gaining less than half of the seats by a few seats, both now starting to negotiate with the minority parties for cooperation.  Such phenomenon (is called ‘Hung Parliament’, maybe the same as the ‘Twisted Parliament (Nejire Kokkai)’ in Japan) was never experienced in this country in the past.  So the argument follows that this might be the end of the ‘Era of 2 Major Parties’.  The same thing happened at the General Election in Great Britain, remember?  Maybe this shows how values of the people are changing and diversifying in this global age beyond just two parties to choose.

The Opening Panel was hosted by the well known anchor person of BBC, Nik Gowing , Part-1 started with a 15 minutes’ comments on the federal election by Ms Annabel Crabb, the chief political writer of ‘ABC Online’, followed by the vibrant discussions by 3 Panelists.

Part-2 started by a 20 minutes’ speech by ‘Lord Nicholas Stern’ on Climate Change and (its) challenge for economic growth, reflecting analyses of economic growth cycle led by technology innovation, each lasting 50-60 years after the industrial revolution; with changes in social structure and function.  Then followed a panel by Dr Raghida Dergham, a columnist and a reporter on diplomacy, Bror Saxburg, Chief Learning Officer of Kaplan, Dr. Daniel Shapiro of Harvard University and myself.

Both discussions at ‘Part 1’ and ‘Part 2’ were extraordinarily interesting and stimulating.

The federal election in Australia is one thing, but on the other hand, in Japan, there were 5 prime ministers in 4 years after Mr Koizumi, and just a week ago Mr. Ozawa announced that he will run for the head, thus for the prime minister, in the Democratic Party of Japan which means that we might have 6 prime ministers in 4 years.  In Australia, the latest election result raised a big political discussion.  How about Japan?  Aren’t we too optimistic, too easy going, not analytical on agendas of canditates, and implications?  Anyhow the way of thinking and behavior of our ‘leaders’ are ‘in the teacup’ mode – just too much.  Good grief….  Nor do I recall hearing any sort of ‘national vision and strategic policies for the issues’ from any of those leading legislators to begin with.

At dinner, I was seated next to Lord Stern so was able to have a very good intensive discussion with him.  This was a great bonus for me.  Actually, I missed chance to see him in Tokyo for 2 times in these two years.  This was a part of our conversation, too.

After dinner, the final session ‘Science, Public Policy and the Elusive Common Ground’ started at 10pm.  I was one of the 2 panelists with Prof Penny Sackett, the ‘Chief Scientist for Australia’ for the Australian government.  This 1 hour session was hosted by CSIRO’s CEO, Dr Megan Clark.

The whole day was full of learning and pleasure.