On April 14, we hosted a special breakfast meeting with Dr. Stephen Morrison, Vice President of the Center for Strategic and International Studies (CSIS) and Director of its Global Health Policy Center.

As many people already know, health insurance and drug pricing systems are being reformed under the administration of Donald Trump. This breakfast meeting was held on the 100th day since the inauguration. The meeting focused on the impact of healthcare system reform in the United States on Japan. This topic was addressed by Dr. Morrison and Dr. Karen DeSalvo, a former director of the Department of Health and Human Services. The meeting was moderated by the president of our institute, Ryoji Noritake.

Dr. Morrison spoke specifically about the prospect of the Patient Protection and Affordable Care Act of 2010 (PPACA), commonly known as Obamacare, or the Affordable Care Act (ACA). According to him, Obamacare broadened health insurance coverage and increased the government’s healthcare budget in order to reduce out-of-pocket expenditures for low-income households. On the other hand, this system increased health insurance costs for people who were already insured, leading to distrust of the government. Dr. Morrison concluded that Obamacare had given rise to an ongoing, heated debate within the United States. He stressed the importance of continuing discussions about the healthcare system.

Dr. DeSalvo, who worked under the Obama administration as the director of the Department of Health and Human Services, brought up some positive examples of Obamacare, and explained the content of the Trump administration’s new healthcare legislation, the American Health Care Act (AHCA). She explained that Obamacare extended to preventative medicine, and was successful from a public health perspective. She also noted how it had contributed to improving the quality of life for many US citizens. She stated that, in her view, the implementation of a value-based payment system had changed the concept of healthcare payments. She also commented that the use of ICT in healthcare in the United States had advanced. Dr. DeSalvo emphasized that the healthcare system in the future must focus not only on medical treatments, but also on ensuring patient quality of life, promoting health management, and improving healthcare as a whole. She concluded by stating that utilizing advanced technology and data was key to creating a new healthcare model that could refine the value-based payment system.

*Value-Based Payment (VBP): VBP is a strategy used by insurers to promote quality and value in health care services. The aim of VBP programs is to shift from pure volume-based payments, as exemplified by fee-for-service payments, to payments that are more closely related to outcomes. After introducing this method, medical payments will change depending on the outcome of treatments.