* * * * * * * * * T E R R I E 'S T A K E * * * * * * *<br>A weekly roundup of news & information from Terrie Lloyd.<br>(<a href="http://www.terrie.com">http://www.terrie.com</a>)<br><br>General Edition Sunday, February 14, 2010 Issue No. 553<br>
<br>+++ INDEX<br><br>- What's new<br>- News<br>- Candidate roundup/Vacancies<br>- Upcoming events<br>- Corrections/Feedback<br>- News credits<br><br>SUBSCRIBE to, UNSUBSCRIBE from Terrie's Take at:<br><a href="http://mailman.japaninc.com/mailman/listinfo/terrie">http://mailman.japaninc.com/mailman/listinfo/terrie</a><br>
<br>BACK ISSUES<br><a href="http://www.japaninc.com/terries_take">http://www.japaninc.com/terries_take</a>, or,<br><a href="http://mailman.japaninc.com/pipermail/terrie/">http://mailman.japaninc.com/pipermail/terrie/</a><br>
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<br>------------- PBXL is Business Communications -------------<br><br><br>+++ WHAT'S NEW<br><br>It is very obvious that the Japanese hospital system is in<br>a state of crisis. In the last couple of years there have <br>
been frequent reports of people dying in the back of <br>ambulances because hospitals are rejecting them due to <br>a shortage of emergency care doctors. The fact is that <br>there is not only a shortage of people -- both doctors and <br>
nurses, but also a growing shortage of beds as well, due <br>to the poor financial condition of many hospitals. <br><br>A rare news report on the subject surfaced last year saying<br>that of the nation's 7,785 non-psychiatric hospitals, at <br>
least 600-700 of them were operating in the red and that of<br>the 80-90 or so hospitals closing down each year (Health <br>Ministry statistics), about half of them were closing <br>because of financial problems. <br><br>
This deplorable situation is, in our opinion, of the <br>government's and medical profession's own making -- with <br>plenty of help from the nation's aging society and the <br>domestic economic slump. <br><br>
The first reason for our placing the blame is based on the <br>fact that it is still illegal for a company to own and <br>operate a hospital, and instead only qualified doctors may <br>head up a facility. This rule could only have been dreamed <br>
up to protect doctors' privileged positions in society since<br>experience abroad proves that companies are indeed very<br>capable of operating a care facility. <br><br>Yes, we realize that some companies such as home/office <br>
security firm Secom have found ways around this ownership <br>law by appointing doctors to run a facility owned by them, <br>but it's not a strong value proposition for investors when <br>you could technically be in breach of the law at any time. <br>
As a result, hospitals are seldom run as sound commercial <br>operations -- and yet they still have to make profits in <br>order to pay salaries, equipment, and building costs.<br><br>[Continued below...]<br><br>------------ Can't Afford a Better Web Site? --------------<br>
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<br>[...Article continues]<br><br>Another issue is the "addiction" of general hospitals <br>nationally to prescription and services reimbursements by <br>the government as their main source of income. This is of <br>
course what happens when you have a universal but <br>compulsory public health system that pretty much excludes <br>private health care and is set up to allow doctors to <br>over-prescribe (up to 50% more prescriptions compared to <br>
the U.K., for example) as a way to make extra cash. <br><br>The Japanese public medical system currently allows for <br>about 5,400 procedures, each of which is strictly regulated<br>in terms of price and method in order to qualify for <br>
government reimbursement. This system does indeed provide <br>a certain baseline of public health care, but not much <br>else. You can forget about discretionary procedures as well<br>as new drugs and treatments from overseas that haven't yet <br>
gone through the very slow approvals process from the <br>Ministry of Health. If you want options, you'd be best served <br>hopping on to a plane to Thailand or Malaysia and buying <br>world-class services at highly discounted prices.<br>
<br>Then of course there is the fact that the system was never <br>intended to deal with the current flood of old people. <br>Despite the fact that the Japanese are the healthiest <br>amongst citizens of advanced nations around the world, the <br>
demand for hospital beds and lifestyle disease treatments <br>continues to escalate. <br><br>As a result, the pressure is on.<br><br>The financial crisis for many hospitals has come about as <br>the government continues to seek ways to cut its annual <br>
spending. Targeted are all types of medical costs, but <br>particularly the massive amounts of fixed fee <br>reimbursements for services and drugs. The cost cutting got<br>a boost with the Koizumi administration in 2002, when the <br>
co-payment costs for seniors was increased and an emphasis <br>was placed on moving from original-maker drugs to generics.<br>The use of generics has since increased dramatically and <br>the government now has a goal of making 30% of all drugs <br>
prescribed to be generics by 2012, up from 18.7% in 2007.<br><br>So the scenario is ugly: an ossified system of <br>self-interested owners (well, the successful ones, anyway) <br>and single-source profits that between them preclude <br>
entreprenuership and price/services differentiation. Now <br>that the main source of income is getting squeezed off by <br>the government, what are financially struggling hospitals <br>to do?<br><br>It seems that one idea is to start selling services to a <br>
new category of user who is NOT bound by the rules of the <br>Japanese health system and its pricing restrictions -- that<br>of the medical tourist. The Japan Tourism Agency has said <br>it will launch a trial program from this April to start <br>
attracting wealthy Chinese who might be interested in <br>having medical procedures conducted in Tokyo. No doubt they<br>are trying to follow the lead of the very successful <br>medical tourism sector in Thailand, where 1.36m people <br>
traveled for medical services that cost just 20% to 30% <br>of similar operations/treatment in the USA and Europe.<br><br>The Agency is cooperating with about ten hospitals in Japan<br>(mainly in Tokyo) and some university hospitals in Beijing,<br>
such as the Tsinghua University hospital. The focus will be<br>on brain surgery, plastic surgery, and oncology. While this<br>sounds like it could be a good idea, the JTA has admitted <br>that it has a number of challenges, including language, <br>
payment methods, and "other" issues. <br><br>We spoke with medical industry expert, John Wocher of <br>Kameda Hospital in Chiba, about the feasibility of such a <br>program. He pointed out many problems with bringing Chinese<br>
patients into Japan, the least of which is the simple <br>matter of getting cooperation from the immigration <br>authorities. Specifically he mentioned the case of a Chinese<br>patient who was only provided a visa after THREE MONTHS of <br>
supplying detailed documentation of his medical need to the<br>Japanese consulate in China. The patient was consistently <br>refused a visa despite Kameda's acceptance of the person <br>for treatment. Finally he was let in on a visa allowing him<br>
to visit a relative who coincidentally is living here. <br><br>Wocher then went on to say that Korea already has a medical <br>visa and it is very easy to apply for. It looks like we have yet <br>another example of internationalization where the Koreans <br>
are leaving Japan behind in the dust.<br><br>Other problems with medical tourists are likely to be:<br>* Logistics -- Specialized transportation may be needed <br>from the airport (expensive)<br>* Language -- Chinese-Japanese interpreter may be needed on<br>
a continuous basis (expensive and difficult)<br>* Legal -- Informed consents for operations, etc., are <br>needed in Chinese, specific to procedure<br>* Fees -- How much to charge? Chinese don't have a national<br>insurance system matched by employers<br>
* Payment methods -- Bank transfers, UnionPay?<br>* Culture -- Wealthy patients are demanding -- are Japanese<br>hospitals ready to treat their patients as customers and <br>not as children? We wonder...<br>* Amenities -- Most Japanese hospitals have utilitarian <br>
rooms -- which may be quite unsuitable for wealthy patients<br>* Medical Records -- Need ability to receive adequate <br>medical history and documentation on existing work done<br>* Post-operative follow-up -- Who will do this and how will<br>
they communicate?<br>* Accompanying family -- Do they also get visas?<br>* Religious Facilities -- How many Japanese hospitals have <br>rooms marked with the direction of Mecca?<br><br>Good luck JTA...! We think the answer to making Japanese <br>
hospitals more profitable is much simpler. <br>* Allow people to pay extra to get services on top of <br>government reimbursed treatments, instead of the current <br>all-or-nothing approach.<br>* Let companies own and operate hospitals so as to provide <br>
a parallel private medical care system (freedom of choice)<br>* Open up the medical sector to commercial competition from<br>foreign companies (now that's REALLY radical!)<br><br>Don't forget our entrepreneur seminars coming up this <br>
weekend, Saturday February 20th in Tokyo and next week<br>Saturday February 27th in Nagoya. For more info, go to:<br> <br><a href="http://www.japaninc.com/entrepreneur_handbook_seminar">http://www.japaninc.com/entrepreneur_handbook_seminar</a><br>
<br><br><br>...The information janitors/<br><br>***------------------------****-------------------------***<br><br>-------------- New CCH HR Guide in English ----------------<br><br>Introducing the all new 'Japan Staff Employment Law Guide'!<br>
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-----------------------------------------------------------<br><br>+++ NEWS<br><br>- High-paid executives to be named?<br>- Body found in landing gear of Delta jet<br>- Beer sales at record low<br>- INCJ fund choosing targets to buy into<br>
- JAL and AA apply for antitrust immunity<br><br><br><br><br>-> High-paid executives to be named?<br><br>The Financial Services Agency (FSA) may require companies <br>paying senior managers more than JPY100m in salaries and <br>
other forms of compensation annually to disclose such <br>individuals names and pay details. Right now the proposal <br>is being floated for consideration, but if accepted will <br>become law by the end of March this year. Apparently the <br>
FSA will require ALL private and public companies that <br>produce financial statements as a basis for public <br>financings and other public activities to participate. <br>(Source: TT commentary from <a href="http://nikkei.co.jp">nikkei.co.jp</a>, Feb 13, 2010)<br>
<br><a href="http://www.nni.nikkei.co.jp/e/ac/tnks/Nni20100212D12JFA04.htm">http://www.nni.nikkei.co.jp/e/ac/tnks/Nni20100212D12JFA04.htm</a><br><br>-> Body found in landing gear of Delta jet<br><br>Unbelievably, a Narita airport mechanic found the body of a<br>
man who stowed away on the landing gear of a Delta jet, <br>while servicing it in Japan. Apparently the man, who had no<br>identity on him, had boarded the jet in New York and had <br>either frozen to death or died from lack of oxygen during <br>
the trip. ***Ed: You'd have to be either desperate or <br>stupid to try this on a 13-hour flight to Tokyo...** <br>(Source: TT commentary from <a href="http://google.com">google.com</a>, Feb 13, 2010)<br><br><a href="http://tinyurl.com/yeum79z">http://tinyurl.com/yeum79z</a><br>
<br>-> Beer sales at record low<br><br>Domestic beer shipments fell to their lowest level in 17 <br>years due to a dramatic reduction in alcohol consumption <br>by young Japanese seeking to cut back personal expenses. <br>
Overall, January shipments fell 12.9%, with regular beer <br>down 11.9% and low-malt happoshu beer dropping 32.8%. As a <br>result, Kirin announced that its earnings fell almost 39% <br>in the current fiscal year. (Source: TT commentary from <br>
<a href="http://marketwatch.com">marketwatch.com</a>, Feb 11, 2010)<br><br><a href="http://tinyurl.com/yb55hs2">http://tinyurl.com/yb55hs2</a><br><br>-> INCJ fund choosing targets to buy into<br><br>The government's investment fund, Innovation Network <br>
Corporation of Japan (INCJ) has said that it has received <br>investment requests from about 200 companies, including <br>Toshiba, Alps Electric, and others with clean and green <br>technologies. The fund, which started in July 2009, has <br>
about JPY900bn (US$10bn) to invest. It will start making <br>investments later this year and is targeting auto makers, <br>electronics makers, measuring equipment firms, and others <br>with expertise that could be applied to the greentech <br>
sector. (Source: TT commentary from <a href="http://businessweek.com">businessweek.com</a>, Feb <br>12, 2010)<br><br><a href="http://tinyurl.com/yzpucy2">http://tinyurl.com/yzpucy2</a><br><br>-> JAL and AA apply for antitrust immunity<br>
<br>With JAL having made its decision to continue with existing <br>partner American Airlines over a counterbid from Delta <br>Airlines, the two firms moved this week to quickly to ask <br>the U.S. Department of Transportation (DoT) for antitrust <br>
immunity as its first step towards being part of the <br>planned Open Skies agreement proposed between Japan and the <br>USA. (Source: TT commentary from <a href="http://nikkei.co.jp">nikkei.co.jp</a>, Feb 13, 2010)<br><br>
<a href="http://www.nni.nikkei.co.jp/e/fr/tnks/Nni20100213D13JF432.htm">http://www.nni.nikkei.co.jp/e/fr/tnks/Nni20100213D13JF432.htm</a><br><br><br>NOTE: Broken links<br>Many online news sources remove their articles after just a<br>
few days of posting them, thus breaking our links -- we<br>apologize for the inconvenience.<br><br><br>--------- BIOS - Bilingual IT Systems and Support ---------<br><br>Formed in 1998, BiOS is a full-service IT solutions <br>
provider, delivering SI and business support services to <br>foreign multinationals, including some of the world's<br>largest banks, logistics, and retailing companies.<br><br>Service Offerings:<br>* IT Infrastructure Projects, Office Setups/Relocations<br>
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-----------------------------------------------------------<br><br>***------------------------****-------------------------***<br><br>+++ CANDIDATE ROUND UP/VACANCIES<br><br>=> BiOS, a Division of the LINC Media group, is actively <br>
marketing the following positions for customers setting up <br>or expanding in Japan, as well as other employers of <br>bilinguals.<br><br>** HIGHLIGHTED POSITION(S)<br><br>BiOS is urgently looking for a number of highly skilled and<br>
experienced Business Analysts, across a number of financial<br>disciplines, to join a large multi-region project being <br>delivered by our partner within a respected and highly <br>visible Japanese investment bank. Using your polished <br>
professional skills, you will be predominantly involved in <br>applications and the equities trading platform support, but<br>also potentially other related areas of the same project, <br>with the main focus of the role being the understanding of <br>
user requirements, analyzing business flows, and developing<br>business and system requirements.<br><br>First and foremost if you have experience in an investment <br>bank, specifically equities and derivatives IT, then this <br>
will be the first step to your successful application. <br>Excellent analytical skills are of course a must, as is the<br>ability to perform across multiple platforms. In addition <br>to this, if you can demonstrate bilingual language <br>
abilities this will be advantageous, but not essential. <br>This is a fantastic opportunity to make a name for yourself<br>in a high-visibility project within a prestigious <br>organization, this demanding role is waiting for your <br>
application now!<br><br>Remuneration is negotiable and highly competitive, <br>depending on your experience and level.<br><br>** POSITIONS VACANT<br><br>- Infrastructure Arhcitect in foreign insurer, JPY8m JPY11m<br>- Network Engineer, Global Telecoms Co, JPY5m JPY7m<br>
- IT Support Analyst, Tokyo Law Firm, JPY3.5m JPY5m<br>- FileNet Architect, European Insurance co., JPY6m JPY7.5m<br>- 2nd Level Helpdesk, Tokyo Medical Co, JPY4m JPY5m<br><br>Interested individuals may e-mail resumes to:<br>
<a href="mailto:stuart.gibson@biosjp.com">stuart.gibson@biosjp.com</a><br><br>** BiOS Job Mail<br><br>Every 2 weeks BiOS sends out a regular communication to its<br>job seeking candidates, called BiOS Job Mail. Every edition<br>
carries a list of BiOS's current and most up-to-date<br>vacancies, with each entry featuring a short job<br>description and a direct link to the main entry on the BiOS<br>home page. Regardless of whether you are unemployed and<br>
searching, thinking about a career change, or just curious<br>to know if there is something out there that might suit you<br>better, the BiOS Job Mail newsletter is an easy and<br>convenient way for you to stay informed. If you would like<br>
to register for the BiOS Job Mail, or to find out more,<br>please email <a href="mailto:stuart.gibson@biosjp.com">stuart.gibson@biosjp.com</a>.<br><br>Interested individuals may e-mail resumes to:<br><a href="mailto:stuart.gibson@biosjp.com">stuart.gibson@biosjp.com</a><br>
<br>-----------------------------------------------------------<br><br><br>***------------------------****-------------------------***<br><br>+++ UPCOMING EVENTS/ANNOUNCEMENTS<br><br>---------------- Start a Company in Japan -----------------<br>
<br>Entrepreneur's Handbook Seminar 20th of Feb, 2010<br><br>If you have been considering setting up your own company,<br>find out what it takes to make it successful.<br>Terrie Lloyd, founder of over 13 start-up companies in Japan,<br>
will be giving an English-language seminar and Q and A on<br>starting up a company in Japan. This is an ideal <br>opportunity to find out what is involved, and to ask <br>specific questions that are not normally answered in <br>
business books. All materials are in English and are <br>Japan-focused. <br><br>EXTRA: If you live in Nagoya, catch our Feb 27th seminar.<br><br>For more details:<br><a href="http://www.japaninc.com/entrepreneur_handbook_seminar">http://www.japaninc.com/entrepreneur_handbook_seminar</a> or<br>
contact yumiko.tanaka at <a href="http://japaninc.com">japaninc.com</a>.<br><br>-----------------------------------------------------------<br><br>---------------- ICA Event - February 18 ------------------<br><br>Speaker: Terry Warren, President-Advantage24 K.K.<br>
Topic: Cloud Computing: Fact or Fiction?<br><br>Details: Complete event details at <a href="http://www.icajapan.jp/">http://www.icajapan.jp/</a><br>(RSVP Required)<br><br>Date: Thursday, February 18, 2010<br>Time: 6:30 Doors open, Buffet Dinner included and cash bar<br>
Cost: 4,000 yen (members), 6,000 yen (non-members)<br>Open to all. Venue is Foreign Correspondents' Club of Japan<br><a href="http://www.fccj.or.jp/aboutus/map">http://www.fccj.or.jp/aboutus/map</a><br>-----------------------------------------------------------<br>
<br>***------------------------****-------------------------***<br><br>+++ CORRECTIONS/FEEDBACK<br><br>In this section we run comments and corrections submitted<br>by readers. We encourage you to spot our mistakes and<br>
amplify our points, by email, to <a href="mailto:editors@terrie.com">editors@terrie.com</a>.<br><br>*** No feedback or corrections this week.<br><br>***********************************************************<br>END<br><br>
SUBSCRIBERS: 9,540 as of February 14, 2010<br>(We purge our list regularly.<br><br>+++ ABOUT US<br><br>STAFF<br>Written by: Terrie Lloyd (<a href="mailto:terrie.lloyd@japaninc.com">terrie.lloyd@japaninc.com</a>)<br><br>HELP: E-mail <a href="mailto:Terrie-request@mailman.japaninc.com">Terrie-request@mailman.japaninc.com</a><br>
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editor to <a href="mailto:terrie.lloyd@japaninc.com">terrie.lloyd@japaninc.com</a>.<br><br>ADVERTISING INFORMATION<br>For more information on advertising in this newsletter,<br>Contact <a href="mailto:ads@japaninc.com">ads@japaninc.com</a>.<br>
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<br>J@pan Inc is Japan's only independently published English-<br>language business magazine. Authoritatively chronicling <br>online the business trends in Japan, each issue brings you <br>in-depth analysis of business, people and technology in the<br>
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