Bibliographic record
Abstract
In 1961, a new and mandatory National Health Insurance plan was enacted in Japan. This healthcare system has succeeded in providing universal coverage while also containing the growth of national medical expenditures (NME) to the rate of growth of the gross national product (GNP), namely,-4-5 % annually, for several decades. All Japanese medical procedures, including dental proce-dures, prescription drugs, and diagnostic tests, are reim-bursed by a fee schedule set by the Ministry of Health and Welfare. The combination of strict fee control and low administration costs has kept the Japanese NME growth below that of the GNP. In 1990, NME was 2O.6 trillion ($187 billion), total diagnostictesting expenditures (DTE) were 2.3 trillion, representing 11.2 % of national medical expenditures (NME). Of this amount, in vitro diagnostic testing accounted for 1.4 trillion, representing 61 % of DTE and 6.8 % of NME. Annually, 1.8 billion in vitro diag-nostic tests are performed. IndexingTerms: healthcare reform/laboratory management Healthcare reform is a critical and urgent issue in every industrialized country. Although the Canadian, German, and British systems are often quoted in the US as a basis for comparison, there is little mention of Japan. From a financial structure, the Japanese health-care system is similar to others established in Germany, France, and The Netherlands, where individuals pay an income-related premium to a national insurance fund covering all residents. The Japanese system has suc-ceeded remarkably well in providing universal coverage while also containing the growth of national medical expenditures (NME) to the rate of the gross national product (GNP), namely around 4-5 % annually for sev-eral decades (see Fig. 1) (1).’ The Japanese Healthcare Insurance System It is difficult to compare healthcare systems across countries because historical and cultural backgrounds vary, as do the definitions of medical expenditures. In view of President Clinton’s reform proposal, it might be appropriate to explain the Japanese system in terms of the core issues outlined in that proposal. Security. In December 1958, a proclamation of the
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".