Recently the ruling parties of the Government of Japan have agreed on a fundamental restructuring of the medical system. According to this restructuring, the insurance premium for salaried men who go to see doctors will increase 50% starting April 2003. Japan has a national health insurance system, which was working well to help Japanese enjoy the longest longevity of life.

Each month, salaried men pay a premium based on their income and number of dependents. When they need any medical treatment, the amount they have to pay is 20% of the actual expenses and 80% is covered by the health insurance; however, starting April 2003 this 20% portion will be increased to 30%.This is the inevitable decision under the current situation, as the Japanese population is aging very fast. As of May this year, 22,430 thousand people, or 17.7%, of the population are over 65, and medical expenses have been on the rise for some time already.

The government foresees the current health insurance system will cease to function or the deficit will skyrocket unless we take drastic measures. Thus the above decision will be only the beginning, and many more measures to restructure the system are to follow. There are talks about stopping or reducing the government subsidy for hemo-dialysis treatments when one reaches 70 years of age. This implies you have very little option but to quietly wait to cease functioning if you are not rich enough to pay for such treatment yourself.

What can we do then? The best solution is not to get sick or to take preventive measures. Unfortunately, not all people are wise enough to avoid things that work against their health. How can we stop drinking or eating fancy food? Besides, not all people are fortunate enough to live healthy lives to begin with. The next best solution will be to stop the deterioration of your condition or advancing the state of disease once you get sick. Last month I had an occasion to see such solutions being put into practice.I visited Dr. Yamada of Shinrakuen Hospital in Niigata, the capital city of Niigata Prefecture, two hours away from Tokyo by Shinkansen. This Shinrakuen Hospital was founded in 1931 and now has 341 beds, and is well known for their adoption of advanced medicine. We visited Dr. Yamada of the Diabetes Treatment Department whose treatment is well known in the medical community.I expected to find somewhat fancy waiting and treatment rooms because of its fame, however when I walked into the waiting room, it was a simple cozy room with regular chairs. On the wall there are a few posters and in the rack placed at the corner, a lot of pamphlets. They were educational materials for the patients to read.Dr. Yamada welcomed us wholeheartedly in spite of his busy workday that had just finished a few minutes earlier.

Dr. Yamada believes in the importance of blood pressure control for the diabetes patients, which has led him to our blood pressure monitors. He explained to us, "I am telling our patients the importance of blood pressure control. Especially the importance of blood pressure measurement at home as many heart attacks take place mostly in the morning, and clinical measurement at a hospital cannot predict that…40% of diabetes patients progress to kidney related diseases. If one ends up having dialysis treatment, not only is it burden or loss of quality of life to him but also costs the government 500,000 to 700,000 Yen per month for such treatment. If the government stops paying for it and one has to pay for it himself, it means no money and no life."The very reason why I visited him was to hear his opinion about our UA-767PC, as we learned the shop at the hospital sells UA-767PCs to the patients. He added, "It is such a small investment for a patient to purchase the blood pressure unit compared to the burden kidney disease brings him." He chose the UA-767PC because of its data storage and analysis capability. A typical diabetes patient measures his/her blood pressure twice a day; once after rising in the morning and again before he goes to bed. The patient comes to see the doctor every two or three months. Then, his nurse or diet trainer downloads the data from the unit and shows the data to the patient including the trend data. Dr. Yamada said, "The important part of this is to let the patient see the data and make him realize how he is managing himself, including the effectiveness of the anti-hypertensive drugs he is taking. The patient must learn to take care of himself." He uses a 130/85 mmHg overall average as the guideline for the patients to follow.

But he added, "I personally believe it should be 120/80 mmHg. Lessening the burden on the kidney is so important, and high blood pressure is the very thing to avoi. To decrease 1mmg of blood sugar or AIC is very tough, but to decrease the blood pressure by 10 mmHg is much easier and effective as we now have very good anti-hypertensive drugs."He added that endocrinology, or hormones, had been his research theme when he was a medical student and he had not studied much about blood pressure or its monitoring. He was surprised to find so many studies being conducted around blood pressure and its monitoring recently. I agreed and hinted at the fact that the electronic blood pressure monitoring has brought many new findings and that we feel we have been one of the pioneers in terms of enhancing the capability of electronic monitoring and making it accurate and economical enough for the medical community.He was very happy with the UA-676PC and appreciative of our effort of making it available to consumers, but did not forget to give us some requests and suggestions for improvement, which concern mainly the design of analysis software.

He gave me the impression he is more like a professor teaching his students in a class, and the fact he was all smiles when he met me made me a believer in preventive medicine. It is so enlightening that there are doctors so concerned about the quality of life of his patients. He is candid when he tells his patients to invest in the instrument that will benefit them in a long term, which should be the ultimate remedy to the patients and to the government to reverse the ever-increasing government deficit over health insurance.I was happy to know that our UA-767PC is contributing to the quality of life of people, which eventually should contribute to keeping the government budget healthy. I left the hospital convinced we have to take Dr. Yamada's suggestions seriously and implement them quickly.

You may address any comments concerning this editorial by email to Mr. Eto