Medicine: Prognosis: Steady Improvement

But the nation's health-care system still lags behind the West's

Japan began to modernize its medicine along Western lines more than a century ago. Despite intensive efforts and some impressive successes, the nation remains underdeveloped by Western standards: its system is loosely regulated and the quality of its care is uneven.

"It's the wild, wild West of medicine," says Seth Goldsmith, professor of public health at the University of Massachusetts at Amherst and author of a forthcoming book on Japanese hospitals.

Health care in Japan is founded on family doctors, generalists who make up about...

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