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Recent data show wide disparity between Japan and the United States in the effectiveness of their health care systems. Japan spends close to the lowest percentage of its gross domestic product on health care among OECD countries, the United States spends the highest, yet life expectancies in Japan are among the world’s longest. Clearly, a great deal can be learned from a comprehensive comparative analysis of health care issues in these two countries.

In Health Care Issues in the United States and Japan, contributors explore the structural characteristics of the health care systems in both nations, the economic incentives underlying the systems, and how they operate in practice. Japan’s system, they show, is characterized by generous insurance schemes, a lack of gatekeepers, and fee-for-service mechanisms. The United States’ structure, on the other hand, is distinguished by for-profit hospitals, privatized health insurance, and managed care. But despite its relative success, an aging population and a general shift from infectious diseases to more chronic maladies are forcing the Japanese to consider a model more closely resembling that of the United States.

In an age when rising health care costs and aging populations are motivating reforms throughout the world, this timely study will prove invaluable.

If there is one thing that describes the trajectory of American education, it is this: more high-stakes testing. In the United States, the debates surrounding this trajectory can be so fierce that it feels like we are in uncharted waters. As Christopher Bjork reminds us in this study, however, we are not the first to make testing so central to education: Japan has been doing it for decades. Drawing on Japan’s experiences with testing, overtesting, and recent reforms to relax educational pressures, he sheds light on the best path forward for US schools.
           
Bjork asks a variety of important questions related to testing and reform: Does testing overburden students? Does it impede innovation and encourage conformity? Can a system anchored by examination be reshaped to nurture creativity and curiosity? How should any reforms be implemented by teachers? Each chapter explores questions like these with careful attention to the actual effects policies have had on schools in Japan and other Asian settings, and each draws direct parallels to issues that US schools currently face. Offering a wake-up call for American education, Bjork ultimately cautions that the accountability-driven practice of standardized testing might very well exacerbate the precise problems it is trying to solve.