“In 2007, US healthcare spending was approximately $7,421 per resident and represented 16.2% of the nation's GDP” (Kaiser). Japan's national health spending represents approximately 8% of national GDP (Kaiser). However, with such low costs, the provision of medical care would be negatively affected. Many doctors in Japan have witnessed overcrowding in hospitals due to the fact that every patient is treated equally and hospital beds are occupied by less urgent cases and there are no penalties for those who overuse the system (Harden). Furthermore, the lack of doctors and nurses on duty affects the quality of care because there are only 1.6 doctors per 1,000 people and 7.8 nurses per 1,000 people, while the average number of doctors is 3.1 and nurses are 8 .2 per 1,000 people (Kaiser). Therefore, doctors and nurses are overwhelmed by long hours and overcrowding, compromising the quality and delivery of medical care.