Health How does the health system work in Japan?

[sawana]

Hi everyone..my name is sima and im interested in getting some information on how the health system works in Japan comparing to the U.S that doesnt have universal coverage for its citizens..i know how sad...however i would appreciate it if someone can email me on how the system works...i would really appreciate it..thanks

 

[KirinMan]

Hi everyone..my name is sima and im interested in getting some information on how the health system works in Japan comparing to the U.S that doesnt have universal coverage for its citizens..i know how sad...however i would appreciate it if someone can email me on how the system works...i would really appreciate it..thanks

National Health Insurance in Japan

Check out that site, it is in English.

To even attempt to explain "how it works" here or in an email would take a hell of a lot of time.

Oh and it "works" pretty good from where I am at.

 

[sawana]

U are the best! Thank u so much

 

[Mike Cash]

Back in the days of HillaryCare being proposed, when America was looking to institute socialized medicine, much attention was given to the Canadian and British models, which by my inadequately informed understanding are both abyssmal failures.

At the time, I always wondered why they didn't take a look at Japan's system. As much as the idea of socialized anything galls my conservative soul as a matter of principle, I have to admit that the system actually does a pretty good job here.

 

[Ewok85]

The system *doesn't* work 100% here, and suggesting otherwise is a bit of a worry.

First it relies on all of its people to pay into the health program, and theres an increasing number of people who don't. I've heard some real horror stories about the workers and policies used in Japan as well.

 

[Mike Cash]

Perhaps I missed something. Did someone suggest that it works 100%?

 

[KirinMan]

The system *doesn't* work 100% here, and suggesting otherwise is a bit of a worry.

First it relies on all of its people to pay into the health program, and theres an increasing number of people who don't. I've heard some real horror stories about the workers and policies used in Japan as well.

Where or what country in the world has a system that works 100%.

I have to agree with Mike on this one. For the number of years that I have been living here it has worked out fine. It is a great system for how it is run. Sure there probably could be improvements but universal coverage here is a reality. People who do not have money are still covered under this system.

It is actually cheaper here to go to the hospital for medical care rather than go to a drug store to buy medicine.

I would love for you to share the "horror" stories that you "heard" about the workers and more importantly the policies.

 

[Ewok85]

Where or what country in the world has a system that works 100%.
I have to agree with Mike on this one. For the number of years that I have been living here it has worked out fine. It is a great system for how it is run. Sure there probably could be improvements but universal coverage here is a reality. People who do not have money are still covered under this system.
It is actually cheaper here to go to the hospital for medical care rather than go to a drug store to buy medicine.
I would love for you to share the "horror" stories that you "heard" about the workers and more importantly the policies.

I'd have to dig them up again, but I know foreigners who have worked or trained here as nurses, doctors and translators who were just stunned at the way that doctors and nurses acted here, as well as stories from Japanese friends of which a large chunk are practicing nurses. Things like lying and malpractice make up a large part of this, and the system works to protect doctors rather than patients. I think the most amusing comment I've had from an experience nurse who has worked in the UK and Japan saying she would rather take her chances in the UK than Japan.

One story I do remember was from my girlfriends mother, who told me a story about when my girlfriend was young and had trouble breathing so they decided to take her to the hospital. They took her to 3 hospitals close to their home and were told they were unable to take on patients, and went to one about 20minutes away. When they arrived they were told that they would have to wait 2 hours to see a doctor, which was OK as they couldn't get in anywhere else, and when they finally saw a doctor they discovered that had they waited more than 15minutes more she would have stopped breathing completely! Wonderful...

One shorter one was a doctor who told regularly told women that vaginal infections would be "washed away" with their periods.

Doctors who tell their patients that tumors are just "blisters" to prevent them from worrying.

When I said 100% I meant that it is far from a perfect system. Corruption is an issue (which was practically institutionalized) and one that has only just been targeted in the last few years (paying off doctors for preferential treatment etc).

I'll have to have a look. But from my nurses I know that mistakes in diagnosis, drug selection, dosage and period/frequency of doses are commonly made mistakes too.

 

[Mike Cash]

I see your point, and could add horror stories of my own. But I read the initial inquiry as being more about the health care system here as regards access and administration. Actual quality of care is another matter altogether.

 

[KirinMan]

I see your point, and could add horror stories of my own. But I read the initial inquiry as being more about the health care system here as regards access and administration. Actual quality of care is another matter altogether.

I see the point as well and I am glad that he clarified his statement.

 

[Ewok85]

I see your point, and could add horror stories of my own. But I read the initial inquiry as being more about the health care system here as regards access and administration. Actual quality of care is another matter altogether.

Ah, well in that case appointments are rare and waiting times are generally low - normally 20-60mins. I have not been sick enough to warrant anything other than antibiotics or some eye drops, so I can't say much about hospitals.

If you have Japanese health insurance (in the forum of Shakaihoken or NHI) medical fees tend to be low. I'm not sure how public/private medical systems work in Japan, but I can ask the resident nurse later on

 

[GaijinPunch]

which by my inadequately informed understanding are both abyssmal failures.

Is that to alude that the American system is a success? Anywhere where an HIV+ person can sit in a waiting room for 8 hours with a 103 degree temperature cannot be considered a success. For rich people, America's system is great. Poor people are screwed. I guess that can be said for most aspects of life in the US though.

It's very likely that the reason it works well in Japan is the lack of variation amongst social classes. Most of the country is lumped into middle class. I can only assume Canada & the UK are not. One must also look at the lack of responsibility on the doctor in the case of errors and misdiagnosis, opposed to the US where they are much more likely to lose their license for a mistake (thus driving prices up due to malpractice insurance).

My take on it: All the systems suck. Get some private insurance, and look both ways before crossing the street.

 

[JimmySeal]

From my perspective, health care here in Japan has been pleasantly affordable, but the actual treatment has been far from pleasant.

Just under a year ago I went to the snazzy, modern-looking hospital in the next town over with an ingrown toenail on each foot. They sent me to a surgeon with a rather rough demeanor who said the only way to treat it was to rip the nails out. Fool that I am, I believed him, received local anesthetic right then and there, and received the treatment. I am not making this up. It took about 2 weeks for the toes to stop bleeding and another 6 months for the nails to grow back. He also prescribed that I take Lamisil, a dangerous medicine intended to treat a condition that I never had and had nothing to to with the condition that I did have.


The affordability of health care also means that doctors don't have to worry about prescribing all manner of medication for their patients, meaning that anytime I go to the doctor's office, I see old people walking out with giant piles of medicine. That can't possibly be a good thing.

 

[Mike Cash]

Is that to alude that the American system is a success? Anywhere where an HIV+ person can sit in a waiting room for 8 hours with a 103 degree temperature cannot be considered a success. For rich people, America's system is great. Poor people are screwed. I guess that can be said for most aspects of life in the US though.

My statement was about socialized medicine. America doesn't have it, so I felt free not to include it in the statement to which you took exception.

(And I think you meant "imply", since "allude" doesn't fit there at all).

 

[ArmandV]

Is that to alude that the American system is a success? Anywhere where an HIV+ person can sit in a waiting room for 8 hours with a 103 degree temperature cannot be considered a success. For rich people, America's system is great. Poor people are screwed. I guess that can be said for most aspects of life in the US though.

Yes, the American system is such a failure, that's why Canadians come here for treatment and the poor are flocking here from who-knows-where to get it. Maybe that's why a person with HIV+ is sitting in a waiting room.

 

[Ewok85]

From what I've heard Scandinavian countries have some of the best welfare and health systems in the world.

 

[Goldiegirl]

I wish America HAD a national health care system. Something...I have to pay for private insurance and it costs $600 a month. That's with me paying the first $5,000 in cost up front and then the insurance covers 80% and I still have to pay 20%. a little off topic, but now on topic...sort of...My husband works for a Japanese company and we are probably going to be living here. I was wondering if I can get insurance here through him? When I was in Scotland and got the measles I went to the doctor and I was covered; it was great. My prescription was covered as well. I would love to not have to pay so much money for insurance.

 

[Ewok85]

I wish America HAD a national health care system. Something...I have to pay for private insurance and it costs $600 a month. That's with me paying the first $5,000 in cost up front and then the insurance covers 80% and I still have to pay 20%.

Thats more or less how the Japanese system works - workers are enrolled in Kenkohoken and the health portion is taken out of your salary, and unemployed and self-employed people pay monthly/quarterly to the government - I don't have exacts, but its about 5~8%, and you pay 30% of health costs.

 

[Goldiegirl]

Thanks Ewok85,

is what you pay monthly out of your salary based on what you earn?

 

[Ewok85]

It is. Theres more information about it here - http://www.sia.go.jp/e/

 

[Goldiegirl]

Great! Thank-you!

 

[GaijinPunch]

(And I think you meant "imply", since "allude" doesn't fit there at all).

Yeah, something like that. I am quite often quick-replying when I should be doing other things like work, sleep, or not drink (some at the same time).

Yes, the American system is such a failure,

Sorry, but any place where the insurance company decides how sick you are and what your treatment is cannot be called a success. At least w/ social medicine nobody is under-treated... at least not habitually.

is what you pay monthly out of your salary based on what you earn?

Yes. It can get somewhat pricey as you climb the corporate ladder. 40,000 yen for health insurance may not be that much for monthly, but having to pay 30% of the costs seems to be rather lame to me for such a high premium.

 

[ArmandV]

Sorry, but any place where the insurance company decides how sick you are and what your treatment is cannot be called a success. At least w/ social medicine nobody is under-treated... at least not habitually.

I've never had any problem with the U.S. system. 20 years ago, my daughter was born two months premature, so she had to be in NICU until she got to around six pounds in weight. I had a PPO (Preferred Provider Organization) medical policy through my work. Because the hospital was part of their PPO network, any time the insurer had a question or dispute over a charge, I just told the group medical insurer, "They're on your network, you have an agreement with them. You too work it out and don't bother me with it." So they did and I was never bothered. Her medical bill alone was over $60,000 (and this was in 1987 dollars).

Naturally, I had insurance claims experience, so I knew how to deal with issues if they arose.

Basically, medical insurers want to make sure that medical care is reasonable and customary for any given medical treatment. Some medical providers (doctors, hospitals, clinics, etc.) are crooked and would run up unnecessary charges.

 

[Goldiegirl]

The problem with the US system (or lack thereof) is that when you work fulltime (as I did) for a small company that can't/doesn't provide health insurance, then you have none. I have to pay $600 a month! If you are working at a small business, chances are you can't afford that steep of a payment. Yeah, when I had health coverage through my ex-husband it was great. We paid a small monthly charge and the first 1,000 dollars and then just 10 percent of any bill after. I would love to be able to get affordable insurance right now. $600 monthly is a strain. But here is were you get nailed again, I have a pre-existing medical condition, so, check mark, I get to pay even more and they won't cover any future illness related to the pre-existing condition. Yep, hospitals and doctors can all be crooked, but what is worse is having to pay for private insurance! Insurance companies are the worst, well private providers anyway.

 

[dark_secrester]

British healthcare sucks. Takes ages to get an appointement, and in most cases they don't ask you if you are British. People come from all over Europe to take from our free heathcare.
We pay tax to keep it running, and keep having to pay more and more each year. But still hospitals are losing money - where the hell is it all going?!!!!!
We pay, and the thing is, you may never need healthcare. But lucky america, you pay when and if you need it.
The American system is much better!
Sorry, I'm in a rambling mood today, and I have no idea why...