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Emergency Medical Care In Japan

Pachipro

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I have Diverticulitis which sometimes becomes inflamed and I have to go to the doctor to receive antibiotics and the pain subsides within 24 hrs. My last problem with it occured about 4 yrs ago.

Well, while I was in Japan these past few weeks it became inflamed and within 24 hrs I developed a slight fever and knew I would have to go see a doctor or go to the hospital. I was a little concerned as I had no national health insurance, but it had to be done regardless of the cost.

My wife called a doctor in the neighborhood and an appointment was made for an hour later. It was a Saturday morning and I figured it would probably be crowded. I had not received medical care in Japan since the 80's and, not knowing the cost, we took 60,000 yen with us as, in the US, with no health insurance, the cost would probably be at least $200 if not more.

We walked the 10 minutes to the small clinic and upon entering, after removing our shoes and using the slippers (pink for females, blue for males) I was amazed that there were only two patients there, an eldery gentleman and a woman with a baby. Surprising for a Saturday morning. The nurse behind the counter took my basic information and asked that I take a seat and the doctor would see me shortly. Unlike the US there were no pages of info to fill out.

Within 10 minutes the doctor called us in and I noticed his diploma on the wall from Tokyo University. I explained my situation to him in Japanese with help from my wife and what kind of penicillin I usually take for the symptoms. He understood what I was talking about, checked his computer for reference and asked that I lie down. Locating the pain on the left side of my abdomen he asked that I take a urine test. I left the cup on the counter in the restroom and as soon as I returned to the room he said that my urine was ok. Now that was fast!

He said that he would give me a 5 day prescription for antibiotics and pain killers and that if the pain did not subside within 24 hrs that I was to return. We went to the counter and we were given the medicine right there! No pharmacy to go to! Our bill was calculated and it was presented to us.

To my astonishment the total bill for the visit, urine test and two prescriptions was 4,610 yen!! Approximately $38 at the current exchange rate! And that was with no National Health Insurance! My wife and I looked at each other with wide open eyes. I asked her if this was the normal cost and she asked the nurse. Yes it was! Unbelievably reasonable. Way lower than either of us expected.

I calculated the cost of what this would have cost me in the US WITH insurance. The co-pays for the doctor, urine test, and two prescriptions would have come out to about $60 and, with no insurance, the cost would have been at least $200! This just goes to show how unreasonable medical costs are in the US.

Anyway, within a couple of days I was fine and my visit to Japan was not interupted at all as, I was still able to function thanks to the pain killers and, I am very grateful that in Japan you are not ripped off for emergency medical care even if you have no health insurance!

Therefore, if you are visiting Japan and become ill don't fear that it will cost you an arm and a leg if you have to receive care.
 

KirinMan

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Thanks for sharing that. While many people, rightfully so in some cases, debunk the overall health system here, overall the care and professionalism of the doctors and hospitals is fine and one shouldn't need to worry about getting treatment if necessary.

I hope that you stay well.
 

bakaKanadajin

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Yes I had a similar experience. Actually when I went I was the only one there. He saw me very quickly and although I didn't need any medication I could see in the receptionists office that a wide array of 'kusuri' was readily available.

One complaint I heard from my friend though (who unfortunately always has a lot of minor health problems) is that compared to the American stuff, the drugs in Japan are a little weak. The allergy medication and enczema (sp?) cream isn't the greatest for example.

The flipside of your experience is that although you were given what you needed quickly, there exists a risk for certain other things. For example, (at the risk of sounding gawdy) when my lady friend decided to use the contraceptive pill it was issued without doing any liver diagnostics, which is usually mandatory from my understanding because those with weak livers have a hard time processing the pill and this can lead to complications.

For the non-emergency stuff, there's also a general 'let's wait and see' attitude. I noticed this during my visit and another of my friends had a similar experience which they found more frustrating due to the nature of their problem.

Overall though, in terms of situations like that which you've described here, and also your basic burn-wrapping and cut-mending, I've found the wait times in Japan are very agreeable.
 

KirinMan

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One complaint I heard from my friend though (who unfortunately always has a lot of minor health problems) is that compared to the American stuff, the drugs in Japan are a little weak. The allergy medication and enczema (sp?) cream isn't the greatest for example.
There is a reason for this as well, doctors here will generally prescribe the medication that has the lowest "active" ingredients as to prevent the patient from, particularly those with chronic problems, building up an immunity to the drug.

If a patient knows the medication name, here in Japan, that they know to work best for themselves they can request the doctor to prescribe if for them. The key however is knowing the drug name here in Japan.

One other reason for "some" not all of the doctors prescribing "weaker" medications is that the patient will need to come back and visit the doctor again for follow up treatment. $$$$$

Because of the costs involved in visiting a hospital here it is actually cheaper in most cases to visit the hospital for even things like the common cold, most pharmacies medications are weaker than what is prescribed from a hospital and cost more than a typical hospital visit.

However going to hospitals in many cases takes quite a bit of time, hence using the pharmacy instead of the doctor. Another option for those that are aware of them are the "kanpo yaku" 漢方薬 かんぽう やく、traditional Chinese medicine or herbal/organic medications that can be found at many specialized pharmacies
 

Glenski

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What I don't understand is why so many medications have to be supplemented with another one to ease stomach discomfort? Can't they make something to treat ailments without affecting the stomach, too? Or is it just another chunk of change in the doctor's pockets?

To the OP, I hope you don't mind my asking, but how can you live in Japan and have a Japanese wife, yet NOT have health insurance? MY wife would be astonished and pushing us for it. Doesn't she have any coverage, either?
 

KirinMan

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What I don't understand is why so many medications have to be supplemented with another one to ease stomach discomfort? Can't they make something to treat ailments without affecting the stomach, too? Or is it just another chunk of change in the doctor's pockets?
That's a great question, one thing I do know is that the pharmaceutical companies here do not spend even close to the same amount of money on research and development of new drugs like the giants do in Europe and the US.

There seems to be a great reluctance here to introduce new medications that would help patients but would increase the costs to the system as a whole.
 

bakaKanadajin

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Why don't they spend the big bucks? Perhaps Japan's pharmaceutical industry isn't as aggressive and politically connected as the Wests. In the USA for example the pharmaceutical industrial machine is huge money, I'd put it up there with the auto makers and weapons industry. Lobbyists and soft money ensure certain companies control the market in terms of newly released drugs. Nothing gets passed without the FDA's blessing and what does get passed is not always the best thing for our health. FDA regulations also prevent some naturopathic remedies from being patented so as to give pharmaceutial companies the opportunity to create a marketable and patentable derivative or alternative. There have been some re-calls, and many drugs will at the very least give you some very serious side-effects.

I think Japan's health industry is more concerned with the whole naturopathically derived lotions and potions approach. Lots of Barley Greens, Noni juice, teas, bacterial cultures to aid digestion, vitamin drinks, vegetable/fruit drinks, etc. as opposed to chemical-laden multi-vitamins, pepto bismol (what the heck is tha stuff anyway?) and other assorted items.

If you walk into a Japanese 薬や there are definitely many different commercial medications available, but there are also a large number of what appear to be herbal and naturopathic remedies as well. They do not appear to be marketed as 'fringe' products, both appear to receive equal commercial treatment and market share.
 

Ewok85

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To the OP, I hope you don't mind my asking, but how can you live in Japan and have a Japanese wife, yet NOT have health insurance? MY wife would be astonished and pushing us for it. Doesn't she have any coverage, either?

"I had not received medical care in Japan since the 80's" is a clue - I used to pay around 14,000/mth for Shakai Hoken health insurance - thats 168,000 a year, and if Pachipro hasn't had to go to a doctor since the 80's (lets say 1987) thats 20 years, meaning 3,360,000 in his pocket. You would have to be in hospital for a month and receive surgery to get that sort of bill.

While this is a good story, its nothing special. Pachipro knew what was wrong, the doctor did nothing but prescribe a basic drug, and everything was fine. I know numerous people who are both Japanese and foreign who have had serious (including fatal) issues with the health system. Just because your local doctor can slap on a bandaid or give you some antibiotics does not mean the entire system is hunky dorey.
 

ArmandV

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To the OP, I hope you don't mind my asking, but how can you live in Japan and have a Japanese wife, yet NOT have health insurance? MY wife would be astonished and pushing us for it. Doesn't she have any coverage, either?

Pachipro used to live in Japan. He was just there for a visit when he became ill. He may have medical insurance that isn't usable in foreign countries. That's why travelers are urged to get travel insurance that would cover sudden illnesses or accidents.
 

KirinMan

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You would have to be in hospital for a month and receive surgery to get that sort of bill.

You make your point however the cost for a month is very much overexaggerated. Dont want people here to get the idea that things cost that much.

They dont. Like I said though you made your point.

Just because your local doctor can slap on a bandaid or give you some antibiotics does not mean the entire system is hunky dorey.

While there are problems with the system as it is, things are not all "that" bad either.

I dont know or have ever heard of any place in the world that has "perfect" health care. Seems that it, health care system problems, is a world wide thing.
 

KirinMan

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Why don't they spend the big bucks?
Because as the system stands they can not charge the same prices for their products that western corporations do to make a profit, which also covers their research costs as well.

Perhaps Japan's pharmaceutical industry isn't as aggressive and politically connected as the Wests

Actually it is very well connected, they manage to keep out foreign competition.
 

Ewok85

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I dont know or have ever heard of any place in the world that has "perfect" health care. Seems that it, health care system problems, is a world wide thing.

But its within these problems that the strengths of the system show - America is often criticised as being expensive, but the level of care and competence is very high, as well as patients being well protected by the legal system that is in place. Can't say the same about Japan on all of those points however.
 

KirinMan

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But its within these problems that the strengths of the system show - America is often criticised as being expensive, but the level of care and competence is very high, as well as patients being well protected by the legal system that is in place. Can't say the same about Japan on all of those points however.

True to a point, but, how many millions or tens of millions of people in the US can not afford health insurance?

Health care in the US is for those that have money and not everyone.

At least here in Japan you dont have to break the bank to go and see a doctor and darn near every person living here can get affordable health insurance, even those with zero income.

Payment is based on one's income.
 

Ewok85

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Payment is based on one's income.

Payment for the insurance perhaps, but everyone is charged the same* when it comes time to see a doctor or buy drugs, and those unable to pay for care are still refused it in Japan.
 

KirinMan

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Payment for the insurance perhaps, but everyone is charged the same* when it comes time to see a doctor or buy drugs, and those unable to pay for care are still refused it in Japan.

Out of curiosity here why do you have the opinion that those that are unable to pay for care are refused it here in Japan?
 

thistle

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The cost of medical care is quite reasonable here, and as it costs us (a family of four) 25,000 min. a month for health insurance, Iam thinking of just not taking it out any longer. It is a rare occurence for any of us to go to a hospital anymore, and I have a heart prescription I have to get every 2 months, but that would be 10,000 every 2 months, so I am thinking why bother!
Many japanese companies cover the health insurance, but it is not in my company.
 

caster51

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My yonger brother have worked as a exchenge docter at Mayo Clinic in Jakcsonville.

his most surprise was a day inspection hospitalization of there.
all stuff was perfect.
however, its expense was $10,000 a day
 

Ewok85

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Out of curiosity here why do you have the opinion that those that are unable to pay for care are refused it here in Japan?

Being married to a nurse working for a major Japanese hospital would be one reason.
 

ArmandV

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...and those unable to pay for care are still refused it in Japan.

Maybe folks in the U.S. ought to keep this in mind the next time they have a problem with the health system and pitch a fit.
 

Goldiegirl

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What health system in the US? Do you mean the kind if your job offers insurance or private insurance where you get get ripped off for $600.00 a month or nothing? The health care provided in the US providing you can pay for it is top notch, but I'd still take less and have affordable health care. I went to the hospital in Tokyo and paid so little that my I didn't have to use my international health insurance because my visit was less than my deductable!
 

Pachipro

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Glenski said:
To the OP, I hope you don't mind my asking, but how can you live in Japan and have a Japanese wife, yet NOT have health insurance? MY wife would be astonished and pushing us for it. Doesn't she have any coverage, either?
I do not live in Japan any longer Glenski. I lived there through out the 70's and 80's. I return once or twice a year for visits and will move there permanently around 2009-10.

When I lived there I DID have the national health insurance after I started my own business. For the four years I was a student I did not have any. I paid about 8,000 yen/month for me and the wife. Once I had severe headaches that wouldn't go away. I went to the hospital in Japan and was scheduled for an MRI of the brain. Three days later I was in and the results were shown to me shortly thereafter, the same day! Luckily I didn't have anything wrong with my brain and the headaches disappeared shortly thereafter. Total cost to me: about 4,500 yen!

In my opinion, I believe the national health care system in Japan is among the best in the world for a socalized system even though it may have it's problems (see below). Here in the US we hear too many horror stories about the systems in Canada and the UK where a person is put on a waiting list for non-emergency surgery that could sometimes take months!

As a matter of fact I heard on the news yesterday that in the UK, if you are a smoker and are scheduled for major surgery, that you must quit smoking for 4 weeks before it will be performed as they said that smokers take longer to heal and this costs the state more money. Also, before the surgery can be performed, a blood test must be taken to prove that the patient hasn't smoked in four weeks.

Ewok85 said:
Payment for the insurance perhaps, but everyone is charged the same* when it comes time to see a doctor or buy drugs, and those unable to pay for care are still refused it in Japan.
Not really true. Maybe things have changed. Two cases in point:

1. While a student in Japan back in the 70's I had no national health insurance and I came down with an absessed tooth. A Japanese friend suggested a dentist in Omiya that would take care of it at almost no cost. It was a long trip, but he took care of it and charged me 3,000 yen for two visits! He spoke English well and when I quried him about it, he said, "No problem. I just put you under someone else's name."

2. A friend of mine who was also a student at the same university came down with acute appendicitis and went to the hospital. He mentioned to the doctor that he had no national health insurance and the doctor said, "No problem. You have it now." Total cost to him for the surgery and a weeks hospital stay: 2,800 yen!

Whether this still happens in Japan today I do not know, but something tells me that it still does. Maybe the Japanese are refused if they cannot pay, but for me and my friend, foreigners no less, we were taken care of and for that I am grateful.
 

Goldiegirl

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Yes in some cases you can get "free" care at taxpayers expense, but when you are in a situation like mine you get screw*d. I own a home, but do not have a job that provides insurance. I have to pay a HUGE monthly bill for insurance; if I want "free" care, I can give up my home and become a burden on the taxpayers. I am in a no win situation. I will take socialized medicine, or some version thereof, with it's problems. I appreciated the care I received in Japan and the cost was reasonable. The same can be said for my care in Scotland.
 

Ranpyon

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Interesting topic ^_^

I have a question about this matter, because I'm going to move to Japan in less than a month ^^;; and I still don't know very well how the insurance thing goes.
My mother is very worried about it, and she's yelling at me all the time because of it lol
I got a pre-college Visa, and I'm going to stay in Japan for a year.
What should I do? Get a private insurance here in Italy or try the Japanese one?
I'm really confused x___x
 
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