- 18 Oct 2004
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Who do you think pays for "socialized medicine" and medical care? There's no such thing as free care. No matter how you slice it (no pun intended), it comes out of someone's pocket.
Emergency Medical Care In Japan
- Thread starter Pachipro
- Start date
Who do you think pays for "socialized medicine" and medical care? There's no such thing as free care. No matter how you slice it (no pun intended), it comes out of someone's pocket.
Goldiegirl
先輩
- 10 Aug 2006
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You are correct, but it allows everyone to get care. The big drug companies and medical companies in the US don't want socialized care because then they couldn't charge ridiculous prices for services. I am more than willing to pay a reasonable amout for care, whether it was through a direct tax or perhaps a monthly payment based on your income etc. Nothing is for free, I am not asking for free anything...just FAIR! I got fair and reasonable treatment in Japan, I would think the US could offer it's citizens that much!
- 18 Oct 2004
- 2,497
- 110
Well, as some of us in Los Angeles would say: Life isn't fair. The fair's in Pomona.
- 19 Jan 2005
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- Thread starter
- #29
Ranpyon: You are only 18 and if you're in good health I wouldn't worry about it. Besides, you're only going to be there for a year. However, if your health is bad I'd opt for the national health insurance. It wouldn't hurt.
KirinMan
後輩
- 23 Jan 2007
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FYI I was a facilities manager for 3 hospitals here in Japan for roughly 10 yrs. That also doesn't include the doctor in the family.
He works at a different hospital.One thing to remember indigent people can get assistance for living expenses from their local governments, plus depending on the hospital, as there are National hospitals as well, people that need medical care can get it.
It all depends on the hospital in question, sure there are private hospitals that will probably refuse you, however if you have the insurance papers they will treat you, they don't ask you if you can pay when you present the insurance card, they take it give you the care necessary then charge you.
You made it sound like even if you have insurance they won't take care of you that is not true.
Also Hospitals are also very good at accepting payment plans for people who do not have the money, they WILL treat you if you have insurance.
I don't want readers here thinking that if they have insurance and are unable to pay for services or care that services will be refused. That is most definitely not the case.
There are hospitals that will provide humanitarian services for the patients.
If a person doesnt have insurance then of course it is understandable that the hospitals will refuse care. That's a totally different subject.
KirinMan
後輩
- 23 Jan 2007
- 2,173
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I would like to clarify something here, Ewok's statement previously on this thread read;
The system here consists of both private, and public hospitals. There are Prefectural Hospital's, City Hospital's, Town Hospital's and Private Hospitals as well. Plus countless numbers of smaller clinics and specialized clinics as well. People are encouraged to use their local area hospitals as the money paid into the National Insurance, a portion of it anyway would then stay in the area and not go to another city or town.
Edited to add this; There are also University or teaching hospitals as well.
All of which accept the Japanese National and or Social Health Insurance. In Ewok's statement here he writes that "payment for insurance", everyone can get the insurance, and if they do not have the money to pay for the medical care, even if holding the insurance card, could be refused medical care. It depends all upon the hospital that the patient goes to.
BUT no hospital that I have ever heard of here has asked people with insurance, ahead of time, if they can or are able to pay. That doesnt mean they dont exist though, so it is possible, but rather improbable from the information I have.
Even people with money in theory could be refused service at private hospitals, that is the hospitals perogative, however unlikely that would be.
It also depends upon the treatment that the person is seeking as well.
The system here consists of both private, and public hospitals. There are Prefectural Hospital's, City Hospital's, Town Hospital's and Private Hospitals as well. Plus countless numbers of smaller clinics and specialized clinics as well. People are encouraged to use their local area hospitals as the money paid into the National Insurance, a portion of it anyway would then stay in the area and not go to another city or town.
Edited to add this; There are also University or teaching hospitals as well.
All of which accept the Japanese National and or Social Health Insurance. In Ewok's statement here he writes that "payment for insurance", everyone can get the insurance, and if they do not have the money to pay for the medical care, even if holding the insurance card, could be refused medical care. It depends all upon the hospital that the patient goes to.
BUT no hospital that I have ever heard of here has asked people with insurance, ahead of time, if they can or are able to pay. That doesnt mean they dont exist though, so it is possible, but rather improbable from the information I have.
Even people with money in theory could be refused service at private hospitals, that is the hospitals perogative, however unlikely that would be.
It also depends upon the treatment that the person is seeking as well.
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DoctorP
先輩
- 3 Jun 2004
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What Obeika says is true. They are also very adament about before you leave, working out a definite payment plan.
My son had surgery for a ruptured appendix. Once our stay was over, we had to work out with them how we planned to pay. (not really any different than in the US) They almost insisted on a recurring payment and really balked at the idea when I suggested cash ($3,500) in full. Even with the insurance, the hospital isn't always paid directly or immediately. Sometimes you are required to arrange payment, then the insurance will catch up to you later.
We received two checks. One from the government insurance, and another from private insurance that I carry for the family.
My son had surgery for a ruptured appendix. Once our stay was over, we had to work out with them how we planned to pay. (not really any different than in the US) They almost insisted on a recurring payment and really balked at the idea when I suggested cash ($3,500) in full. Even with the insurance, the hospital isn't always paid directly or immediately. Sometimes you are required to arrange payment, then the insurance will catch up to you later.
We received two checks. One from the government insurance, and another from private insurance that I carry for the family.
KirinMan
後輩
- 23 Jan 2007
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Thanks for sharing that CC1 you reminded me of something else as well.
If by chance you have an extended stay in the hospital, they will give you a bill at the end of each calendar month for the care you received.
Some services are not covered by insurance, for example meals, diapers, charges for private or semi-private rooms, etc etc.
It makes it easier on the patient to keep up with the bills instead of getting one huge bill at the end of the hospital stay.
I don't remember the exact figure either but if one has a bill that is greater than 65,000 yen in any one given calendar month, please don't anyone quote me on that figure it may have changed somewhat, some of the costs are refundable from the Social Ins, or National Ins. plans, minus of course the "non" medical related bills.
One needs to take the paid bill to the local town or city office and fill out the necessary paperwork for the refund.
If by chance you have an extended stay in the hospital, they will give you a bill at the end of each calendar month for the care you received.
Some services are not covered by insurance, for example meals, diapers, charges for private or semi-private rooms, etc etc.
It makes it easier on the patient to keep up with the bills instead of getting one huge bill at the end of the hospital stay.
I don't remember the exact figure either but if one has a bill that is greater than 65,000 yen in any one given calendar month, please don't anyone quote me on that figure it may have changed somewhat, some of the costs are refundable from the Social Ins, or National Ins. plans, minus of course the "non" medical related bills.
One needs to take the paid bill to the local town or city office and fill out the necessary paperwork for the refund.
DoctorP
先輩
- 3 Jun 2004
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The one thing that really irked me with my son's hospital stay was that you have to buy those little prepaid cards for the TV and the refrigerator. That really angered me...but I understand it is a means of revenue for the hospital.
The weird part is that you are free to bring in your own TV or laptop and use at your will...you just have to pay to use theirs!
I borrowed a laptop for my son and took him bags full of DVD's to help pass the time along with PC games. (only 10 years old) He would stay all day alone, then I would show up at night and spend the night there.
The weird part is that you are free to bring in your own TV or laptop and use at your will...you just have to pay to use theirs!
I borrowed a laptop for my son and took him bags full of DVD's to help pass the time along with PC games. (only 10 years old) He would stay all day alone, then I would show up at night and spend the night there.
KirinMan
後輩
- 23 Jan 2007
- 2,173
- 68
When I was in the hospital I brought my own TV and fan and the nurses were surprised at my "gall" at not adhering to what they thought was acceptable. I was like you, there was no way I was going to pay roughly 5 thousand yen a day for over 6 months just to watch TV.
I told them they were nuts and asked them to do the math.
2 months later a memorandum came down to all patients, which was also included in the inpatient guidebook/information, electrical applicances such as TV's, VCR's, DVD players, laptops, fans etc etc would be allowed, however a monthly electricity charge would be included with the monthly bill.
The TV and fan were about 3,000 per month. They still made out like bandits but at least I didnt have to pay nearly 700,000 yen to watch the damn TV.
DoctorP
先輩
- 3 Jun 2004
- 2,193
- 93
We were at Chubu, and there was no extra charge for the electricity. But he was only there for 2 weeks, not 6 months.
- 19 Jan 2005
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- Thread starter
- #38
Obeika and Ewok (or anyone who knows), you both seem to know a heck of a lot when it comes to medical care in Japan and it has been very informative. Thank you. Maybe you can help me out on this:
I relayed my story on the cheap cost of my "emergency" in Japan with no health insurance to a collegue and he would just not believe that a doctor/clinic could charge so little as "normal" cost with no insurance. His argument was that, since the doctor incurred alot of expenses going to university and a hospital/clinic/doctor has much overhead, how the hell do they stay in business? He claims I am BSing him or that I somehow received the cost for an insured person. He has a point and I never thought about it.
My comment to him was that, although the "full price" health care is very cheap and reasonable compared to the US and a patient need not be in fear of losing their home or declaring bankruptcy for major surgery or an emergency like in the US, that the private doctor/clinic/ hospital is probably reimbursed by the government for the remainder of the "full" cost that I paid or that maybe the doctor/hospital/clinic is subsidized by the government. I said that I would check on that and get back to him.
Do you know if this is true and, how does it work for the doctor/hospital/clinic when they treat an uninsured person at such a low cost? In my case, I went to a private general practitioner.
I relayed my story on the cheap cost of my "emergency" in Japan with no health insurance to a collegue and he would just not believe that a doctor/clinic could charge so little as "normal" cost with no insurance. His argument was that, since the doctor incurred alot of expenses going to university and a hospital/clinic/doctor has much overhead, how the hell do they stay in business? He claims I am BSing him or that I somehow received the cost for an insured person. He has a point and I never thought about it.
My comment to him was that, although the "full price" health care is very cheap and reasonable compared to the US and a patient need not be in fear of losing their home or declaring bankruptcy for major surgery or an emergency like in the US, that the private doctor/clinic/ hospital is probably reimbursed by the government for the remainder of the "full" cost that I paid or that maybe the doctor/hospital/clinic is subsidized by the government. I said that I would check on that and get back to him.
Do you know if this is true and, how does it work for the doctor/hospital/clinic when they treat an uninsured person at such a low cost? In my case, I went to a private general practitioner.
KirinMan
後輩
- 23 Jan 2007
- 2,173
- 68
The way charges are incurred during a doctors visit entail a rather complicated, but computerized point system. Each point being equal to XX number of yen. All points are then added up for the services rendered and you get your final bill.
So your urine test was XX number of points, the medicine XX number of points so on and so forth. Plus his consultation and since it was the first time that you were at that clinic they made a file on you correct, a "karute" which they take a few hundred yen for administrative purposes.ﾂ ﾂ The charges are uniform throughout Japan.
Pure speculation here but I am willing to make a bet that he charged you full price. I personally would have been shocked if I received a bill for "4,610 yen" for the services or treatment that you received.
If you had insurance you would have paid 1/3 of that price or roughly 1,500 yen which sounds reasonable.
This is also speculation as well however believe it or not, but that is my educated guess here that the doc charged you full price, nothing discounted.
Costs are held down by the government by only allowing doctors and hospitals to charge XX number of points for each service.
The doctor/clinic/hospital has to be able to balance the services/treatement rendered to bill the "individual patients" insurance provider, which also includes, in the case of the National Insurance, the government.
The hospitals also have semi-yearly or yearly audits as well to ensure that the books aren't getting "cooked" and the government/insurance unions are not getting ripped off.
Do you have the receipt for payment from the doc?
Now for a doctor treating an uninsured patient I am not sure but I dont think he can claim reimbursement from the government, and that he does it as either charity or charges full price.
Edited to add....Now people may also understand why in some/many? cases here in Japan the doctors want their patients to return for follow up checkups. They make their money on volume and not necessarily on quality. However there are popular hospitals and clinics where the care is outstanding and by word of mouth patients flock there because of the skill and professionalism of the doctor(s)
So your urine test was XX number of points, the medicine XX number of points so on and so forth. Plus his consultation and since it was the first time that you were at that clinic they made a file on you correct, a "karute" which they take a few hundred yen for administrative purposes.ﾂ ﾂ The charges are uniform throughout Japan.
Pure speculation here but I am willing to make a bet that he charged you full price. I personally would have been shocked if I received a bill for "4,610 yen" for the services or treatment that you received.
If you had insurance you would have paid 1/3 of that price or roughly 1,500 yen which sounds reasonable.
This is also speculation as well however believe it or not, but that is my educated guess here that the doc charged you full price, nothing discounted.
Costs are held down by the government by only allowing doctors and hospitals to charge XX number of points for each service.
The doctor/clinic/hospital has to be able to balance the services/treatement rendered to bill the "individual patients" insurance provider, which also includes, in the case of the National Insurance, the government.
The hospitals also have semi-yearly or yearly audits as well to ensure that the books aren't getting "cooked" and the government/insurance unions are not getting ripped off.
Do you have the receipt for payment from the doc?
Now for a doctor treating an uninsured patient I am not sure but I dont think he can claim reimbursement from the government, and that he does it as either charity or charges full price.
Edited to add....Now people may also understand why in some/many? cases here in Japan the doctors want their patients to return for follow up checkups. They make their money on volume and not necessarily on quality. However there are popular hospitals and clinics where the care is outstanding and by word of mouth patients flock there because of the skill and professionalism of the doctor(s)
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Ewok85
先輩
- 14 Nov 2003
- 2,401
- 44
My wife has anemia, as well as a few other problems, and it always annoys me to no degree when she goes through a bad spell and the doctors refuse to give her more than a few days medication when she is having symptoms that they know will last for at least two weeks, and have the gall to tell her to "come back" if she needs more - despite the fact that she can barely walk.
Lately shes been good but we had some bad times last year and one doctor was close to breaking me with his attitude.
Lately shes been good but we had some bad times last year and one doctor was close to breaking me with his attitude.
KirinMan
後輩
- 23 Jan 2007
- 2,173
- 68
I would suggest that your wife contact the local Doctors association and find a hospital or clinic that better serves her needs. Talk to them and they should be able to recommend a doctor that she feels more comfortable with seeing.
Also as you wrote earlier she is a nurse so odds are she is probably aware of what doctors can or can not prescribe when it comes to her medication.
Depending on the illness doctors can prescribe up to I think it is 30 days of medication at one time. However they are limited by guidlines here and as much as some of the doctors may want to supply her with more medication by law they can not. It is one of the poor points of the system.
Saitama Medical Care Network
If your profile is correct that is a link, in Japanese, to a medical network, there may be some information there that would be useful in finding a doctor or hospital that could assist her needs better.
I sincerely hope your wife gets/stays healthy.
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Ewok85
先輩
- 14 Nov 2003
- 2,401
- 44
We're all sorted now, there was just a while when her blood count got so low she would pass out if she exerted herself, such as going up or down stairs. She's aware of the restrictions on medication and thought it was pretty ridiculous too (and gets her medication from her hospital as well as having some at home).
What really got to me was the doctor telling her to come back another day because in his words "I can't understand you, so I can't help you" (she was so weak she wasn't able to talk). I was ready to deck the guy, I couldn't believe it. Never gone near him again.
What really got to me was the doctor telling her to come back another day because in his words "I can't understand you, so I can't help you" (she was so weak she wasn't able to talk). I was ready to deck the guy, I couldn't believe it. Never gone near him again.
KirinMan
後輩
- 23 Jan 2007
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Glad to hear that things got sorted out.
Did the doctor happen to be maybe in his late 40's or maybe older? If he was I can understand, not agree with or justify, but understand where his poor "bedside" manner came from.
KirinMan
後輩
- 23 Jan 2007
- 2,173
- 68
Well if you feel he was negligent then report him to the local Doctors board, you have that option open to you.
But his age explains a lot he is of an age where doctors here in Japan were looked at like god's. There were not that many and the ones that could afford the education were treated with a huge amount of respect and it was rare that a patient would EVER think of telling a doctor what they felt was the problem. I'm sorry I dont have a lot of time right now and I will fill in the background a bit later, it mat give you an insight into his gruffness and arrogant behavior. Believe me he isnt the "only" one like that.
- 19 Jan 2005
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- Thread starter
- #47
Thank you Obeika for your information. It makes a little more sense to me now. Still the cost, even though the full price may seem expensive to you, made my head spin with glee considering costs here in the US! I felt as if I won the lottery or something! Quite a contrast in what I felt and what you would have felt if you were charged the same price for the same services.
KirinMan
後輩
- 23 Jan 2007
- 2,173
- 68
Ok let me finish what I wanted to write in my earlier reply;
Back in the late 1950's and 1960's though to the early 1990's doctors here in Japan were viewed as being infallable. Whatever they said was "right", nearly no one questioned their procedures or manners. Much of this stems from the fact that there were not enough doctors per captia as necessary.
Plus the Japanese culture itself plays a part in how the "average" Japanese person looks at an "educated" person. And on the ladder of education a doctor is about as high as one can get.
I trust you know the "value" that Japanese people put on education. The schools that an indivdual graduates from is more important than what they actually may know. People veiwed doctors and their opinions as being the "final" say. Once again no one questioned them. It is also a cultural thing as well.
No one questioned their, the doctors, decisions and many became legends in their own minds.
Now step forward to 2007, there are still many doctors practicing today that grew up in the era of infallability. They are unacustomed to having patients question their diagonosis or even ask questions about the treatments that they propose. They are also extrememly arrogant and look down upon younger or less experienced doctors than themselves.
Doctors never had to worry about the "sales" aspect of their profession, they never had to concern themselves about whether or not patients would come to their clinics or hospitals. They were "gods"
Now younger doctors, particularly ones in their early to mid 40's and younger realize that the system is becoming more geared towards the patient and their needs and not what the doctor's think or feel is pertinent. They are more aware of the "business" side of being a doctor and their own infallability.
The younger doctors also know that patients now a days are more interested in their own "condition" and no longer accept blindly what their doctor tells them is their "problem". Plus patients now have more access to information than before and can ask pertinent questions about their own conditions, many times to the chagrin of the (older) doctors themselves.
This is not to say that all older doctors are arrogant sob's but to say that the younger doctors here are more willing to listen to their patients and what their needs are than any time in the past.
- 19 May 2007
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Wow .... I am in the medical proffesion here in Japan and I know the difficulties of running of a hospital in this day and age and I can't believe the naieve biased oppinions of some of you. Sure not every Doctor here in Japan is an expert in his/her field , but neither is all the Doctors at home.
Obeika, your blatant disrespect for that hospital rules is why the medical system is getting worse all the time. If you think treating patients for free is fine then so be it, but the government does not emburse hospitals as much as you would like to believe. So of corse they are going to want you to pay for things like TV and electricity. Just b/c we don't expect that at home does not mean we can bring those ideas here. If you don't want to pay those prices , don't watch TV、read a book.
And Ewok85, at the risk of commenting on a Doctor I do not know( he could well have been rude and inconsiderate) not all Doctors are like that as I have many friends who are Doctors and are very considerate towards "gaijin" and they are also well into thier sixties.
Obeika, your blatant disrespect for that hospital rules is why the medical system is getting worse all the time. If you think treating patients for free is fine then so be it, but the government does not emburse hospitals as much as you would like to believe. So of corse they are going to want you to pay for things like TV and electricity. Just b/c we don't expect that at home does not mean we can bring those ideas here. If you don't want to pay those prices , don't watch TV、read a book.
And Ewok85, at the risk of commenting on a Doctor I do not know( he could well have been rude and inconsiderate) not all Doctors are like that as I have many friends who are Doctors and are very considerate towards "gaijin" and they are also well into thier sixties.
- 19 Jan 2005
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- Thread starter
- #50
The doctor that treated me was, I'd guess, in his late 40's; was very polite and considerate of my condition, and was not rude or arrogant whatsoever as I had expected from past experience. I was very pleased with the treatment I received from him and his genuine concern for my condition.FrustratedDave said:
