A Few Words on Japan’s Health Insurance

Health care is on my mind. Yes, due to everything happening in America. I want to share my experiences with something that I often hear described as universal healthcare. This post is going  give you my personal story. It is not going to be an in depth statistical or cost/benefit analysis of this system. I don’t really know those numbers. What I do know is what it is like to live in such a system and how it has impacted my quests for health care.

Here are some things I know. Japan, where I have lived since 2004, often gets mentioned as one of those places with socialized medicine and universal health care. I’ll be honest that I’m not really sure if that is completely true.

What I do know is that there are many protections in place to get insurance coverage for as many people as possible. You can get it through your job. If you aren’t full time, you can get it through the government. If you aren’t paid up, you will be contacted about it. I am fairly certain there is even a law that to maintain my VISA, I need to keep paying into insurance.
You might have read that this type of health care promotes huge wait times and a lack of freedom in choosing doctors.

Well, because the system is universal I’ve never been told I couldn’t see a certain doctor. The closest is on occasion I’ve had to visit a more general doctor to get a referral to a specialist. But, that hasn’t happened to me often (maybe once or twice) and I’ve been able to get an appointment that same day. And honestly this was long enough ago where I can’t say exactly why was going on do to language barriers.

As for wait times, I’ve had to wait in a crowded waiting room for sometime an hour or two. At doctor’s offices where they don’t allow appointments, encourage people to come early and take a number, in areas where it is known many elderly use doctors as social outreach. Basically, the times I’ve had to wait have been more do to cultural reasons than medical.

Because there are also different doctors that I’ve been to that have more modern approaches to waiting lists. The pediatrician we use has online reservations, a phone service option, and they text message you any changes and even give you a 45 minute start time message. This is a doctor who wants to reduce waiting room time and as a result we’ve never spent more than 30 minutes in the waiting room. And yes, it was a same day appointment. Keep in mind that this is in the middle of Tokyo.

As for price, well, I recently had an acute ear infection that took a main visit and two follow ups. There were three different prescriptions that meant multiple daily doses for over three weeks. I paid less than $50 for everything.

I once had an emergency room visit, complete with ambulance ride. Fortunately nothing invasive was needed. But we needed some prescriptions and they gave me an IV. This still ended up less than $100.

(Basically I had a severe cold that blocked my nose. I spent the night breathing in cold, dry air to the point my uvula got inflamed. I woke up, coughed and it blocked my airway. Incredibly scary, but once I could calm down and effectively swallow it back into place I could breath again, but we had already called an ambulance during the panic stage.)

I’ll be honest that I don’t really know how much I am paying a month for this. I know at my former job it was around $400 a month. My wife paid a similar amount. Since then I went back to grad school, changed jobs, so did she, we had a child, who the main payer was for the family changed and then changed again, etc. End result is I’m currently not sure how much I pay. I know I pay in more than I take out. For now.

Listen, I don’t think Japan’s health insurance is perfect. It doesn’t cover preventative medicine for one thing. Or pregnancy/childbirth. There is a whole confusing stipend/getting repaid system that just confuses me.

But it works. And most of the criticisms I hear aimed at this kind of system are not problems that I have faced, nor have I heard others complain about.

I’ll admit it. I’m in favor of universal healthcare. I think as a society we have more to gain by aiding all than. And I also know that not everyone thinks access to health care is a right, and that some don’t feel it is their responsibility to help with the health care of others

And some just are doing their best to support their own families and are understandably worried about being asked to shoulder more burden.

I don’t have all the answers. But I do feel there is a lack of information about what it means to live under such a system and that much of what I see written is full of boogeyman prophecies.

But, believe it or not, I’m not telling you that you must support universal healthcare, but I am saying that if wait times, high prices, and lack of choice are reasons you oppose it, then notice that none of those plague the system I live with.

Implementation is an important step. It is arguably the most important step. It can turn a nobl idea into something broken. I look back at America and see the amount of opposition the ACA faced and I remember how many governors refused aspectsof the initiative. I remember those and think about how easy it is for failed implementation to make good medicine a bitter pill.

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2 thoughts on “A Few Words on Japan’s Health Insurance

  1. As I recall the health care which I used in the 80’s and 90’s on and off, it was petty bare bones in terms of comfort and the wait times YES! On Sado Island the hospital was the social club I believe. Recently my husband had an overnight stay in a hospital in Indiana (across the boarder from my home state Michigan) and WOW! The food, attention, precision and the view from the private room! It was a surgery plus hospital stay that billed out at 60k just for the facility. Our insurance will cover all but a 2k deductable and my premiums are around 450 a month for three people (family rate). I would like something in between a rusty ah-stick and doctor who tells me to drink more beer (countryside Japan) and a luxury stay. I was thinking 10-15k would have been a better sticker price.

    1. Yeah, some of the smaller town doctors feel pretty stark. My first x-ray in Japan I ended up standing on what looked like an old wooden peach box.

      I’ve been lucky enough not to need hospitalization, but I know that the group rooms are essentially free (with insurance) and private rooms can get pricey depending on the room and the overall facility.

      Bedside manner can also be in short supply. I didn’t want to muddy the waters of the main article, but I often think some of my problems with how things to do with the culture than with the insurance system. Older doctors can really buy into the doctor-as-king idea and get cranky at any question. I’ve had older doctors get fussy with me for asking what sickness I have instead of just thanking them for a prescription.

      But as more doctors study abroad this is shifting.

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