Uninsured in Japan: a medical trip report

Most of you probably don't know, but I have been living/working in Japan for the past 5 years. Over this period, I have been without health insurance for 4 of those years - I was put into the national healthcare plan when I came over as a high school teacher, and when I finished my contract the school canceled my coverage. I have not been to a doctor since that time, terrified of how much it would cost.

Today, I went in, insurance-less, to the doctor for the first time. In light of our problems back home, I felt I should share this with all of you here.

bonsai superstar's diary :: :: Yesterday morning, I woke up feeling like someone punched me in the nose. As I was sober the night before, I am 100% sure this is not what actually happened. Understandably, this worried me. So I did what every uninsured American probably does when they feel unwell: checked WebMD's symptom checker. Everything from leukemia to staph to sinus infections came up. I decided to chug some echinacea tea and sleep it off, hoping I'd be better the next day.

The next day, my entire face was swollen and painful, and I was blowing my nose every 30 seconds. Shit. After another web search found someone suggesting whatever I had could spread to the brain if unchecked, I resigned myself to getting checked out. I still had my rent money (around 600 in USD) for the month in my wallet, and my landlady is nice enough that I could probably get an extension, I thought. If it was just sniffles I'd have stayed home, but my face already didn't even LOOK like me. I have to work on live TV next week, and it's not an all-caucasian remake of Rudolph, so I bit the bullet.

I found a hospital nearby that was still open in the evening (many places here, after mid-afternoon, you're screwed) and said I needed to be checked out, but I did not have insurance. The receptionist seemed a little concerned, but checked with other staff and then told me that if I paid in full, and brought photo ID with my name and address included, I could see the doctor. I asked if I needed an appointment.

"No, not at all," the receptionist said. "We're open until 7pm, just come in at any time. We'll be waiting for you." On a Friday night, in the middle of the 2nd biggest city in Japan, in the midst of a swine flu epidemic that is just now starting to calm down.

I came in, explained that I was the foreigner on the phone earlier, and they gave me a sheet to fill in, standard medical background stuff and a place to write down what was wrong that caused you to seek treatment. I filled it in, and after a bit of waiting was brought in to see the doctor, apparently the main guy since his last name is the one on the sign.

We talked a bit about my symptoms, when they started. He checked my throat and nose, asked about my mucus consistency, then showed me on a computer screen display of the throat/sinuses where and what was inflamed, and diagnosed it as an acute sinus infection that apparently is going around quite a bit right now. He promptly wrote me a prescription for 3 days worth of pills and told me to come back if there was no improvement. I thanked him and left.

I went back to the reception area, they gave me a card for the hospital, and 2 papers: 1 was the prescription sheet, one was my bill. Keep in mind this is the full price, as I am not insured (a Japanese under the national insurance would pay 1/3 of this).

3,900 yen. As of writing this, that's about $43. I paid them, said thank you, and left. The pharmacy was directly next door (for prescriptions in Japan, you either get them inside the hospital, or usually a place very close to it. OTC drugs are sold at regular drug stores). I headed in, gave them the paper, and they handed me another form to fill in. One of the staff very kindly walked me through it to make sure I understood everything. Incidentally, one of the questions was "do you have an interest in generic drugs?" I checked the "hell yes" box.

Almost the moment I handed back the form, the other pharmacist came out and apologized for making me wait. She brought out 3 different drugs　(anti-biotic, an expectorant, and something for stomach problems) - each 3 days' worth. She explained when to take them and their use, then stuck them in envelopes in a plastic bag, along with a free handwarmer and a printout with pictures, descriptions, and use instructions of each medication. Then, she handed me the bill, apologizing for it being so expensive because I was uninsured.

3,100 yen. Or if you prefer, 34 dollars. In all, this trip to the doctor cost me less than $80 and took less than an hour (I arrived at the clinic at 6:15, I left the pharmacist drugs in hand at 7:05).

This is not a perfect country by any means. There are many things that I feel we do better in America. I have heard of (and seen) some terrible medical facilities here. But when I get 3 prescriptions filled in 5 minutes and they are SORRY they have to charge me a whopping 30 bucks for it, and I see people back home paying many times that, I have to wonder how we're managing to do things just this wrong.

http://www.dailykos.com/storyonly/2009/12/18/816168/-Uninsured-in-Japan:-a-medical-trip-report

Corporatism.

It explains all of the ills of america. The absolute blind worship of "business".

:)

it's a good one.

to settle permanently. Don't think I haven't considered it.

I am guessing someone would be out @$500 or more here. Others may have a better feel for the cost and what a doctor would do.

And she has a medical condition.

Fortunately, she has insurance, which is great.

Even so, when she had an emergency in the middle of the night, it was almost impossible to get into a hospital--and in this case, time was of the essence. Finally they got her into one! Then, it actually took forever for them to let her go, LOL. She ended up having to change doctors, to one affiliated with a hospital, in case she ever needs emergency treatment in the middle of the night again.

Another problem is that they generally don't give prescriptions that last more than a month.

Same thing with my husband's $25 root canal in the Netherlands.

Self-employed people go on the public plan, where the premiums are based on your income.

However, my point was that in all countries that have private insurance as part of a universal health care system, the government directly regulates prices.

:dem:

-Laelth