Sunday, March 16, 2008

I'm over 70, so my costs are 10% of the total...

As a long-term American resident of Japan, I cannot praise the national health care system too highly. Though I have had the usual experiences of long waits and inexperienced young doctors at a large public hospital in Tokyo, the quality of care and inexpensive medicine and services I now receive is exemplary. At 71, I have the expected range of geriatric problems—osteo-arthritis in feet and hands, cranky knees, cataracts, prostate hyperplasia— plus Hepatitis C. Only the latter can be life threatening. The local public hospital in the small rural own where I live was limited in its ability (read unable) to treat the Hep C. After a nasty fall that injured a shoulder rotator cuff for which the local hospital rehab person was not able to cope, I was recommended to a private clinic in the next prefecture. The doctor there practices both Western and Oriental medicine, and he cured a friend's chronic lung condition almost overnight. His clinic is covered by the national health care. His intelligent and careful regimen for the Hep C has brought the viral count down almost to the point of defeating it, and that may still happen. Acupuncture is also available there under the health care system; this helps the arthritic pain greatly and probably slows the progress of the disease. The acupuncture also treated the pain and helped effect the use of the injured shoulder.

The rambling, anecdotal comment is to illustrate that one is able choose one's doctor in Japan and that the quality of medical treatment, if carefully chosen, can be excellent. Also, since I am over 70, my medical and medicine costs are only 10 percent, repeat 10 percent, of the total cost. For example, recently a CT scan cost me only ¥2,000 (roughly US$18). This quality of medical treatment and the low cost under the national health care system is one of the major reasons why I feel that a return to the US would be a disaster for me medically. I could not expect to find a doctor with the same intelligent application of two medical traditions and certainly could not afford the increasing cost of treatment, etc. as my body ages.

Kim Schuefftan
Gumma, Japan

Saturday, March 1, 2008

National Health Care--no reservations required

My experiences here in Japan are the same. Dental care is also included, which is an issue that also needs to be addressed in the U.S., where dental care is separate for some reason.

There are no reservations needed - just walk into any clinic near you. They are almost all private - not run by the government. So you have complete choice.

When I had bronchitis recently, I just asked a neighbor which doctor she recommended and walked right over.

Doug Lerner
Tokyo

My coverage is more comprehensive and more transparent...

I also use the Japanese Universal Health Care system and love it. It's easy to use, I can go to any hospital/clinic I want (most are private), and it actually costs me less than what my friends pay in the US. Yet my coverage is more comprehensive, more transparent, and for the most part stress free. I also put my employees on it. It takes about 30 minutes to enroll them and then I never worry about it again. All I need to do is make sure there's enough $ to pay each month. It's dead easy.

Posted on YouTube by mikestky1

The costs of health care are a fraction of what one pays in the US...

Even for those not on the Japanese National Health Care plan, the costs of health care in Japan are a fraction of what one pays in the US. One has to wonder why.

Costs for universal healthcare will, no doubt, rise here in Japan as the population rapidly ages. However, the system is still fair, equitable, and efficient.

I do hope things get straightened out in the US!

Posted on YouTube by Tokyopairodice

It's nice to kow I've got nothing to worry about...

I'm also a teacher on the JET Prgoram, but I was previously an exchange student here, and I've always had national health care. It's nice to know I've got nothing to worry about. I had to get a root canal, and it was a bit scary, not only the prospect of the operation, but having to consult with the dentist in my second language. But when it was over, I handed them my national health care card, and I only had to pay 30%. So it's not even totally free, but it goes a long way.

Posted on YouTube by stovelkor

When I turned 23, I lost all military dependent priveleges...

I teach English on the JET Program in Japan. Growing up, my father was in the American Air Force, so I had free access to health care. When I turned 23, I lost all military dependent privileges, and was forced to buy private health insurance. It was a total waste of money, and I suddenly had to fear getting sick because of the financial burden, not just the disease. That is one of the main reasons why I came to Japan: their government seems to care more about my health than mine does.

Posted on YouTube by bschlabs

considering the life expectancy of the Japanese, the system works...

My family and I also have had great experiences with Japanese health care. It is great to just be able to just zip over to the doctor when you need to. Most doctors are open on Saturday too. Even if one has to make an appointment- say for a dental cleaning or a mammogram- the wait is minimal- a week or so. Considering the life expectancy of the Japanese- women especially- one can see that this system works.

Posted on YouTube by mitsugojp3

Every experience with the national health care system has blown me away...

I have only lived in Japan for 4 years, but every experience with the national health system has blown me away. So many great interactions. I had some chronic ear pain, so I just looked up the nearest private specialist in my area, walked into his small practice without calling ahead, and was seen within 15 minutes. Total cost was less than $30. Another time I had a urinalysis and time discussing results with the doctor, no drugs needed, so just: $2 TWO DOLLARS.

Posted on YouTube by delackner

Americans are worried about choice. In Japan, there IS choice...

I dont know a single Japanese person who would prefer the US system.

There was a time when I fell through the cracks in Japan and had to pay full price, and even then it was way cheaper than in the US.

Americans are worried about choice. In Japan there are many hospitals to choose from, and some are better for certain specialties than others. There IS choice.

Also, there are supplemental private insurance plans to take up any slack in the nat'l system.

Many people in the US have no choice!

One more thing: even if people fear the system will run in the red, so what? It's a worthy thing to spend money on. The fire department runs in the red but it serves an important purpose.

In Japan highways are expensive to use (tolls) and hospitals are cheap. In America it's the opposite. We will spend taxes for free roads but not for health care. Shows where the priorities are.

YouTube post by kirkdunkirk

My husband was laid off, but Japan has a plan that covers everyone...

We are living in Tokyo, Japan. We moved here, planning to stay at
least two years, hopefully more. It was a shock when my husband's
division in the company was laid off. We lost our health care.
Happily, Japan has a health care plan that covers everyone and we are
charged according to what we can pay. It even covers foreigners like
us. Doctor's visits and even the cost of medicine is very low and
reasonable.

Hmm. Maybe the USA should give it a try?

Ruth Inglsrud
Tokyo

All people under 6 and over 70 have 100% coverage...

As a young American woman in Japan 30 years ago I remember commenting to my husband, an M.D., on the reason for the longevity of women in Japan. At the time, the life expectancy was 83 for women and 79 for men. Japanese women outlived, not only Japnesse men, but as a national group had the longest life expectancy in the world. I said that it must be due to the diet. He corrected me immediately saying that it was the health care system. Recently I was even better able to understand the meaning of this. My friend and former Japanese language teacher who had not been feeling well was hospitalized for tests. They did a 24 hour electrocardiogram on her saying that the usual 15 minute one was not enough. She was told that during the night her heart had stopped beating for six seconds and that had this happened during the day while she was up and around rather than lying in bed, it would have been a massive heart attack. She had to have open heart surgery. In order to do this they had to open up the chest cavity by forcing her ribs to open. Then they took the heart out and inserted a mechanical valve inside one of the main arteries. There were three surgeons in attendance and it took more than four hours. She had to stay in hospital for a whole month. And of course she had visits to the doctor afterwards. She's fine now. The doctors said she went through it well because, although she was 71 years old, all her other internal organs were in good health. They also commented on her positive outlook as a factor in her recovery. The total cost of all of this was 1,800,000 yen, which comes out to almost $17,000. In Japan all people under six and over seventy have 100% medical coverage. We have a national health care system here. This means that in old age you don't have to worry about where the hospital expenses are going to be coming from.

Dorothy Dufour
Japan

The mood was shock and disbelief that any country could be so callous...

My experiences with universal health care have been in Australia, not in Japan, but I think they are equally applicable. Two and a half years ago, my wife's mother in Australia was diagnosed with terminal cancer. My wife and I moved from Japan to Australia to care for her during the final months of her life. The care she received was excellent throughout. She was able to go to the hospital whenever she wanted for as long as she wanted, wait times were never longer than what would be expected at a hospital in the US, and her doctors were able to recommend procedures for her based on whether they thought they would be beneficial rather than without worrying whether or not they would be covered by her insurance. All her medication was subsidized by the national health care system, and the most we ever had to pay out of pocket was $20AU. In the end, except for the small amount we had to pay for medication, all the care she received cost us nothing. My wife and I were able to focus on spending quality time with her in her last few months rather than worrying that her treatment would bankrupt us.

I lived in Australia for two years and made use of their national health care system numerous times myself. Depending on the billing practices of the doctor, a visit to the GP would either cost nothing at all or between $20 and $30AU. Last June I had surgery to repair a perforated eardrum and was admitted to the hospital overnight, and I found the care I received to be of the highest quality at no cost to myself.

Yes, the tax rate in Australia is higher than in the US, but higher taxes are not crippling the Australian economy. Australians are prosperous and happy, and small businesses thrive there. Thanks largely to generous social programs that help insure a basic standard of living for all Australian citizens, Australia has nowhere near the level of crippling, hopeless poverty that afflicts some parts of the United States. The Australian universal health care system is now so popular that to attempt to eliminate it would be political suicide.

I watched Michael Moore's Sicko in Australia last summer, and the general mood in the theater was disbelief and shock that any country could be so callously barbaric toward its own most vulnerable members. I agree with them, and think that if America truly wants to call itself a standard-bearer for freedom and equality in the world it should start by making sure that its own most needy citizens get the health care they desperately need.

Isaac Griffith-Onnen
Australia/Japan

Under the US system, I probably wouldn't be alive...

I am a major beneficiary of Japan's National Health Insurance single-payer system. I was enrolled in it by my then host family within the first two weeks of my arrival here some years ago and I've been on it ever since.

Over the years, a medical condition I have that I knew about since college had gradually worsened -I was being closely monitored by medical specialists here- and it was determined that surgical intervention was required. At the time I was mulling whether to have it done here or back in the US, which would've cost me over $35, 000, since I was uninsured there.

I elected to have the surgery done here, which was fully covered by my National Health Insurance above the Y50,000 (about $500) monthly deductible, that included a month-long hospital stay. However, there were complications, requiring another emergency operation. This extended my hospital stay another two weeks, but all additional costs were fully covered by the NHI.

Five years later, my condition worsened again, requiring yet another surgical intervention.
Once again, it required another 1-month hospital stay. The first and third surgeries I underwent were decided after I had deep consultations with my specialists. They had agreed to undergo the first surgical procedure that I had insisted be tried, which ultimately required the third surgery. So it was my decision -not the specialists- that ultimately lead to my requiring further surgery. However, all of it was covered by NHI.

Had I not come here to Japan and stayed back in the US, I shudder to think where (if) I'd be (living) today. I wasn't 'gainfully' employed and had no health insurance (having this "pre-condition" would've probably rendered me uninsurable anyway). At best-case, I would have had the operation(s), and be in medical debt of well over $100,000 now, or worst-case, dropped over dead due to lack of treatment because I couldn't afford the surgical intervention.

So for, me, Universal Health Care works. Under the current US health care system? Well, I probably wouldn't be here to relate this anecdote to you.

Anonymous
Japan

I can see any doctor I want...

My life right now has brought me to Japan for a while and fortunately for me, I have to say, one of the most wonderful benefits of living here is access to health care. I can see any doctor I want almost anytime I want. If I am sick one day, I can go to the doctor, without an appointment and wait a bit and I WILL see the doctor. And, in addition, I can decide which doctor I want to see and I can also choose to see any specialist I like. And with the national health plan, I often pay only a small fee at the end. I and my husband work and just like everyone we pay taxes to cover health care...believe me it is so worth it!

I remember one time when I was in the states and I was so sick. Sick as a dog. So I called my primary care doctor's office, explained how I felt and asked to see the doctor that day. The secretary asked me to come in two weeks! Two weeks?! If I were extremely lucky I might be better by then and then would not need to see the doctor....If I were extremely unlucky...well... I could be dead! Can you imagine telling anyone to come in two weeks?! "Excuse me, I think I am having a heart attack...."oh, too bad, can you come for an appointment in two weeks?" Good grief, give me a break!

Luckily for me, living in Japan with a national health plan, I never have to worry about that scenario anymore! However, I do worry about all my relatives in the States: mother, father, sisters, brothers, nieces, nephews, uncles, aunts. They deserve the kind of access I can now take for granted. I will vote for the candidate that will help provide a similar kind of health access for my friends and family in the States and I encourage everyone else to do the same!

Karen Wakayama
Japan

The hospitals don't turn anyone away...

My experience with the Japanese national health care system has been positive over my eight years here. I pay 30% on all necessary medical and dental procedures, which makes it possible to take care of myself properly on a roughly $2600 / mo salary. Two years ago I broke a metacarpal bone in my hand doing martial arts, and I got surgery for less than $300 at my local hospital. It has healed perfectly. Another plus of the system: even if you forget to pay your premiums, you can get treatment on the spot and pay later. They don't turn anyone away. My only issue with the system is that regular gynecological checkups aren't covered!!! You have to pretend you have a pain in order to get an exam. But 90% positive especially in comparison to my ghastly experience with New York City public hospitals, aka the first circle of hell.

Anonymous
Japan

As you age...

As a long-term American resident of Japan, I cannot praise the national health care system too highly. Though I have had the usual experiences of long waits and inexperienced young doctors at a large public hospital in Tokyo, the quality of care and inexpensive medicine and services I now receive is exemplary. At 71, I have the expected range of geriatric problems—osteo-arthritis in feet and hands, cranky knees, cataracts, prostate hyperplasia— plus Hepatitis C. Only the latter can be life threatening. The local public hospital in the small rural own where I live was limited in its ability (read unable) to treat the Hep C. After a nasty fall that injured a shoulder rotator cuff for which the local hospital rehab person was not able to cope, I was recommended to a private clinic in the next prefecture. The doctor there practices both Western and Oriental medicine, and he cured a friend's chronic lung condition almost overnight. His clinic is covered by the national health care. His intelligent and careful regimen for the Hep C has brought the viral count down almost to the point of defeating it, and that may still happen. Acupuncture is also available there under the health care system; this helps the arthritic pain greatly and probably slows the progress of the disease. The acupuncture also treated the pain and helped effect the use of the injured shoulder.

The rambling, anecdotal comment is to illustrate that one is able choose one's doctor in Japan and that the quality of medical treatment, if carefully chosen, can be excellent. Also, since I am over 70, my medical and medicine costs are only 10 percent, repeat 10 percent, of the total cost. For example, recently a CT scan cost me only ¥2,000 (roughly US$18). This quality of medical treatment and the low cost under the national health care system is one of the major reasons why I feel that a return to the US would be a disaster for me medically. I could not expect to find a doctor with the same intelligent application of two medical traditions and certainly could not afford the increasing cost of treatment, etc. my body ages.

Hope this is helpful and that this experience has some relevance,

Sincerely,

Kim Schuefftan