Tuesday, April 14, 2009

Coming from a Conservative Family, I was Suspicious of Universal Health Care

As an American citizen, I know how it is in the states. During college, I was slightly covered by the university's student insurance plan, but when I actually needed it, it only covered a part of the costs, and I found out how little when I got the bill. I could have bought a nice car for the price. I had to use my student loan money to pay it off.

After University, I tried my hand at working independently. But with the plans being confusing and requiring a separate university degree just to understand what I was supposed to be choosing/paying for/ and getting, it isn't any wonder that I gave up on trying to be insured. I just tried to keep myself healthy and rely on over-the-counter medicine.

Then I came to Japan. While working for the government, I was first introduced to the universal healthcare plan. I admit, having come from a conservative family, I was suspicious of this system. It certainly took a large chunk of my salary, but once I was familiarized with the ins and outs of it, I grew to respect it. To be fair, I will list both the bad points along with the good points.

Bad point 1: senior citizens, who pay almost nothing for a visit to the doctor, will go to the hospitals almost every morning to get looked at for whatever ails them. However, it should be noted that there are a growing number of small clinics connected in some way to the larger hospitals, and so people can go to the small clinics, see a local (read as family) doctor to get a first look, then if needed, get a referral to a doctor in the major hospital, jumping to the head of the line when needed.

Bad point 2: Dentists here are all about painless dentistry. that means that each visit will be a week apart and last for 10-15 minutes. This will continue for 3-5 visits depending on what is needed. The first time will be about 1500 yen, which includes X-Rays, and subsequent visits will be about 6-700 yen. Detractors will say this is evidence of the dentists milking the system, but the visits are truly painless. Unlike when I had a cavity filled in my homeland of the U.S. I was given 2 hours of excruciating pain as the doctor jabbed, drilled, filled, etc. then had to deal with a lot of pain when the local anesthetic wore off. To make matters worse, the filling came out not 3 days later, and I had to pay another 80 dollars for the dentist to put it back in... (dentistry wasn't covered by my u.s. insurance at that time). I have had a root canal, and 2 different cavities filled while here in japan, and the price hasn't changed one bit.

Good Point 1: Children are free. Depending on which prefecture you live in, the government gives a subsidy in cash every 4 months to care for babies through to elementary age. And the medical visits for children to pediatricians is 100% free. that includes the medicine as well. That also includes all the shots and check ups that babies need to become immunized. All free.

Good Point 2: Medical expenses are refunded. Go the hospital in Japan? Save the receipts if you are living here, and when you go to pay your taxes, submit a form with the receipts and whatever wasn't covered by the insurance (which covers about 90% of any medical fees and medicine fees) can help land you refund money.

Good Point 3: no paperwork. Seriously. I was SOOOOO tired of filling out requisite forms in the U.S. for my insurance company I initially used when I arrived in Japan. Here I get a card. I give the staff my card, and they give it right back when I am done. That's it. I don't have to get a doctor to write forms in triplicate.

Good Point 4: The prices don't change. The premiums are the same every year. They don't change as a result of having used the insurance. Here is a negative example of what happened to my father in the States. He had a problem that required him to stay in the hospital for a few days. He remembers only receiving two asprins for pain during his entire stay. Yet when he got the itimized bill, he found that they charged him for having supposedly received pills every hour for the entire time he was in the hospital. Yes, that's right! They charged him for apparently taking hundreds of pills that never entered his room let alone went down his throat. When he told his insurer about the fraud, they told him there was nothing that could be done. They would still raise his insurance premium for having used the insurance at a hospital and cost them so much. As for the hospital overcharging him, that was explained away as the way hospitals operate nowadays. when
someone doesn't have insurance and comes into the ER, people who have insurance are charged for their medicine. The insurance companies raise the rates of the people paying money for their insurance and don't do much to stop the hospitals unless too many people complain, and then they just stop allowing their customers to use their insurance at the hospital. They don't do anything to stop the fraud itself. So in the states, those who pay for insurance pay more for paying for those who don't pay anything for their visits to the ER. Wouldn't it just be better if EVERYONE was covered, and the rates stayed the same regardless of who used them or how much was needed?


1 comment:

Daniel said...

The general trend of looking outside the UK for quicker and cheaper dental treatment in certainly on the rise. Sites like www.dentalholiday.co.uk offer a "NHS" alternative abroad and are seeing great success so far.