The system works well, and I'm living proof of it

Four years ago I was diagnosed with invasive breast cancer. While I have lived in Japan for over 25 years and it is very much my home, the thought of undergoing treatment for a major, life-threatening illness abroad was something I had never contemplated and admittedly it was terrifying. However, I quickly learned that I was in the best of hands. The standard of care I received throughout the year-long process of surgery, chemotherapy, and radiation was equal to or better than what I would have received had I been living in the U.S. The period from diagnosis to surgery was fast, and there was never any question of access to the latest treatments and therapies for my form of the disease.

Because I am self-employed, my type of Japanese national health insurance covers 70% of the cost of any treatment with a 30% co-pay. This 30% is minimal for normal doctor visits because the cost of the visit is so low from the start. I did not know what to expect in the way of costs for major surgery and chemotherapy though. I had heard horror stories of single chemo treatments costing $4,000 in the U.S. However, I consistently found that the costs in Japan for the identical drugs and therapies averaged 70% less than the costs in the U.S. Hospitalization costs were closer to 90% less. Further, the Japanese system has several built-in safety nets to help families through catastrophic illness. Whenever the total co-pay for a family exceeds 65,000 yen (approx. $650) in a single month (under the rules four years ago), the insurance system steps in to pick up a larger percentage of the cost. I had several months where I exceeded the limit and each time I received a refund. The system also makes the cost of health insurance, all medical treatment, and the cost of transportation to and from the treatment tax deductible. Thus, what you do not receive as a refund during the year, you get back in a tax refund at the end of the year. Thanks to overall lower costs, an all-inclusive health insurance system, and these safety nets, my family and I never had to worry about the financial burden of my illness and were able to focus 100% of our energies on my recovery. The system works and it works well. I am living proof of it.

Marjorie Dewey
Chiba, Tokyo
Whiteside County, Illinois