Saturday, August 15, 2009

The Japanese Receptionist Apologized for the High Costs

I have Diverticulitis which sometimes becomes inflamed and I have to go to the doctor to receive antibiotics. The pain subsides within 24 hrs and disappears after about three days. My last problem with it occurred about 4 yrs ago.

Well, while I was visiting Japan a couple of years ago with my Japanese wife, it became inflamed and within 24 hrs I developed a slight fever and knew I would have to go see a doctor or go to the hospital. I was a little concerned as I had no national health insurance, but it had to be done regardless of the cost.

My wife called a doctor in the neighborhood and an appointment was made for an hour later. It was a Saturday morning and I figured it would probably be crowded. I had not received medical care in Japan since the 80’s when I was living there full time and, not knowing the present cost without insurance we took 60,000 yen (about US$600) with us as, in the US, with no health insurance the cost would probably be at least $200 if not more.

We walked the 10 minutes to the small clinic and upon entering, after removing our shoes and using the slippers (pink for females, blue for males) I was amazed that there were only two patients there, an elderly gentleman and a woman with a baby. Surprising for a Saturday morning as in the US on a Saturday the offices are booked solid and one must wait at least an hour over ones scheduled ”appointment”. The nurse behind the counter took my basic information and asked that I take a seat and said the doctor would see me shortly. Unlike the US there were no pages and pages of info to fill out for a first time visit.

Within 10 minutes the doctor called us in and I noticed his diploma on the wall from Tokyo University. I explained my situation to him in Japanese with help from my wife and what kind of penicillin I usually take for the symptoms. He understood what I was talking about, checked his computer for reference and asked that I lie down. Locating the pain on the left side of my abdomen he asked that I take a urine test. I left the cup on the counter in the restroom and as soon as I returned to the room he said that my urine was ok. Now that was fast!

He said that he would give me a 5 day prescription for antibiotics and pain killers and that if the pain did not subside within 24 hrs that I was to return. We went to the counter and we were given the medicine right there! No pharmacy to go to! Our bill was calculated and it was presented to us.

To my astonishment the total bill for the visit, urine test and two prescriptions was 4,610 yen!! Approximately US$38 at the then exchange rate! And that was with no National Health Insurance! My wife and I looked at each other with wide open eyes. I asked her if this was the normal cost and she asked the nurse. Yes it was and they apologized for the cost with my having no health insurance! Unbelievably reasonable in my opinion and there was no need for them to apologize if they knew the cost of such a visit in the US. It was way lower than either of us expected. Had I been living in Japan it would've cost me about US$7 - $10 for the visit under their health care system.

I calculated the cost of what this would have cost me in the US WITH insurance. The co-pays for the doctor, urine test, and two prescriptions at a pharmacy would have come out to about $60 and, with no insurance the cost would have been at least $200! This just goes to show how unreasonable medical costs are in the US.

Anyway, within a couple of days I was fine and my visit to Japan was not interrupted at all as I was still able to function thanks to the pain killers and had a wonderful time during the rest of my visit. I am very grateful that in Japan you are not ripped off for emergency medical care even if you have no health insurance!

Therefore, if you are visiting Japan and become ill, don’t fear that it will cost you an arm and a leg if you have to receive emergency care as the costs are very reasonable to one without insurance.

It's funny how many of the major pundits never mention Japan's Single Payer System and how successful it is. Rather they point fingers at the UK's and Canada's bad systems. In Japan anyone can go to any doctor or hospital at any time for any test or surgery or care. In Japan's system no one is turned down due to pre-existing conditions and everyone is required to participate and the monthly premiums average around US$250. THE per capita cost in Japan to the government is around US$2,500 whereas in the US the per capita cost, with the present system, is over $6,000!

Would such reasonable and affordable care happen in the US with a national health care system and the prices be so affordable? I think not as the US system is designed for profit whereas in Japan all prices from major surgeries to prescriptions to the number of stitches is set by the Japanese government every two years and hospitals must be not for profit. It would, in my opinion be a disaster in the US. The US must go slow on this and all congress people should be required to read the bill before it is passed. If not it will cost the US and their people trillions and will fail. Besides, the system is too corrupt in the US for it to be a success as the majority of our government is bought and paid for by the pharmaceutical industries and the insurance industries IMO. It's doomed to fail unless the people are vigilant and ensure that a reasonable system is enacted and where the average person can read and understand the bill now before congress!


Americans Who Can't Go Home Because of Health Care

Can't Go Home from Turtlebox Productions on Vimeo.

Cost for care in Scotland was zero

I'll make this short. Our daughter suffered for years in the United States with an undiagnosed case of Myasthenia Gravis. Her doctors, including a neurologist in New York, failed to diagnosis her disease and dismissed the symptoms as psychosomatic. Mind you, the symptoms, as we learned later, were classic for a young woman with this admittedly rare disease.

After moving to Scotland to start a Masters program, she could finally no longer swallow reliably or talk for more than a few minutes before her muscles no longer worked. After receiving no useful care at an emergency room, she went to see our local GP who referred her to the local teaching hospital. There, based on nothing more than a conversation and superficial examination, the UK equivalent of a new resident correctly diagnosed the disease. Since then, she has been hospitalized for a month, given two very expensive courses of IVIG treatment, and had her thymus removed in major, open chest surgery. Thankfully she is now much better and about to head off for a Ph.D. program in England.

Recently, we flew back to New York to consult with perhaps the world expert on Myasthenia. After reviewing her symptoms and treatment he declared that the doctors in Scotland were doing all the right things. He then asked how much this cost. He had a bit of a hard time understanding that the cost was exactly zero. By the way, I spent about two months paying various bills associated with that one visit to his office. Quite a contrast I'd say.

Is the system in the UK perfect. Of course not. Did they provide superlative care for our daughter. Absolutely.

New York