I have lived in Japan off and on for close to fifteen years and for most of that time have been covered by the National Health Insurance (now, at the university where I work, I am covered by a slightly different socialized medical plan that is union-based). I pay 30% deductible. In all these years, I have found this coverage to be nothing but a source of relief and peace of mind. Many people back home in the U.S., and this includes myself when I lived in Virginia and California, are at some times in their lives without insurance, which means they cannot afford basic preventative medical care much less necessary treatment. Indeed, it is only now AFTER having had coverage under Japan’s national plan that I truly understand how lax the U.S. is and no longer see it as “the way things are” or have to be; actually, I am more fearful of returning to the U.S. where basic health care is not considered a fundamental right of citizens. Here, when my husband broke his toe in a minor accident one night, the ambulance came within fifteen minutes. They took us to a nearby hospital where he received immediate, excellent treatment after hours, including seeing a doctor, getting X-rays, and having a splint put on. All in all, less than $50.00. His follow-up care was personal and complete, inspiring his confidence to go there for all his medical needs in the future. In my case, five years ago I discovered that I was losing vision in my left eye. I went to a university teaching hospital where I had it looked at by a professor and doctor of, it turned out, the highest quality in the country; in the following weeks, I would have surgery on my eye to have a scleral buckle put in to prevent further detachment of my retina and potential blindness if I had not received immediate attention. My care was the best from start to finish, as was follow-up and results: my eye is now better vision-wise than it was before the operation and I have had no problems with it since. I shudder to think how I might have put off the crucial, initial examination of my eye if I had been in the U.S.
Admittedly, as foreigners, we sometimes get special attention or treatment, I think, in Japan, but in comparing my care with my Japanese neighbors and those in the waiting room or my hospital room I always hear and see how they take for granted their nationalized medicine. Consequently, their complaints about having to wait or not being able to make appointments or the like are the complaints of those who are invested in making their system work better, not of those who want to change to a system such as we have in the U.S. Is there anyone from any country who would prefer that? I would find that hard to believe, unless he or she were someone from a country without any health care at all – but then again, in that case, the U.S. can be said to be in effect on a par with a country that offers no health care, even if it has great doctors and facilities. It has health care only for those who can afford it, it seems, in too many cases.
How did we reach this point of such patently unpersuasive, false arguments about “socialized medicine” in violation of our “capitalist” society, thereby losing sight of the democratic aims voiced in the Preamble to the U.S. Constitution, one of those aims being, you will recall, that the government will “promote the General Welfare” on our behalf? What is included under “the General Welfare” if not basic protection and promotion of health care for all citizens? If other countries can do it, why can’t we? Although Europe is in recession just as are we, its citizens feel it less thanks to its safety net systems. Let’s argue about which safety net system, not to have one or not! Universal health care works under capitalism, is not without inconveniences such as waiting and bureaucracy, and it is certainly not “free,” as we can see in Japan. Despite its imperfections, as imperfect as democracy itself as we strive to improve our country for the benefit of all, the universal health care system in Japan offers safety, quality, and security that I would take any day over, well, nothing – which is what the U.S. offers too many of us all the time, or at least at that some point in our lives when we most need it. My deductible two cents.
Mary Knighton
Tokyo, Japan
California
Showing posts with label doctor. Show all posts
Showing posts with label doctor. Show all posts
Saturday, April 11, 2009
Thursday, March 12, 2009
Appendicitis surgery
It was early February a couple years ago and I had just finished
eating dinner with my host family in Kobe. I went to bed with a bit
of a stomachache, but nothing too serious. I woke up a few hours
later with severe stomach pains and, well, I spent a fair amount of
time that night hovering over the toilet bowl. I finally got to bed a
couple hours later and woke up feeling much better. Just a case of
food poisoning I thought.
I had a glass of water and in an instant, as if it was the catalyst
for a complete bodily meltdown, I was back repeating the same scenario
during the night before but feeling even worse. My Japanese host
mother drove me to the hospital down the street. When we arrived, the
nurses helped me on to a stretcher and I waited about twenty minutes
or so before they started taking my MRI and a few tests, I don't
remember too well. I remember there was a massive machine that
injected a giant syringe of warm fluid into my blood stream so they
could take pictures of my abdomen. A little bit after, the doctor
looked at the results and decided I had appendicitis.
Unfortunately, they couldn't do surgery on me because they were
already busy through to the next day. "So this is how it all ends" I
remember thinking for a few moments.
But the doctor came back to me a few minutes later and told me an
ambulance was waiting outside to take me to a nearby hospital that
could do the surgery right away. I arrived at the hospital, the
nurses brought me in, the anesthesiologist anesthetized me, and I woke
up in a bewildered state sometime later. The doctor came into my room
and said that it had burst so he had to disinfect the entire stomach.
Thus, instead of the normal quick twenty minute or so surgery that it
normally takes for an appendectomy, mine lasted about two hours. "It
was a little difficult," the doctor told me that night.
In Japan it seems they like to keep you around in the hospital for a
bit longer than the states, so I was kept for ten days, just to make
sure I was all well and ready to enter back into society. It wasn't a
wonderful experience, but the nurses were nice, and the doctor came in
to give me exceptional explanations of the procedure, with plastic
models of the body and everything. I ended up paying about $1,900
dollars.
Gavin
Japan
Hawaii
eating dinner with my host family in Kobe. I went to bed with a bit
of a stomachache, but nothing too serious. I woke up a few hours
later with severe stomach pains and, well, I spent a fair amount of
time that night hovering over the toilet bowl. I finally got to bed a
couple hours later and woke up feeling much better. Just a case of
food poisoning I thought.
I had a glass of water and in an instant, as if it was the catalyst
for a complete bodily meltdown, I was back repeating the same scenario
during the night before but feeling even worse. My Japanese host
mother drove me to the hospital down the street. When we arrived, the
nurses helped me on to a stretcher and I waited about twenty minutes
or so before they started taking my MRI and a few tests, I don't
remember too well. I remember there was a massive machine that
injected a giant syringe of warm fluid into my blood stream so they
could take pictures of my abdomen. A little bit after, the doctor
looked at the results and decided I had appendicitis.
Unfortunately, they couldn't do surgery on me because they were
already busy through to the next day. "So this is how it all ends" I
remember thinking for a few moments.
But the doctor came back to me a few minutes later and told me an
ambulance was waiting outside to take me to a nearby hospital that
could do the surgery right away. I arrived at the hospital, the
nurses brought me in, the anesthesiologist anesthetized me, and I woke
up in a bewildered state sometime later. The doctor came into my room
and said that it had burst so he had to disinfect the entire stomach.
Thus, instead of the normal quick twenty minute or so surgery that it
normally takes for an appendectomy, mine lasted about two hours. "It
was a little difficult," the doctor told me that night.
In Japan it seems they like to keep you around in the hospital for a
bit longer than the states, so I was kept for ten days, just to make
sure I was all well and ready to enter back into society. It wasn't a
wonderful experience, but the nurses were nice, and the doctor came in
to give me exceptional explanations of the procedure, with plastic
models of the body and everything. I ended up paying about $1,900
dollars.
Gavin
Japan
Hawaii
An Opposing View
I do so as a twenty one year resident of Japan and also as someone who has had and continues to have extensive medical problems including asthma, slipped disc in back, pinched nerve in neck, herniated esophagus , hernia, gout and a disease of the liver. In spite of all these problems I manage to lead a very active life as a university lecturer and owner of a small business.
I think it is impossible to talk about health care in Japan without talking about health in general in Japan. The Japanese are the longest lived people in the world (in spite of their smoking habits) and I attribute this largely to the fact that these people eat a healthier diet than Americans, eat LESS than Americans, Weigh less than Americans, and are far more physically active than Americans. Can you really just talk about their national health care system without talking about the fact that Japanese have access to the best mass transit system in the world? What does that mean? It means that millions of Japanese walk to their train stations, walk up the stairs to the platform, down from the platform and walk to work. I don't know the national statistics but I do know that I walk an average one hour a day just getting to and from work and doing my shopping and daily errands. Consider how much slimmer and healthier New Yorkers (subways!) are than people in Mississippi (take the car to the mailbox). I would say more than half of Japanese use the mass transit system which goes some way to account for their fitness. Do we have decent mass transit in America?
Certainly Japanese have acquired bad eating habits from the West (especially America) but they still have a measure of portion control unheard of in the U.S.. The reason American housewives are the size of sumo wrestlers is because they (and their husbands and kids) eat as much as sumo wrestlers. I have been with Japanese friends in America who thought the portion they were served was actually for everyone at the table (four people). America, take the fork out of your mouth!
America does have the edge where smoking is concerned, but the Japanese are catching up rapidly. Smoking is definitely losing it's cachet with the young.
So what I want to say here is that the reason the Japanese are healthy is because of their lifestyles, not because of their health care system which is deeply, deeply flawed. True, everyone is eligible, but WHAT are you eligible for? You cannot talk about health care in Japan without actually talking about the quality of that care. Access alone is not the only issue. It is access to QUALITY health care that matters and the Japanese do NOT have it. In twenty one years of living here and using Japanese doctors (not to mention teaching doctors English at the University level) I have been consistently shocked at the almost total lack of accountability within the system. Doctors are a pampered elite here who are never questioned and never , never contradict each other. The system is such that if you do ask for a second opinion you are banished forever from the clinic where the first doctor made his diagnosis. Malpractice is common...and deadly, I have two close friends who were very seriously injured by malpractice here...both of whom had to return to the U.S. to have their problems taken care of. People die here because of the very, very serious problems in the system. They die (and are maimed or suffer) because the system
is a failure. The system here fails from top to bottom. Medical schools regularly accept the sons of doctors as a matter of course whether or not these people are qualified to be in medical schools or not. Medicine is a family business here. PLEASE do not even begin to think that the admissions system is honest (I am on the faculties of FIVE Japanese Universities and should know). Doctors graduate medical school with poor training and an even poorer idea of their responsibilities to their patients and communities. This pattern continues throughout their careers.
Let me provide just one example of how bad the system is. As far back as the 18th century Tobias Smollet (a medical doctor himself) was decrying the practice of doctors owning dispensaries. There is a clear conflict of interest if the doctor profits from prescribing medicines he sells. That is exactly what happens here. Medicines are (dangerously and expensively) over prescribed. The best evidence of this I know is that doctors regularly prescribe a stomach medicine to alleviate the symptoms caused by taking too much medicine! For a simple cold I was once prescribed ELEVEN different medications (remember the tax payer foots the bill so patients have little incentive to complain). Yet, the medicines prescribed are often
ineffective because the dosage of active ingredients is much lower than that sold in the U.S. (and this is where Japanese drug companies help themselves at the public trough).
I would argue that one thing that keeps the Japanese so healthy is the certain knowledge that if they get sick they will have to go see an incompetent doctor.
One of the aspects of our system Americans love to hate is the fact that lawyers drive up the cost of health care through their lawsuits. Try living in a society where a doctor can maim, cripple or kill you and there are no lawyers to help you find redress. Oh, there are good lawyers in Japan, (quite the opposite of their medical brethren), but they have very ,very little success challenging the medical system.
What I conclude from my twenty one years of experience here is NOT that national health care is a bad idea or that we should not try it, but that we need to look at GOOD models (France and maybe Germany?) not failed models (definitely Japan). We need to learn from the mistakes of others not simply assume these mistakes are inevitable.
But if you ask me whether I think America should change it's health care system to be more like Japan's, all I can say is
you should call the suicide hotline and have them talk you out of it.
Jeffrey Tarlofsky
Japan
California
I think it is impossible to talk about health care in Japan without talking about health in general in Japan. The Japanese are the longest lived people in the world (in spite of their smoking habits) and I attribute this largely to the fact that these people eat a healthier diet than Americans, eat LESS than Americans, Weigh less than Americans, and are far more physically active than Americans. Can you really just talk about their national health care system without talking about the fact that Japanese have access to the best mass transit system in the world? What does that mean? It means that millions of Japanese walk to their train stations, walk up the stairs to the platform, down from the platform and walk to work. I don't know the national statistics but I do know that I walk an average one hour a day just getting to and from work and doing my shopping and daily errands. Consider how much slimmer and healthier New Yorkers (subways!) are than people in Mississippi (take the car to the mailbox). I would say more than half of Japanese use the mass transit system which goes some way to account for their fitness. Do we have decent mass transit in America?
Certainly Japanese have acquired bad eating habits from the West (especially America) but they still have a measure of portion control unheard of in the U.S.. The reason American housewives are the size of sumo wrestlers is because they (and their husbands and kids) eat as much as sumo wrestlers. I have been with Japanese friends in America who thought the portion they were served was actually for everyone at the table (four people). America, take the fork out of your mouth!
America does have the edge where smoking is concerned, but the Japanese are catching up rapidly. Smoking is definitely losing it's cachet with the young.
So what I want to say here is that the reason the Japanese are healthy is because of their lifestyles, not because of their health care system which is deeply, deeply flawed. True, everyone is eligible, but WHAT are you eligible for? You cannot talk about health care in Japan without actually talking about the quality of that care. Access alone is not the only issue. It is access to QUALITY health care that matters and the Japanese do NOT have it. In twenty one years of living here and using Japanese doctors (not to mention teaching doctors English at the University level) I have been consistently shocked at the almost total lack of accountability within the system. Doctors are a pampered elite here who are never questioned and never , never contradict each other. The system is such that if you do ask for a second opinion you are banished forever from the clinic where the first doctor made his diagnosis. Malpractice is common...and deadly, I have two close friends who were very seriously injured by malpractice here...both of whom had to return to the U.S. to have their problems taken care of. People die here because of the very, very serious problems in the system. They die (and are maimed or suffer) because the system
is a failure. The system here fails from top to bottom. Medical schools regularly accept the sons of doctors as a matter of course whether or not these people are qualified to be in medical schools or not. Medicine is a family business here. PLEASE do not even begin to think that the admissions system is honest (I am on the faculties of FIVE Japanese Universities and should know). Doctors graduate medical school with poor training and an even poorer idea of their responsibilities to their patients and communities. This pattern continues throughout their careers.
Let me provide just one example of how bad the system is. As far back as the 18th century Tobias Smollet (a medical doctor himself) was decrying the practice of doctors owning dispensaries. There is a clear conflict of interest if the doctor profits from prescribing medicines he sells. That is exactly what happens here. Medicines are (dangerously and expensively) over prescribed. The best evidence of this I know is that doctors regularly prescribe a stomach medicine to alleviate the symptoms caused by taking too much medicine! For a simple cold I was once prescribed ELEVEN different medications (remember the tax payer foots the bill so patients have little incentive to complain). Yet, the medicines prescribed are often
ineffective because the dosage of active ingredients is much lower than that sold in the U.S. (and this is where Japanese drug companies help themselves at the public trough).
I would argue that one thing that keeps the Japanese so healthy is the certain knowledge that if they get sick they will have to go see an incompetent doctor.
One of the aspects of our system Americans love to hate is the fact that lawyers drive up the cost of health care through their lawsuits. Try living in a society where a doctor can maim, cripple or kill you and there are no lawyers to help you find redress. Oh, there are good lawyers in Japan, (quite the opposite of their medical brethren), but they have very ,very little success challenging the medical system.
What I conclude from my twenty one years of experience here is NOT that national health care is a bad idea or that we should not try it, but that we need to look at GOOD models (France and maybe Germany?) not failed models (definitely Japan). We need to learn from the mistakes of others not simply assume these mistakes are inevitable.
But if you ask me whether I think America should change it's health care system to be more like Japan's, all I can say is
you should call the suicide hotline and have them talk you out of it.
Jeffrey Tarlofsky
Japan
California
The Japanese system is easy to use and transparent
Eye infection
I was on vacation last summer and left my contact lense in a little bit too long. My eye became red and stayed pretty red even after the lense had been removed for a couple of days.
When I returned to Japan, the redness persisted so I decided to visit an eye specialist. Japan's Universal Health Care system allows participants to go to any doctor at any clinic/hospital, many of which are private; there are no 'health care networks' here like there are in the US. You simply go where ever you'd like to go (freedom!). In my case, it was an eye clinic 2 minutes' walk from my office.
I presented my health care card (monthly premiums are deducted directly from my pay in the same manner as social security in the US) to the receptionist and was seen by the doctor after a 20 minute wait.
The doctor gave me an eye exam and two different types of eyedrop medication. The cost for the visit & medication was $20. The entire ordeal took less than an hour and my eye returned to normal about 4 days later.
I like the Japanese system a lot. It's easy-to-use and transparent. As both a user & business person, I find it highly affordable and hassle-free. I would recommend a similar system to anyone.
Mike Stensrud
Tokyo (via Oregon)
I was on vacation last summer and left my contact lense in a little bit too long. My eye became red and stayed pretty red even after the lense had been removed for a couple of days.
When I returned to Japan, the redness persisted so I decided to visit an eye specialist. Japan's Universal Health Care system allows participants to go to any doctor at any clinic/hospital, many of which are private; there are no 'health care networks' here like there are in the US. You simply go where ever you'd like to go (freedom!). In my case, it was an eye clinic 2 minutes' walk from my office.
I presented my health care card (monthly premiums are deducted directly from my pay in the same manner as social security in the US) to the receptionist and was seen by the doctor after a 20 minute wait.
The doctor gave me an eye exam and two different types of eyedrop medication. The cost for the visit & medication was $20. The entire ordeal took less than an hour and my eye returned to normal about 4 days later.
I like the Japanese system a lot. It's easy-to-use and transparent. As both a user & business person, I find it highly affordable and hassle-free. I would recommend a similar system to anyone.
Mike Stensrud
Tokyo (via Oregon)
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