Why Make Life Worse for High Risk People

I feel that in the United States there is a general tendency to be more nervous about the government trying to "help" with health care support than one really needs to be, and those of us living outside the United States in countries with government-supported health care plans which are really helpful do have some insight into how useful such programs can be.

I retired a few years ago, and am now receiving a state pension from Austria as my main source of support - after having paid into the system for more than 30 years. (The minimum for receiving an Austrian state pension is 15 years - which I exceeded by more than a factor of 2.)
The Austrian state pension is very generous if compared to some countries like the United States, but I presume that you also pay much more into it during your working years.. (This is basically a good idea, I think.)
Being retired and receiving an Austrian state pension, if I were to be living in Austria (including perhaps certain other EU countries as well), I would still be eligible to be participating in the Austrian National Health Insurance.. But, living in Japan now more than in Austria I am not currently eligible to be in the Austrian National Health Insurance program. I am eligible however for the Japanese National Health Insurance program, which I have joined.

The impression I have is that with the National Health Insurance plans,
"everybody" is eligible, irregardless of whether you have the "bad luck" of falling into a high-risk group or not. But, when there is no National Health insurance program, and you must get health insurance from a "private" group, or have none at all, these companies may well discriminate against high-risk people, and they may be left "out in the cold". These people are in an "unlucky situation" anyway, and to make the situation for them even harder, that is something one should want to avoid somehow, if possible. By including a substantial fraction of the entire population of the country in a National Health insurance program of some kind, one can spread the risks over a very large number of people, so that individual people do not need to be "singled out" for difficult situations.
This is even more true in countries with large populations like the United States.

Jim McNaughton
Japan/Austria

My first reaction to "socialized" medicine was negative

When I was 11 I moved with my family to France. My first reaction when I heard the phrase "socialized medicine" was negative, since I had heard of socialism only in negative contexts in my US public schools, but I noticed that my parents were thrilled by the affordability of medical care. When we moved on to Africa one of our extended families' main concerns was of course our health, but for expatriats living there, the care at top notch hospitals in Nairobi was excellent and very affordable. I did not have much first hand experience of the healthcare system during my 6 years there, but I visited others and witnessed the care they were given and their satisfaction with the expertise and facilities offered for excellent prices. I found myself thinking that if I ever needed a major surgery when in college in the US, that I would seriously consider a trip back to Africa for the care and service offered by the hospital. Although the flight itself would be pricey, it would surely be a better option overall. The irony of this thought was not lost on my teenage mind.
In the previous 5 years I have mostly lived in Japan, and been covered by the national insurance program for very reasonable fees. Whenever I have been sick I have gone to the doctor and received excellent treatment and follow-up. I am always amazed at the price that I pay when I leave... so low! My only health concerns come when I travel back to the US. I am uninsured there, and I worry what I would do if I had an accident or fell sick. I certainly think twice before I go to the doctor in the US, but I don't hesitate to make a visit when I am sick in Japan. Ever since my first experience with socialized medicine in France I have dreamed of a day when the US put such a priority on keeping all its citizens healthy. I do hope that I will live to see the day that it becomes a reality! There are many good models to follow so we should pick the best of each one to make a great American healthcare system!
Keely
Kanazawa
Kentucky

We can't understand a developed country without universal coverage

Healthcare in The Netherlands keeps getting toyed with at the national level, so this is up-to-now. It isn't completely free unless you're below a certain income, and above that, or if you're self-employed, how much you pay depends on what kind of policy you buy. Everyone is insured. With an above average income, my insurance (worldwide medical, dental, physio, repatriation, medicines, basically whatever I need) with €150/$200 annual deductable (I chose that limit) costs €1700/$2300 a year, with my employer paying half, and me getting a group discount on the rest, so that works out to something like €50/$67 a month. That's it. This includes doctor's visits, medications, physiotherapy, even things like visits to a nutritionist or a problem overseas.

But as an American, the things you always worry about are also the larger incidents. The ones I've had would have cost more than my house in the US. About 15 yesrs ago I was travelling for work in Africa and had to be taken by ambulance to a hospital, admitted overnight, tested, followed up intensively (my insurer offered to fly me home, but I took my regular flight) . The Namibian hospital phoned my Dutch insurer, and everything was arranged between them. I never even saw a bill. I saved receipts from the private doctor I saw for the rest of my stay, and was refunded that amount when I got home.

A few years later, I was visiting in Texas and had a different problem, also involving hospitals and so on. That time the hospital had a hard time processing my foreign insurance and I did see the bills (ouch), but again was able to pass them directly to my insurance company.

Then (gee, I sound like a physical wreck) a few years after that I survived a brainstem stroke. In The Netherlands. The doctor's house call, the ambulance, the time on the Stroke unit, medications, an MRI, aftercare, excellent neurologists and nursing staff -- all paid by my insurance.

The Michael Moore movie 'Sicko' is incomprehensible here. People complain about the annual fiddling with our coverage, but they can't understand a developed country without universal coverage. They go to the doctor when they're sick. They go to physios if they need them. They see the dentist routinely. They fill prescriptions.


Linda McPhee
The Netherlands

Chiropractor visit costs $5

In the US, going to see a chiropractor or doctor would cost a minimum of $25 per visit, but in Japan seeing a chiropractor costs me about 500 yen (approx. $5). Seeing a doctor, well, it depends on if he or she's a specialist or not. But in general these visits are cheaper than the ones I had in the States. Also, the fact that I had a pre-existing condition doesn't seem to affect anything here in Japan.

I'm a little afraid to go back to the US, as I don't have insurance there and, if something happens, things could get complicated. In the US, my family has always had to fight with the insurance company to get coverage on anything more than a co-pay ($25)--and this was the insurance provided by the city. In Japan, there hasn't been any fighting for me thus far, and I can see any doctor I want. I don't have to check to see if he's "on my plan." My family in the US has had trouble getting the medical care they need because the doctor who specializes in such-and-such area doesn't isn't on their insurance plan.

I hope the US will give its citizens and legal residents better health care in the near future.

Amanda
Japan
Texas

I wish Obama would consider single payer health care

I have a couple good health care stories since I first came to Japan 4 years ago but the one that sticks in my mind the most was 2 years ago at Christmastime.

(For reference I am under the Japanese National Health Care System which is a single payer system that takes a fixed percentage of my salary every month)

Two days before Christmas 2 years ago I had developed a extremely sore throat and was worried so I decided to go to my local hospital in Chofu. When I arrived I had a severe fever and I could barely swallow. I walked into the hospital and was seen by a bi-lingual physician almost immediately (maybe a 5 minute wait after showing my National Health Care Card) who examined my throat, asked when it had began and took my temperature. He decided that a throat culture was necessary and it was sent to the lab. In the meantime he prescribed a painkiller and antibiotic and asked me to come back in 2 days. While the painkiller certainly helped my throat pain, it seemed that the antibiotic was having no effect. When I went back to the hospital they informed me that I had a severe case of Strep throat and I needed a much stronger antibiotic, which was prescribed immediately.

After 1 and 1/2 weeks of antibiotics I was healthy and able to enjoy the New Years celebration (unfortunately no alcohol)!

The total cost of this treatment including prescribed drugs and lab work?

Roughly 7000 yen ($70.00)

I honestly can't imagine if the same thing happened to me in the states, nor how much it would have cost as I usually never could get affordable coverage back home. I am a firm believer in the Single Payer Health Care System, and I wish it was on the table for the upcoming Health Care Initiative that President Obama will be working on.

Michael Hoctor
Japan
Massachusetts

Our health has improved since being in Japan

My family of 5 live in Japan. We have coverage from the US. I never joined the national health care because I felt that we were covered under our own insurance from the US and that seemed suitable at the time.

However, we have been to the hospital twice since living here. I was bitten by an animal shelter dog at a fundraiser once. The jagged bite mark on my leg was bleeding and the nurse suggested I go to the hospital immediately for injection and a check up. I checked in at the Red Cross Hospital in Hiroo and waited 45 mins to see a doctor. I saw the doctor first, not a nurse, or technician or aid but the Doctor. He cleaned my wound, inspected it, applied antibiotic ointment and dressed it. I received a dose of antibiotic and a prescription for 3 pills a day for 10 days. The bill for the hospital was 7000 yen and the prescription was some similarly small amount.

My second trip to the same hospital was when my son fell 10 ft to the ground while playing on the playground. He landed on his hip and was shaking and cold and couldn't walk. We feared a fracture on the hip and took him to the hospital. They informed us that since we didn't have an appointment we couldn't be seen. We asked again, nicely, and they agreed to see us after the other patients had been seen. We anticipated a long wait. My son, however, was called back for a consult with the doctor in 30 short minutes. He did a check up and put Isaac through a full range of motion. He sent us for xrays. Xrays indicated that my son had not broken any bones. He applied an adhesive medicated bandage to my son's hip area to keep the pain from bruising down. He sent us home with a prescription for medicated bandages which I was able to fill for 1500 yen. The entire visit took about 1 hour and cost me 15,000 yen. ($140 USD)

Service has always been wonderful and polite. I feel good when I visit the doctors here. My husband and I have received medication for blood sugar and anxiety. He paid an equivalent of $45 for glucophage and I have paid the equivalent of $28 for lorazapam for anxiety spells. This is without any aid from my US insurance drug plan. This is just the cost of medication over the counter from the doctor's prescription. I was shocked the first time I ever had to have medicines here. Without any drug plan at all medication costs here are so much lower than the US. I didn't offer any national health card to cover the medicines. I assume it's because the greediness of pharmaceutical corporations isn't as rampant in Japan as it is in the US. Affordable medicines are the norm.

Since we have lived here we have enjoyed the walking and trains and bike riding. We have enjoyed the abundant healthy vegetables. We have each lost 60 lbs and no longer require medications for blood sugar or anxiety.

Our health has improved greatly since being in Japan and the times we've needed help with our healthcare it has been a pleasurable and thrifty experience.

We return to the US in June. I am more than a bit afraid to move back to the US. I fear the slovenly, sedate, lazy lifestyle that is so common in the US. And the strain that kind of lifestyle puts on the entire system in the US. There are no accessible bike lanes in many cities in the US. The people in their gas guzzling vehicles feel they own the road and would never deign to ride their bike to the grocery when they can drive the 2 miles from home to the store instead.

Americans have a lot to learn from other parts of the world with regard to health care and every other aspect of their daily living. But that's a whole other rant you didn't ask for.

W - in Tokyo

I have No medical horror stories

I've been living in Japan for 33 years
3 of my four children were born here (the eldest child was born in Denmark -- that cost me $26.00)
Last year I had a 3-hour surgery and stayed in the hospital for 3 weeks.
I/my family have never had difficulty paying any medical bills.
I have NO medical horror stories to tell.
Karen
Japan
California