I was out with a friend in Kyushu, he got a little
too inebriated and fell down a flight a stairs, putting a huge gash in
his head. He was unconscious for a minute or so but he woke up and we
eventually got him to a hospital. We brought him in, showed the front
desk his Japanese health card that was in his wallet. Soon after, two
nurses came out right away and took him to the back and got him
stitched, (about ten stitches) cleaned up and gave him a place to rest
for the night on the hospital bed. He told me he got a bill a bit
later for a little over 10,000 yen, or a little over a hundred
dollars.
I wonder how much this would have cost back in the states?
Gavin
Japan
Hawaii
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
National Health Insurance paid all but 30% of cancer treatment
My friend Sally Chaney got pancreatic cancer, perhaps in 2005, in Kyoto, and only had 'Global' health care, from America. With chemotherapy and radiation therapy coming up in one week, she went to the Sakyo Ku ward office, where they signed her up for National Health Insurance, no charge. The National Health Insurance paid all but 30%. 'Global' picked up the 30%. Six months later she had to have a stomach operation, to repair a hole made by the radiation therapy. The National Health Insurance paid, but 'Global' refused to pay the 30% "because they only pay one time for any one illness." Sally died of it a year later.
Linda Crawford
Kyoto
New Hampshire
Linda Crawford
Kyoto
New Hampshire
The French system is better than the Japanese
Friends --
This is painful, but I feel I should contribute to the discussion of the health-care issue. My story is that of the sudden and unexpected death of my late wife, Hatsue, last May 5th.
My wife was of Japanese origin, but she had lived in the US for some 36 years, was an American citizen, and a proud and active Democrat.
We retired to Chiba city in mid-2006, and built a new home on a plot of family land. The objective was to take care of Hatsue's elderly mother, whom she felt she had neglected by staying so long abroad. She wrote in the wet concrete outside the front door, "For my mother---with love."
I should note that Hatsue was an independent-minded person who paid close attention to her health. She had a trim figure, ate well, and exercised.
We are only a few hundred meters from the Chiba Medical Center, formerly a "national" hospital that has been privatized. It is a major facility, with all the usual services.
My wife complained to an internist in June of 2007 of stomach pains. She was given an endoscopy, which proved negative. Later in the year, she complained of violent shoulder pain. She was given scans of her neck and shoulders, all of which were negative. She was transferred to a female psychologist, on the theory that the stress of moving back to a by now unfamiliar environment and building a house had caused stress that was responsible for her pain. I accepted this diagnosis, because there had indeed been a great deal of stress.
Hatsue received permission to go to a "pain clinic," where she received shots of what must have been very powerful palliatives. She was finishing a month's series of these shots and felt that she had made enough progress that she was about to schedule "rehabilitation," when she collapsed in late April.
We took here to the Medical Center, where we were told that she could not be hospitalized because of a lack of beds. I insisted on a blood test, and the results--a total lack of sodium in her system was one-- led to her hospitalization on a Sunday afternoon. Sh was given extensive tests and we were informed on Tuesday that she metastasized cancer in "at least" eight organs, including a large growth in her brain, and we were shown the x-ray pictures. She was placed on morphine (we had always agreed between us that we would not authorize desperate measures if our partner was to be in just this sort of situation).
Hatsue passed away peacefully the next Monday (Children's Day), seven days after entering the hospital. The death certificate read "lung cancer."
The cancer specialist at the Medical Center told us that a simple chest x-ray would have revealed the cancer at any point in the previous year.
I hasten to say, however, that Hatsue never evinced any of the symptoms of lung cancer. She was able to move around more or less normally, walking to her pain clinic visits for a round trip of two kilometers even during her final month.
I have consulted with American specialists and talked to academic experts on Japanese health care to try to make sense of this tragedy. The Americans refuse to speculate on failures in diagnosis, but point out that Hatsue probably had the most vicious form of cancer: small cell. If you Google "small cell cancer," you will see that the only suggestion is to try to get yourself into a trial of some new treatment. The academic experts on Japanese medicine defend the Japanese health-care system as making only the average number of diagnostic errors and note that there are no limits to test ordering that restrict Japanese physicians from testing broadly.
But those of us who live in Japan know that there are serious problems with the Japanese health-care system. I am told that a Japanese doctor see more than 6000 patients each year on average, versus an average for an American doctor of just over 2000. I
f you have gone to a Japanese doctor, you know what this means. You are granted no more than two or three minutes with an obviously impatient physician who gives you an extremely compressed "bottom line" diagnosis and treatment in a peremptory tone that brooks no questions. The ignorant patient is granted no role in his or her own health-care. To use the famous analogy, the patient is presumed to be too dumb to help to determine if the hoof beats are those of a horse or a zebra.
I am told there is no system for ongoing education for medical professionals in Japan, and that there are no specialty groups (the "academies" and the "boards" in America) that set standards and qualifications for practice in specialized fields.
This overloading of the average Japanese doctor must trace back to restrictions on entry that probably mirror the cartel-like practices that infect so many other professions in Japan.
My own conclusion after some forty years of involvement with the Japanese health-care industry is that the Japanese people owe their high longevity figures to a diet that is steadily being corrupted by American (or is it Western?) influences and to the exercise that even middle class persons get by use of the public transportation system, with its walks to the stations and the stairs that they must climb and descend on a daily basis. (The latter, of course, are being replaced by elevators and escalators.)
I understand that the French system is much more promising as a source for ideas for American health-care reform than the Japanese. The French exercise a great deal of control over medical education, and I am told that unless their model is followed, there is not much hope for American success.
Rod Armstrong
Japan
Virginia
This is painful, but I feel I should contribute to the discussion of the health-care issue. My story is that of the sudden and unexpected death of my late wife, Hatsue, last May 5th.
My wife was of Japanese origin, but she had lived in the US for some 36 years, was an American citizen, and a proud and active Democrat.
We retired to Chiba city in mid-2006, and built a new home on a plot of family land. The objective was to take care of Hatsue's elderly mother, whom she felt she had neglected by staying so long abroad. She wrote in the wet concrete outside the front door, "For my mother---with love."
I should note that Hatsue was an independent-minded person who paid close attention to her health. She had a trim figure, ate well, and exercised.
We are only a few hundred meters from the Chiba Medical Center, formerly a "national" hospital that has been privatized. It is a major facility, with all the usual services.
My wife complained to an internist in June of 2007 of stomach pains. She was given an endoscopy, which proved negative. Later in the year, she complained of violent shoulder pain. She was given scans of her neck and shoulders, all of which were negative. She was transferred to a female psychologist, on the theory that the stress of moving back to a by now unfamiliar environment and building a house had caused stress that was responsible for her pain. I accepted this diagnosis, because there had indeed been a great deal of stress.
Hatsue received permission to go to a "pain clinic," where she received shots of what must have been very powerful palliatives. She was finishing a month's series of these shots and felt that she had made enough progress that she was about to schedule "rehabilitation," when she collapsed in late April.
We took here to the Medical Center, where we were told that she could not be hospitalized because of a lack of beds. I insisted on a blood test, and the results--a total lack of sodium in her system was one-- led to her hospitalization on a Sunday afternoon. Sh was given extensive tests and we were informed on Tuesday that she metastasized cancer in "at least" eight organs, including a large growth in her brain, and we were shown the x-ray pictures. She was placed on morphine (we had always agreed between us that we would not authorize desperate measures if our partner was to be in just this sort of situation).
Hatsue passed away peacefully the next Monday (Children's Day), seven days after entering the hospital. The death certificate read "lung cancer."
The cancer specialist at the Medical Center told us that a simple chest x-ray would have revealed the cancer at any point in the previous year.
I hasten to say, however, that Hatsue never evinced any of the symptoms of lung cancer. She was able to move around more or less normally, walking to her pain clinic visits for a round trip of two kilometers even during her final month.
I have consulted with American specialists and talked to academic experts on Japanese health care to try to make sense of this tragedy. The Americans refuse to speculate on failures in diagnosis, but point out that Hatsue probably had the most vicious form of cancer: small cell. If you Google "small cell cancer," you will see that the only suggestion is to try to get yourself into a trial of some new treatment. The academic experts on Japanese medicine defend the Japanese health-care system as making only the average number of diagnostic errors and note that there are no limits to test ordering that restrict Japanese physicians from testing broadly.
But those of us who live in Japan know that there are serious problems with the Japanese health-care system. I am told that a Japanese doctor see more than 6000 patients each year on average, versus an average for an American doctor of just over 2000. I
f you have gone to a Japanese doctor, you know what this means. You are granted no more than two or three minutes with an obviously impatient physician who gives you an extremely compressed "bottom line" diagnosis and treatment in a peremptory tone that brooks no questions. The ignorant patient is granted no role in his or her own health-care. To use the famous analogy, the patient is presumed to be too dumb to help to determine if the hoof beats are those of a horse or a zebra.
I am told there is no system for ongoing education for medical professionals in Japan, and that there are no specialty groups (the "academies" and the "boards" in America) that set standards and qualifications for practice in specialized fields.
This overloading of the average Japanese doctor must trace back to restrictions on entry that probably mirror the cartel-like practices that infect so many other professions in Japan.
My own conclusion after some forty years of involvement with the Japanese health-care industry is that the Japanese people owe their high longevity figures to a diet that is steadily being corrupted by American (or is it Western?) influences and to the exercise that even middle class persons get by use of the public transportation system, with its walks to the stations and the stairs that they must climb and descend on a daily basis. (The latter, of course, are being replaced by elevators and escalators.)
I understand that the French system is much more promising as a source for ideas for American health-care reform than the Japanese. The French exercise a great deal of control over medical education, and I am told that unless their model is followed, there is not much hope for American success.
Rod Armstrong
Japan
Virginia
The quality of medicine is very high
I think the best story I could give, and one that is particularly personal for me, is the cost and
quality of having a child in Japan. My wife and I just had our first child and we were both (maybe me
more as she’s Japanese) amazed at the quality and cost to having a child in the country. First,
Japan has one of the lowest mortality rates in the world because the quality of medicine is very high.
I would certainly say this was the case with our childbirth. Second, the net cost to us was only about
200,000 to 300,000 yen ($2-3K). Although I’m sure location plays a part (we live in Tokyo), it is our understanding
that all Japanese can get the same cost almost anywhere in Japan. I would say the process here
is very easy and certainly a relief when you hear of the big costs that can occur with having a child in the U.S.
We were very impressed with the entire process.
Aaron Lloyd
Japan
California
quality of having a child in Japan. My wife and I just had our first child and we were both (maybe me
more as she’s Japanese) amazed at the quality and cost to having a child in the country. First,
Japan has one of the lowest mortality rates in the world because the quality of medicine is very high.
I would certainly say this was the case with our childbirth. Second, the net cost to us was only about
200,000 to 300,000 yen ($2-3K). Although I’m sure location plays a part (we live in Tokyo), it is our understanding
that all Japanese can get the same cost almost anywhere in Japan. I would say the process here
is very easy and certainly a relief when you hear of the big costs that can occur with having a child in the U.S.
We were very impressed with the entire process.
Aaron Lloyd
Japan
California
I appreciate the psychological security of being covered
When I enrolled in Japan's National Health Insurance program, I used to protest and complain that I had to pay for all of the people who went to the doctor for every little ailment or just hung out at hospitals to see their friends and because they had nothing better to do. However, I realized that in whatever circumstance I'm in - illness, accident, emergency - I am covered for medical treatment. Of course, the coverage is basic, but it covers dental and that really helps. I can go about my life not worrying about how I will be able to pay for medical treatment because the Japanese government will take care of most of my basic needs.
I switched to shiokyosai insurance for educators, but I now really appreciate the psychological security of being covered.
Edwin Aloiau (orginally from Honolulu, Hawaii)
Tokyo, Japan
I switched to shiokyosai insurance for educators, but I now really appreciate the psychological security of being covered.
Edwin Aloiau (orginally from Honolulu, Hawaii)
Tokyo, Japan
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
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
Health care is not a commodity
It is clear that the United States needs universal healthcare for everyone.
In the U.S., you cannot have healthcare without a fulltime job. This is very limiting to people like myself who want to work in specialized fields as teachers, freelance writers, etc., that don't always have fulltime positions with benefits.
I've lived in Japan on and off for the past 10 years. Here I've been able to get affordable health insurance through the government under $400 per month, which can be less or more pending my annual income. If I were to get full coverage for my family in the United States even at a lower income than what I make in Japan, it would cost close to $600 a month with employee subsidized insurance and over $1000 if I were to pay it on my own.
Once when in the U.S., my health insurance costs went up 20 percent from one year to the next, while my wages did not increase at all. This great of an increase can only be explained by the insurance industry's desire to exponentially increase the return to their stockholders, as well as by the absurdly high salaries they pay some of their workers. I feel healthcare is not a commodity, but the right of every person.
It makes sense that people who make more should pay more in taxes to help subsidize the cost of services for all. Most people are hard workers, and there is only so much a person can do in one day no matter if they are billionaires or making under $20,000 a year. Both deserve the same right to live. If both were lost in a snowstorm climbing a mountain together, we'd send the same rescue team and put them both on the same helicopter, wouldn't we?
We are all climbing the same mountain.
Thanks.
Adam H.
Japan
Wisconsin
In the U.S., you cannot have healthcare without a fulltime job. This is very limiting to people like myself who want to work in specialized fields as teachers, freelance writers, etc., that don't always have fulltime positions with benefits.
I've lived in Japan on and off for the past 10 years. Here I've been able to get affordable health insurance through the government under $400 per month, which can be less or more pending my annual income. If I were to get full coverage for my family in the United States even at a lower income than what I make in Japan, it would cost close to $600 a month with employee subsidized insurance and over $1000 if I were to pay it on my own.
Once when in the U.S., my health insurance costs went up 20 percent from one year to the next, while my wages did not increase at all. This great of an increase can only be explained by the insurance industry's desire to exponentially increase the return to their stockholders, as well as by the absurdly high salaries they pay some of their workers. I feel healthcare is not a commodity, but the right of every person.
It makes sense that people who make more should pay more in taxes to help subsidize the cost of services for all. Most people are hard workers, and there is only so much a person can do in one day no matter if they are billionaires or making under $20,000 a year. Both deserve the same right to live. If both were lost in a snowstorm climbing a mountain together, we'd send the same rescue team and put them both on the same helicopter, wouldn't we?
We are all climbing the same mountain.
Thanks.
Adam H.
Japan
Wisconsin
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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