a trip to the hospital: health care in Japan and America

Have you wondered how the Japanese health system compares to that of America? I can't say that I know much about either, save that of some quick Wikipedia research and firsthand experience, both which I will share here. 

The US spends more on health care per capita and as a percentage of GDP than any other nation, and life expectancy at birth in the USA is 78.49 years, ranking 50th in the world. The World Health Organization (WHO) ranked America as the highest in cost, 37th in overall performance, and 72nd by overall level of health. In 2010, the Patient Protection and Affordable Care Act (Obamacare) was signed into law, requiring individuals to become insured in hopes of reducing overall government spending on health care, and fining those who are uninsured. 

Since 1961, Japan has offered universal health coverage which allows all access to preventative, curative, and rehabilitative services at an affordable cost. Insurance is also mandated, but local governments offer national health insurance plans. Patients enrolled in national health insurance pay 30% of the cost while the government pays 70%. Hospitals, by law, must be run as non-profits and corporations are not allowed to own or operate hospitals. Medical fees are regulated by the government to keep them affordable. Households are also eligible for monthly thresholds. With these structures in place, Japan ranks about 20th in the world. People in Japan have the longest life expectancy at birth in the world.

As a JET, you are enrolled under the national health insurance. If you are married, your spouse is covered as well. The JET Program itself provides additional insurance in the case of a freak accident. Not long after arriving in Japan, both my husband and I received our national health insurance cards.

I don't know anyone who thinks that the situation in America is ideal. It sometimes takes weeks to make an appointment, and many people I know won't go unless they are seriously ill. As a child, when wining about my health, my dad used to tell me, "Are you bleeding? No? Then you're fine." As a soccer coach, his motto was, "Walk it off." He taught me to be tough. Unfortunately, another personal lesson that came with that is a resistance to visit the doctor. If there's a chance of my body healing itself, I like to take that chance. I'll probably be fine. And with the expense and inconvenience of American health care, for many Americans, including myself, visiting the doctor is a last resort. I have had to wait in the doctor's room for over a half an hour for them to return. Usually it seems that they want to run test after test, "just to be sure." To me, it seems that hospitals in America are money-making-machines.

In Japan, I have heard two sides to the story:  First, that the medical field is generally distrusted, and that Japanese people do not want to be medicated, but I think this is kind of an outdated story. Secondly, I have heard that people visit the hospital at the slightest inkling of a cold!

After some pressure from  my husband and family members, I took the risk of visiting my local hospital, because it seemed that antibiotics would be necessary. Here is an account of my first time visiting the hospital in Japan with the help of my supervisor.

Your first visit to the hospital will be without an appointment. You will show your insurance card to the receptionist and they will create a hospital card for you. For future visits, appointments are first come first served and automated, on computer consoles that operate like the machines used when buying a ticket at the movie theater or maybe self-checkout at the grocery store. People line up an hour or more before doctors arrive to get a good spot in line. Old people don't have anything better to do I guess, and they have probably been awake for a few hours already. They also line up outside the grocery store on Sunday morning to get the best deals. But I diverge..

After a bit of paperwork and within 10 minutes of arrival, I was issued my card and in with a doctor. In my small town of 20,000, I was surprised because the doctor not only spoke English, he had a terrific bedside manner and a kind disposition. His English medical vocabulary was quite surprising. After prescribing antibiotics and explaining my condition to me, I received my bill and prescription.

I paid at one desk, they faxed my prescription to a nearby pharmacy, and I picked it up immediately. The entire visit: getting my health card, being tested and seen by the doctor, paying, and picking up my prescription took less than 1 hour, and less than ¥3000. I visited for my follow-up today, the antibiotics worked their magic, I was given a clean bill of health, and a cheap one too, no more than ¥500.

I had such a positive experience that I won't hesitate to visit the doctor again. Say what you will about universal health care, ("In Canada the wait times are outrageous!  The quality is terrible!") but in Japan, it's efficient, comfortable, and affordable. Not only have a been cured of my illness, I think I have also been cured of my fear, distrust, and hesitancy to visit hospitals.