Why I love my Japanese social insurance

I found out a few days ago that my Japanese social insurance was still intact, so I decided to see a doctor about my neck and finger pains from a skiing accident a couple of weeks ago. It was awesome. Here's why.

I had no appointment and was a new patient at the orthopedist in Ebisu; but two minutes after I walked in, the doctor was calling my name. I explained what was hurting; he moved my joints gently, asking what hurt, and then sent me to x-ray. Three minutes later, I went straight to the back room where I got a massage and electric nerve stimulator treatment for 20 minutes each. Then they very carefully taped my finger and my neck. Two minutes after that, I was back in the doctor's office reviewing my x-rays on a computer screen. His explanation was simple but thorough, and he encouraged me to come back for more massages for 350 yen each.

Total bill: 6000 yen. Total time spent: 45 minutes.

Next, I bicycled over to Meguro station to get my eyes checked. I forgot to bring a spare set of contact lenses, and my old ones were sticking to my eyeballs. Again, no appointment, just my insurance card. I asked how long the wait would be. There are four people ahead of you, the lady said. I asked her how much it would cost. Less than ten bucks. Four minutes later, I was in the doctor's office, hopping from one eye-checking machine to the other checking for everything under the sun that could be wrong with my eyeballs. Everything was good, and he gave me several options on contact lenses from a folder. Then he gave me a free pair and two prescriptions: one for contacts, one for glasses.

Total bill: 980 yen. Total time spent: 20 minutes.

The last time I went to the doctor was at a hospital in San Francisco after injuring my pinkie in a basketball game. After three and a half hours of waiting, I was given a hasty x-ray by a technician, who told me she thought there was nothing wrong, though she wasn't a doctor so she couldn't say for sure. Then she told me to leave. Nobody ever called me or told me what was wrong with my finger, so I assumed it was fine. I can't remember how much that visit cost, but I got a mysterious bill from a x-ray lab a year later that I am still trying to decipher.

Comments

[SHiNiCHi]

agreed. its so much easier to go to doctors in japan and korea than in the u.s.

not that american doctors are bad, but the system itself is just so unreliable and unefficient.

[miyagawa]

I wonder why you still have your social insurance in intact (are you paying taxes in Japan too??), but it feels weird that in Japan you can get these "regular" treatments really quick and cheap but if you need an emergency treatment, you can't. (as in http://www.tokyomango.com/tokyo_mango/2009/02/many-japanese-die-in-ambulances-because-of-strange-policy.html)

[Gen Kanai]

There are certain aspects of the Japanese health care system that work really well, certainly basic care and preventative care is better than in the US.

But if you're looking for cutting-edge techniques or drugs, then Japan is slow to adopt them. Japanese have to travel overseas to get surgeries or drugs that are not yet approved in Japan.

Bloomberg just had an article to day about how the rest of the G7 nations have had vaccines for haemophilus influenzae type b (Hib, a form of meningitis) but Japan has yet to approve this vaccine.

http://www.bloomberg.com/apps/news?pid=20601109&sid=aB3VEOh74lEM&refer=home#

Being conservative about drugs and testing and vaccines is obviously important, however there's the danger of being too conservative as well. That's where Japan is on a number of important health-related issues.

Dentistry is not as good in Japan than in the US, imho. This is both an issue of the patients as well as of the dentists.

[Matt McKnight]

That's really interesting. I don't even care about the price that much, but there is not an amount of money I could pay for that sort of treatment in the US. I have gotten lucky a few times, but the time it takes to get an x-ray here is generally insane. There is a real market here for fast health care, we just need the AMA to allow for more medical schools, and the ABA to allow for limits on malpractice claims...I guess that's not going to happen.

[kklein]

Lisa, I think you were lucky. There are good days and bad, good doctors and bad. I've lived here (Japan) for the better part of 10 years, and yes, overall, I like the system. I especially like that my "social insurance" payment covers both me and my wife for healthcare AND the equivalent of Social Security in the US. It's more than what I've ever paid in the US, sure, but it covers way more than I could afford for the same services in the US.

All that being said, I find that I have to go way too many times even for simple treatments. It's fine if whatever medicine from the 80s they give you actually works, but it almost never does, and you're back in their office 4 days later. For chronic problems (allergies and acid reflux), I've just started stockpiling over-the-counter stuff from the US. It costs less to go to Wallmart on a trip home and stock up on generic Zantac and Claritin than it does to schlep my rear over to the doctor every 3 months for nothing more than a refill. Takes less time, too.

It sounds like you found a good seikeigekka (What is that in English? Osteopath?) there in Ebisu, but I bounced around Chiba-ken for 3 months after a scooter accident (my fault) getting my knee looked at by progressively higher-recommended doctors, getting x-rays and an MRI, and no one could tell me why my knee sent pain shooting up my leg every time I bent it. I did the whole massage/heat/smelly-adhesive-bandage-things thing, and followed their advice about keeping a brace on it, but it never got any better.

Finally, my officemate emailed her sister who was finishing up med school. I explained again what happened and when it hurt. She wrote back in 10 minutes: "You have bruised your patella, and the brace is putting pressure on it, slowing its healing. Take the brace off." I did, and about a week later it was fine. I was happy to finally be better, but why could a med student diagnose me over email better than 3 specialists who actually took my money and time?

I have a wonderful dentist now, but she's a long train ride away (Amano Dental Clinic in Toranomon--Mayumi Kanno; she's awesome, and although I speak Japanese just fine, she speaks excellent English, for anyone who needs that!), but that is after a string of disappointing or terrifying experiences, one of which has left one of my teeth such a mess I'm probably going to lose it (and have Kanno-sensei give me an implant!).

What I'm saying is that, over all, my medical experiences around Japan have been extremely mixed--way more mixed than I've had living around the US. Overall, I've found the doctors in big metro areas (like Toranomon, Ebisu, and Meguro) to be much better. So I submit to you that you are cheating. ;-)

Finally, as a Japanese taxpayer, um... God the tax offices are a mess here. How long have you been living in the US, and your insurance is still active??? When they're not misplacing people's retirement accounts (that they've been paying into for 30 years), they're giving health coverage to people who haven't payed into the system for... How long?

Sometimes I think of getting my citizenship so I could vote, but I think that might be even more frustrating, because I don't think it'd do any good.