JAPAN NEWS AND DISCUSSION
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In an OECD survey of 36 nations on people's perceptions of their living conditions, Japan ranked 21st in terms of quality of life; Australia, Norway and the U.S. were the top 3. What do you think of that?
( 12 )
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The Fukuoka mayor is banning public servants from drinking alcohol for a month; the Osaka mayor has declared war on tattoos on civil servants. What do you think of all this?
( 21 )
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Why do you think Facebook's stock failed to live up to the hype in its trading debut?
( 13 )
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Which sport, when played well, do you think is the most exciting to watch?
( 62 )
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What's the difference between an average burger and a great one?
( 12 )
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- Business Teaching Positions - Part-time - Kanto Region
- Interac, Tokyo
- Salary: ¥3,000 ~ ¥5,000 / Hour
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- National Relief/Substitute Teacher - summer start
- Interac, Tokyo
- Salary: ¥275,000 ~ ¥300,000 / Month
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- 営業パーソン
- 加治金属工業株式会社, Tochigi
- Salary: ¥240,000 ~ ¥350,000 / Month Negotiable
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65 Comments
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some14some
Badly damaged by corruption virus and needs to be replaced. While reviewing the whole system, there should be least importance to shortage of money, aging society or premium hike. Now let expert begin Homework and present patient friendly system till Kan Govt lasts (Dec. 2010) !
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Farmboy
I think it's pretty good in terms of allowing most people to get adequate medical care, but some specific areas need to be updated.
For instance, if you go to the dentist, your insurance will cover an "insurance cap," which is a poorly-done remnant of Mediaeval dentisty, but will not pay for a modern cap, so it's an out-of-pocket expense. I imagine other fields of medicine have similar problems with the cost of certain modern procedures.
An additional problem, I hear, is a lack of young, highly-trained physicians. Many more are needed. When the older doctors retire, I don't know if the new ones can handle the job. That remains to be seen.
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Papigiulio
I think its good and cheap. In Holland its like 10 times as expensive as here. so far no complaints except the health care SYSTEM itself, not the insurance.
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ebonyninja
I think the monthly payments are entirely toooo high! I am forced to pay more than y70k per month (based on my annual salary) and rarely use the coverage. Mostly for dental work and then it only covers bare-bones work, and not quality work, which most dentists will ask you the moment you sit in their chair "Are you willing to pay extra for good care?". And I cannot forego the coverage...because they need my money to cover the other individuals that either pay nothing, or pay very little, and have a family of six.
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telecasterplayer
It is completely superior to the American system in every way.
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whyRUasking
Wah Wah Wah... you poor poor thing. Many of us wish we had to pay that much, then we could believe we are getting paid fairly. Wah, Wah, I feel so bad for you. Tell 'ya what.... move home.
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IronBeard
It would be more convenient if you could still opt out and go for a private scheme from back home instead - they are usually cheaper and will cover 100% of charges for most work, including dental. Same goes for the pension scheme.
Apart from that, I think it's actually fairly good. It's the opening hours of surgeries that I can't get my head around.
Only thing is, if you were raised in the UK, living by NHS 'go home, get some sleep and drink plenty of fluids' rules, it's unlikely that you will make the most of your insurance here anyway. I have been to the doctor's ONCE in 4.5 years, and it cost 1500 yen. Still donated around 10% of my salary to them, but hey, with the exchange rate the way it is I can't really complain.
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american_bengoshi
That statement is not completely true. Foreign insurance companies, especially US insurers, are notorious for refusing to pay claims. Most importantly, they refuse to pay for pre-existing conditions. For that reason alone international health insurance will never be accepted by the Japanese govt. as a substitute for national health insurance. Of course, the main reason for making everyone pay for national health insurance is the financial need to keep the system going.
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Disillusioned
From my experience they never retire. I also agree the basic health cover only entitles you to very basic treatment, which to me, is completely wrong for the amount of money I pay for my family. We are paying nearly third of our income and I have a mouth full of dental work done through the national health system that is only guaranteed for five minutes or fifty feet. I also don't like the fact there is no such thing as a general practitioner in Japan. Every clinic has its own little medical niche and if you don't fit the criteria you have to go somewhere else. Oh, you can't just walk into a hospital with a minor injury either. You have to be referred. So, the health insurance system itself, without the corruption, is acceptable, but the level of care for the price is just wrong!
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porter
I am satisfied but 30% if something serious occurs can be a lot. Kids are free which is great.
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papasmurfinjapan
I quit the Japanese system because I rarely go to the doctor and the monthly payments were getting too high. My (Japanese) wife then rejoined with our son based on her income.
She is earning less than 10man a month, and still has to pay 23000 yen a month for health insurance.. the premiums are way too high for people on low incomes.
I know a number of families who have no insurance because they cannot afford to make monthly payments for health insurance on top of all the other taxes they have to pay.
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GW
The thing I hate is its paid like its a tax not health insurance, I dont mind paying some more to help others who cant but dont appreciate being fleeced.
Dentists.........typically very poor quality. Too many trips to/from
TOO MANY DRUGS! Allow docs to earn a living without having to become legal drug pushers!
The amount of time people have to waste to use medical fascilities is HUGE, also adds costs to employers & society.
Dont forget to get yr supplementary ins because if you have to be hospitalized, cancer or other serious surgery you will go broke if you dont have it!!!
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cleo
Yes you can - I did it all the time when my kids were little and accident-prone.
I think you must be lucky in where you live. Mostly they aren't free. They should be.
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bicultural
Way too expensive, but I guess that means I'm making too much money :)
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Eyeblack
Good in many ways, but doctors prescribe too much medicine.
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muttinjapan
telecasterplayer - Writing it's superior to the American one in EVERY way? That's a bit of a stretch - granted, no one is going to defend the American insurance mess with all the problems it has, BUT:
I had paid insurance by my uni employer, no such luck here - in the States, 10 dollars co-pay for high quality care - NO 30% fees in addition to my current astronomical monthly payments.
Modern medicine - in Japan some doctors still practice complete quackery. Some of the most archaic practices go on in Japan, look at dentistry! Most doctor's offices I've visited look like they've come direct from a doctors office in 1950s USSR.
I think Japan's system overall as a benefit to soceity is slightly better but in terms of actual personal care, it was better in almost every case in the States and Europe including doctors that were knowledgable and listened to their patients - none of this tatemae jazz - and were more willing to do holistic medicine or proscribe treatments that were cutting edge.
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limboinjapan
It has its pros and cons.
Pros;
A percentage paid by the user that make people think before going to the doctor for every little thing,
Income based so those with lower incomes can still afford it.
Covers most everything including medication and dental.
100% coverage for small children (the time they end up going most often to the doctors)
Free choice of where you can go and what doctor you can see.
For the "kokumin hoken" (self employed, part time worker, City administered insurance) a maximum monthly limit on how much you can pay out of pocket (the 30% you pay at the doctors) of around ￥60,000 for higher income people and ￥30,000 for lower income everything over that is reimbursed.
Tax deduction if your yearly out of pocket payments exceed ￥100,000 (the 30% you pay)
If you are having financial difficulties and trouble paying the premiums ( Kokumin Hoken) the ward or city office will usually be understanding and lower the monthly payment and stretch it out for as long as it take but they will not cut you off
Cons:
Not enough controls to force employer to put so-called "contracted" workers on the "shakai hoken" and pay their part.
If your monthly out of pocket expense ( the 30%) is very high you need to pay it first, then wait a few months before the difference of the monthly maximum mentioned above is reimbursed. (hard to do for the lowest income people.)
Premiums based on the previous years income ( Kokumin Hoken) making it difficult for those who have a fluctuating income, during good years its not a problem but during a bad year that may follow a good year you have high premium when your earnings are very low.
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limboinjapan
@muttinjapan;
Where do you live?? Deep in the mountains or on a sparsely inhabited island?
My local dentist has a very modern place equipment that is still not available in much of the west (Japanese dentist were doing inlay when the USA was still using mercury filled amalgamate) and FYI most of the most advanced dental equipment in the world come from Japanese companies (the chairs, drills, and white amalgam are mostly Japanese).
As for doctors, my son has a chronic medical condition and has had 2 operations both done in a new way and with equipment not available at the time in the USA or much of the rest of the west, and his daily medications are still not available despite being better than anything now elsewhere ( still in approval process in the USA but available in Europe)
And I live in "shitamachi" Tokyo.
Moderator: Readers, we remind you that the question is about the health insurance system, not the level of health care or medical equipment or technology.
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flipdinjp
Japanese health care needs improvement, its better than some places and worse than others...as for my experience in JP works for me and my family well, people complain about it/or praise it based on cost vs. use vs. quality vs. one's income.
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limboinjapan
I do think that Japan needs to modernize the cards and move away from the old paper heavy world and get some IC chip cards that can be used more easily when you need to use it in other areas of Japan.
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smartacus
I've had trouble getting coverage for some dental treatment, which I could never quite understand. Gold fillings, for example, are apparently not covered.
I also believe alternative medicine and therapies are not covered by health insurance here, but I may be wrong.
Also, is it true that childbirth is not covered because it isn't considered "being sick?"
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Zenny11
Smartacus.
Japanese medical won't cover cosmetic stuff like gold or porcelain fillings. They only cover essential treatments(ie metal fillings) anything over that is out of your pocket.
Yes, child-birth is not covered as it is not a needed procedure(one by choice), in exchange your ward will give you a certain amount(varies between wards) when you register the birth. Medical will kick in when there are medical complications/needs during pregnancy and delivery.
Curses of a socialised medical care, they are designed to keep you healthy not make you look pretty, etc.
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limboinjapan
@Smartacus;
Actually the health insurance for dental is a little complicated and I have found that many dentist do not know exactly what is covers (should have been part of my cons for both dental and medical a more clear understanding of what is and isn't covered)
For example some dentist told me only standard Pt base casted inlay fillings are covered but my dentist and 3 others have explained that that is not true, in the case of caps for the front teeth (again answer varies) the insurance covers 4 upper and 4 lower front teeth for porcelain (some said 2 upper 2 lower) also covered are white resin type caps for certain teeth also covered is white resin based amalgam filling as well as casted resin.
Now as I was told it all depends on the location of the teeth resin cannot be used on molars or front teeth because it is not strong enough one more option covered are Pt based caps with white plastic covering facing outwards.
But in every case gold is not covered but why get it seeing the Pt based ones are stronger.
Yes it is very confusing and I a sure that many of the older doctors and dentist are not even sure themselves what is covered.
As for birth the logic is ( don't ask me why I still haven't figure it out) that it is not a medical condition but a natural process so it is not covered but once you register as being pregnant at your ward office you will receive a pregnancy booklet and with this a certain number of prenatal visits, ultrasounds and test are covered, then after birth most places in Japan give you between ￥200,000 and ￥300,000 which is usually the cost of a standard birthing clinic ( not a large hospital but a clinic that usually use midwives yo actually help in the delivery).
But note that ant birth that is not "natural" for any medical reason it then covered buy insurance.
Also one great thing that is sometime a problem in the USA and other countries without universal coverage is that if the child is born and need any medical treatment (premature, sick etc..) the child is automatically covered!
Many so-called "alternative" medical treatment are covered but in Japan they are just called medical as they are often standardly offered.
Covered in all cases are "kampo" often call Chinese medicine but actually more natural (tested and approved) traditional plant and other ingredient medication, also some clinics are approved for things like acupuncture, massage therapy and a few other things but for these to be covered a "doctor" must prescribe them.
Like many insurance plans in the USA or when you travel the rules on what is covered and what is not can be hard to figure out but asking and checking around you will fined that a lot more is covered by Japan's insurance system then many think it's just that you must follow a certain order to get it.
Basically start at point A, move on the B etc.. then once you get to what you really want then getting it again is virtually automatic.
It all may sound complicated but it does work, all in all you get good care if you keep you mind (and ears) open.
Some things are not covered until a certain age is reached like general yearly checkups and mammogram but again Japan in all it pragmatism leaves loopholes for earlier mammogram all the doctor has to say is he thinks he feels something and voila you are now covered, same goes for a full body checkup, just get to know your doctor and he will do the rest!
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the_sicilian
Agree that the dental coverage gets a little complicated, and they do not cover braces at all. But not a big deal.
I'm just not sold on the whole social medicine. My wife needed surgery for cancer, and the doctor said that unless she wanted wide open surgery (no advanced techniques), she would have to wait 2 1/2 months. We flew to the US and used my insurance and she had a whole kidney removed within 3 weeks of the first phone call.
You'll get care in Japan, but not top quality. The young doctors are OK, but there are not enough of them because they can't make enough money.
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combinibento
I will agree with muttinjapan. Japanese insurance may be affordable and less bureaucratic, but the quality of doctors pales in comparison to what you get in the west, US, etc
Moderator: The question doesn't ask you about the quality of doctors. Stay on topic please.
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limboinjapan
the_sicilian:"I'm just not sold on the whole social medicine. My wife needed surgery for cancer, and the doctor said that unless she wanted wide open surgery (no advanced techniques), she would have to wait 2 1/2 months. We flew to the US and used my insurance and she had a whole kidney removed within 3 weeks of the first phone call."
I think many here have the wrong idea about the Japanese health insurance system.
Japan's system is less Social medicine and more along the lines of a government insurance plan.
The hospitals in Japan just like in the USA vary widely in Quality and services Public hospital are usually cheaper and therefore your 30% deductible is lower but you may wait a longer time for some services but if you wish to pay a little more or have a supplementary health coverage like the ￥1000 a month coop or post office insurance you are free to go to some of the larger private hospital and University hospitals (all still have prices set by the government but higher then publicly owned ones).
I now that this is going off topic but I really think some of you do not check things, you are so sure that your USA system is better that you immediately run, the Japanese system and doctors have and still do produce some of the most cutting edge medicine in the world and a lot of what you think was done in the USA was actually perfected here the whole concept of Arthroscopy was from Japan and one of the first to perfect it was also Japanese most of the latest lung and colon cancer treatments are also Japanese.
The Japanese health insurance lets you chose where you want to go if you do not like the treatment or what is offered at the place you are going then shop around, I have been through the cancer situation and the first hospital messed up and delayed so move to a larger more modern University hospital and we were treated better then any thing available anywhere in the world at the time (only available in Japan then, now the standard in the USA)
So please stop passing on false information, here like in the USA there are good places and bad and the Japanese health insurance lets you chose where you go. It's up to you to do your homework just like back home
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Klein2
No complaints at all. I don't think most people are very qualified to evaluate a doctor or what care they are getting, so I fade most complainers.
I talk to my doctors and work with them on arranging care for me and mine. I know the names of most generic drugs. I don't self prescribe, but I can usually tell a doctor what will work and what won't. For me.
For different reasons, I have received care from about 30 doctors and some mail it in, while others are tops. I just choose. I would say 3 were downright scary. 4 were effective but goofy. If I had to generalize, I would say that the women and young ones are the best, but the older ones are exremely knowledgeable... they just don't connect well. I understand the fees and why they are paid. I pay far more in medical insurance than I use, but I am happy about that because I don't live in a country with sick people.
Japanese people should be proud of their system. I think it is very effective and efficient. It compares favorably with the system I grew up using, which some say is "the best in the world"TM.
Just for fun, I should share that I recently saw a doctor to have some work done and shot the bull with him a little bit. Nice guy. He gave me some advice and a smile. It was a major hospital in my area. The bill was 210 yen. Well. OK!
Is that too oblique? Do I have to come right out and talk about insurance? Well, let me sum it up. I pay my money. It is a lot, but I don't worry a bit about health care. It is a huge load off of my mind, and it is worth it. That is what insurance is, but you know what is better? I don't have to worry about my family or extended family either, because I know that they are covered too. And my employees. And the school teachers and all the kids at school, and the guy at the 7-11 who touched my hand today. It is a good feeling. I don't worry about them. And none of them worry about me either. That rocks.
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limboinjapan
Klein2: "I pay far more in medical insurance than I use"
Thank you because with my son and I, I pay a lot less than I use! And that is a great weight of my shoulders!
As for the rest of what you wrote I second it all.
I don't know for sure but I would bet that a good part of the reason Japanese live longer is due to preventative medical practices and that is due to the insurance system.
I am over 40 and have a chronic condition so on top of the over 40 yearly check up offered under the system I also get 2 more just for safety all covered, and during one of these they realized that one of my meds was potentially causing damage due to long term use so they stopped it and I now take an different one under many other systems this would not have been possible and some time down the road it would have been a bigger problem.
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Foxie
Nothing to complain, I always received great treatment with very long explanations about my condition with a lot of concern from doctors. I even had the treatments double checked with my doctor back in Europe and he was impressed too. 19,000 yen per year is all I have to pay with Kokumin, you can't beat it.
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Patrick Smash
The system is okay, but really needs a higher excess on visiting a doctor to keep the crowds of old folk with minor sniffles at bay. First visit for each individual reason should invoke a higher spot charge. And child birth needs to be covered, c-section or otherwise.
The problem with overseas policies is that they do not insure you after a certain age. Most policies stop at 60, so for any of us brave enough to grow old here, the Japanese system is really a necessity once a few years have passed.
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Sarge
It doesn't cover acupuncture, which it should.
Acupuncture is effective in many cases where standard medical treatment fails miserably.
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cleo
Dunno how you wangled that - according to the bill I got this year there is a minimum per capita charge of 28,200 yen per year plus another 28,200 per household, so the minimum charge is 56,400 yen per year. Have an income, own property or be aged over 40 and that shoots up.
I wouldn't complain either if I only had 19,000 yen to pay. How'd you do it?
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GW
foxie
Y19,000/yr, are you sure thats right...........damn if thats true I am paying in one yr wud cover you for about 30yrs...................
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Klein2
Klein2: "I pay far more in medical insurance than I use"
Once I did not use it for a whole year. They sent me a towel or a calendar or something. I think I "paid" 8000 dollars for that towel, or something like that.
I am a real nice guy. Enjoy your care everyone. Do something nice for somebody today.
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Klein2
"And child birth needs to be covered"
I seem to remember that along with company benefits, partial coverage of some procedures, minimal private insurance, and subsidies by local government, it all kind of washed out. I think having a kid in Japan comes to about 4-5000 dollars out of pocket ... roughly 500 000 yen, or probably less than that, which is just nothing compared to what it might cost elsewhere. All I really remember is that the amount was so low that I did not even worry about it.
People worry about having enough money to raise kids, as they should, but the birth part is a lot less expensive than what I was prepared for.
Sarge, I had lower back pain and my chiropractic was covered. Worth every yen I and the state paid. I think it was administered as physical therapy for a diagnosed condition, which might be a loophole. Good luck on the needles. I will not say it will never happen, but it seems that it won't be covered in my lifetime.
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limboinjapan
Child birth cost ￥500,000 yen in a major hospital ( my ex had complications during pregnancy so the local birthing hospital would not take us) but both the hospital and the clinic had LDR everything went normal so nothing covered but the city reimbursed us ￥300,000 second child was cheaper because of a shorter hospital stay and our out of pocket expense was ￥50,000 so nothing to complain about.
As for acupuncture I had it at my local doctor that also has massage available for back pain all covered, like I said there are medical clinics that have all 3 type of treatments available and covered but I have noticed they are rarely in central Tokyo or in the richer areas seems to be a "shitamachi" thing.
@Cleo; Had a bad business year last year so this years payments for 1 adult and 2 children runs ￥3,295 per month a total of ￥39,540 for the year I can't complain my son was hospitalized 3 times already this year and in our ward at his age he is still 100% covered with business being slow I would have been in trouble.
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hokkaidogirl
I think it works for the Japanese. When I was there, I had no complaints. I was happy with the dental too. I really like the doctor and dentist I went to. They knew what they were doing and were up on all the latest stuff.
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american_bengoshi
Childbirth should be covered 100%, especially considering the country is desperate for more children.
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yokomoc
The amount you pay isn't meant to correspond with the care you receive; that's the point of an insurance system over direct-pay. You pay higher rates because you can, and it allows those who can't afford it to get treatment. With the money you pay in you've probably given enough to save several childrens' lives. You're a lifesaver - be happy and proud!
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Newsman
Kokumin hoken is a great deal if you're poor, and if you're rich it's not a burden (rates are capped at a certain point) but if you're in the middle class it takes one heckuva bite out of your salary. I have long suspected that the reason it is so much more expensive for middle-class workers than shakai hoken (of course, since the company foots half the bill of shakai hoken) is to gently discourage workers from leaving company employment of their own accord to set up shop for themselves.
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cleo
Maybe you're confusing 'hospital' with 'clinic'? I've never known a public hospital turn anyone away with a minor injury, though if they're crowded you may have to wait your turn and if it's outside surgery hours there might be a kerfuffle verifying that you can pay/have insurance. If it's a clinic and the doctor's not there and it isn't a serious injury, they may well point you elsewhere.
Moderator: Readers, please keep the discussion focused on insurance, not the availability or level of health care itself.
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the_sicilian
Limbo: Well, the thing with the USA is if you have a good job (I do) and have a good health care provider / insurance (I do), I can get better care than I have experienced here in Japan.
Example: My US health plan caused me to pay, on average, about $800 out of pocket for 3 kids being born. All normal births. But like I said above, I do pay about $400 a month for my coverage.
The problem I have with the Japanese system, and yes, it is a social system, is that when you go to the hospital, you find a lot of people with very low level sickness waiting to be seen. In the US, as an example, you have your own PA or family doctor to take care of this type of thing. HEre, a lot of baa-baa's are in there because they have a cold.
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ukguyjp
I teach full time at university.
I pay 50, 000 yen per month (about US$ 500) for the Japanese system, it is compulsory to join the system if you are a university teacher, although some universities 'out out' illegally.
I just spent 2 weeks in hospital for a slipped disc. I had excellent care. The hospital bill was 150,000 yen, (US$ 1500) I will pay about 30% of that.
It's not cheap, in fact it's probably a bit too dear, but I have a good job and I accept my responsibility to subsidize people on lower incomes. Goodness knows I have been low income myself in the past. What goes around comes around.
Incidentally, the health care I received in Japan has generally been good, and often excellent.
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GW
ukquyjp,
You were lucky, sounds like you didnt have a any surgery, if you did yr costs wud have been a lot more, this is why I said in an earlier post that if you want proper coverage in Jpn you need to buy yr supplementary ins to cover operation costs & the hotel/food bills otherwise it cud bankrupt you, watch out you`ve been warned!
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TanakaTaro
Are you sure that's right? I pay that much a month...
I think the health insurance system isn't too bad. Still having to pay 30% is a bit of a rip off but I feel much safer than if I had private insurance or no insurance at all.
Much better than the American system but not as good as the European systems.
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limboinjapan
the_sicilian: "In the US, as an example, you have your own PA or family doctor to take care of this type of thing."
I guess you really have not made any effort to learn about Japan you just assume.
The Japanese insurance system unlike those of much of Europe and Canada is mostly based on Private clinics and hospitals and like Canada there are plenty of private practices.
My "kokumi hoken" let me chose where my family goes, We have 3 private doctors offices we use one is a GP one Pediatrician and one Gynecologist all take appointments, all know us so we pass quickly all have privileges in the Large University Hospital we use when my son needs more than just regular adjustments for his problems.
As I have said before the Japanese insurance is a government run insurance and not a government run medical system 90% of all medical treatment available is done at Private offices, clinics and hospitals.
This is what makes it so good and versatile you can chose where you wish to go, if you don't know how the system works or are not able because of language then it is not the systems fault.
@ukguyjp: "I just spent 2 weeks in hospital for a slipped disc. I had excellent care. The hospital bill was 150,000 yen, (US$ 1500) I will pay about 30% of that. It's not cheap, in fact it's probably a bit too dear"
The Japanese insurance covered 70% had you been there a month you would have still only ended up paying around ￥60,000 because under the system that is the Maximum you can pay out of pocket per month as for ￥150,000 for 2 weeks hospitalization compared to the USA that would be cheap and that is another benefit of the system it sets the maximum fee a hospital can charge for each service (they don't have to charge the maximum but they can).
GW: "if you want proper coverage in Jpn you need to buy yr supplementary ins to cover operation costs & the hotel/food bills otherwise it cud bankrupt you, watch out you`ve been warned!"
This is just fear mongering of the type I have been hearing from Americans for 19+ years,
The Japanese system has set Maximum out of pocket expenses at around ￥ 30,000 a month for lower income people and ￥60,000 for higher earners anything more is covered by the insurance,
Also food, medicine, and room charges are all included in the insurance system unless you opt for semiprivate, private rooms and request special meals and this would be the same in other countries.
My sons last operation (with a technique only now available in the USA but not at the time) cost ￥1,000,000 for his entire care (made inquiries it would cost $ 40,000 now in the USA) the insurance covered 100% due to his age but had it not I would have paid 30% up front ￥300,000 and then been reimbursed by the insurance ￥270,000 later (takes about 1 to 2 months).
But if you are so frightened by the system then for around ￥1000 a month you can get a supplementary insurance from the post office or coop that covers most other charges.
The Japanese insurance system has many options and failsafes you just need to find out what they are but please stop spreading false information.
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Sasoriza
Klein2, childbirth and any procedures related cost nothing in my home country. However, excluding this, I think Japan's health insurance system is excellent.
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Zenny11
I have had an extensive(6-weeks stay) in a Red Cross Hospital and the cost was little. My Wife during her 6-years of Cancer treatment had very good coverage/tratment and that included surgery by the top-surgeon at the NCC, etc.
Granted we were both on a Company Medical Aid(IT specific but still 70/30) and I took a top-up scheme with Aflac. Actually from her breast reduction surgery we GAINED about 150.000Yen, once all the paperwork was processed.
One thing many people are also not aware that national health-care provides 100% FREE medical for kids up to school entry and than a 80% coverage till end of JHS(IIRC).
I have found a few Dud-doctors but the majority were well educated and gave good treatment. Was surprised that many doctors can speak english but don't advertise it.
Another thing to look out for is which Doctor accepts people on Social Welfare(usually very good) and which Doctors decline ANY Medical Aid(usually mental specialists, etc).
Granted the paperwork with the Nations Health Service can be a pain. but you will get most of your expenses back.
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limboinjapan
@Sasoriza:
I agree child birth should be included and there has been some debate lately within the DPJ many are asking why Viagra should be covered but birth control pills and at the same time child birth.
No one ever said the system is perfect and many know that it needs some changes to adjust to modern times.
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Foxie
Cleo, GW: I guess the rates change according to the location you are living in. I really only pay Yen 19,100 per year. It helps living in the sticks.
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cleo
I live in the sticks too, and if different sticks have such a difference in rates, I think the system blows.
I wanna live where Foxie lives.
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GW
Clearly after reading all these posts there are lots of different situations & a lot of miss or miss-leading info, I dont claim to be an expert but I can tell you the supplementary cancer insurance we have saved us a ton of yen when my wife had to be operated on & no no special rooms or meals or anything.
One thing is clear to me & its always been this way the health insurance system in jpn is as clear as mud & there appears to be areas with very heavy subsidies if all these posts are true and a Cleo says that sure as hell aint fair & I live pretty rural as well, no deals for me anywhere I have lived for the last 20yrs.................
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limboinjapan
GW: "One thing is clear to me & its always been this way the health insurance system in jpn is as clear as mud & there appears to be areas with very heavy subsidies "
Actually it is clearer then many USA insurances where they seem to deny coverage based on things like pre-existing conditions or my favorite ( that happened to me when I was working there) the procedure was not pre-approved. (how could I it was 3:00 AM and an emergency)
Basic coverage is the same all over Japan where things can change is that some municipalities make things like Child coverage last longer and have preventative programs that may differ (not unlike each state or Provence in the USA and Canada ).
Private hospitals can Charge more if the type of procedure is not the one that is covered ( just like USA insurance companies don't pay if it not what they consider approved ) but those procedures are usually available in University hospitals and if you have a bit of ingenuity you can talk your way into getting it done there and under the insurance system even experimental procedures are covered at University Hospitals because that is how the Japanese Government decides what will be covered in the future.
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MASSWIPE
The health insurance system in Japan is good because it is, to a large extent, decommodified. This doesn't mean there are no cash registers in the hospitals and clinics (as is the case in the UK), but considerable government regulation ensures that the vagaries and excesses of shareholder capitalism do not become a key factor in the provision of what is, after all, a necessity and not a commodity. And there is also the convenience of the National Health Insurance system, which makes it easy to get treatment at virtually any health care facility in Japan.
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the_sicilian
Limbo: Understand, I am relaying what my experience has been. My wife had no choice to go to another hospital unless we wanted to fly to another part of Japan, after our doctor gave a referral to a specialist, and he was not very willing to do that.
So you discount my experience because you think I do not understand the "system"? My wife is Okinawan, and we live in Okinawa. She has a pretty good handle on how the "system" works. Maybe more so than you , being she is a native and you appear not to be. So to expedite the process (and anyone with cancer will tell you that is the priority), it was better to get out of the system for treatment.
And my comments of hospital overcrowding are valid as well. An aging population and every small sickness being sent to hospitals is a bit difficult to deal with.
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Zenny11
the_sicilian.
My Wife was very quickly referred to the local NCC(National Cancer Clinic) after the Biopsy.
There she had to redo ALL the tests that took a long time at initial clinic but this time they were all done within 2 days.
Granted the NCC is crowded as they usually serve a large area(only 2 in Tokyo/Chiba area) but they are excellent.
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GW
limbo,
I will say this my wife had her operation 10days after her condition was confirmed, I am grateful for that, we were refered to Nihon Idai a big monstrous uni hospital in Chiba, great place but I can tell you we were damned glad we have the extra insurance otherwise I wud have been out millions of yen. The docs were great, although my mother in law almost had a heart attack when the docs called us after the operation, then proceeded to show the organs they JUST removed from my wife on a tray to explain this & that! God what an experience!
Dont get me wrong we both still go to this hospital when we can as its good, but costs can get expensive depending what yr in for
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Zenny11
Agree with GW the top-up schemes are good and people should get one.
When my wife was diagnosed they immediately transferred 300.000Yen just for the diagnosis.
Unfortunately she needed 6-months Chemo to shrink the tumor before the Operation.
Those top-up schemes also up the daily allowance for hospitalisation as the usual 5.000Yen/Day don't cover much(even 10.000Yen/Day as was in my case was exceeded).
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limboinjapan
GW: My apologies I really did not mean or wish to offend you I did not realize you were in Okinawa ( it is known for problems)
I am Glad things worked out for you and your wife.
As @Zenny and I who have both had similar experiences we got referrals to large hospitals ( Asking is one thing but in Japan it is some times better to just demand as I did they dare not refuse).
I brought my girl overseas to USA and Europe to see if they could offer better and they both could not so I know she got the best care available anywhere but even that was not enough.
The one thing I did and still have a problem with Japanese insurance is having to pay the 30% first and then waiting for the difference over the monthly maximum to be reimbursed in 2 months during my GFs cancer treatment this meant large pay outs every months then waiting.
We used a large University Hospital and a regular ward 4 to 6 people per room there were no supplementary charges food, meds and room charges were all covered by insurance.
Again my sincerest apologies if I offended you.
Limbo
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the_sicilian
Zenny: My wife's urologist actually works out of the Ryukyu University Hospital, which is the place for anything resembling advanced surgeries. If going to mainland Japan was an option, I might have done that but going to the USA was better. That's all.
I do like that we pay only a small percentage for care, and in general the care is good. But the crowding is something that I hope can be addressed. I feel there should be more incentives to be a doctor or nurse here.
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limboinjapan
@the_sicilian:
My post at 04:10 PM JST - 29th September should have been addresses to you very sorry again wasn't on the ball a little tired I guess.
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GW
hey limbo,
realize you stuck my gw by mistake, anyway I have no problems with anything you have posted just experienced things differently is all.
I will say I have never heard of this maximum payment per mth you keep mentioning. I know you can deduct yr expenses from income if you go over Y100,000 per yr or there abouts thankfully its been about 7yrs since i qualified for that deduction!
But again I have never heard of the max payment per month you mentioned.
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limboinjapan
GW: "I will say I have never heard of this maximum payment per mth you keep mentioning."
If you live in Tokyo there is a booklet issued by the Tokyo government in English, Chinese, Korean and I think a few other languages (yes Japanese) that is titled something like "Living in Tokyo" ( the title changes a bit some times) it is free and has all the info on insurance calculations and the monthly maximum set each year.
I have seen similar booklet in other cities it also has a lot of other useful information including hospitals and emergency procedures it is usually available at the ward offices and usually near the alien registration counter.
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limboinjapan
@GW:
Zenny11 said that in his case he had to fill forms in order to get the reimbursement, don't know where he lives but where I live the "Kokumin Hoken" did it automatically but when I was on "Shakai Hoken" I had to remind them and it took a lot longer ( I didn't know I had to let them know so I asked them only about 4 months later and then it took them 3 more months to pay)
Now I was at the Hospital with my son today ( a regular thing around here) and I asked the billing people about this and a nice man their said that "If" you still have your receipts and know what "hoken" you had at the time you paid over the maximum even if it has been years you may still be able to get your reimbursement today!
Now he did say there could be a catch if you used those receipts as a tax deduction and now claim the reimbursement then you had better file a tax adjustment form for those years or you could be hit with tax fraud for claiming a tax deduction on the part you were reimbursed.
I know it sounds like a lot of trouble but that depends on how much you can get reimbursed I guess!
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WilliB
It is basically Obamacare, but without including millions of illegal residents.
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