The 101 for the Japanese healthcare system
Japan has had a universal health care system in place since the 1960’s and has enjoyed the benefits of such a system. Coming from another country with a health care system it is something I can appreciate and understand, not just the positives but also the negatives about it.
The problem with Japan’s health care system is 3 fold:
- an aging population
- low economic growth with high rates of unemployment
- a negative population growth i.e. low birth rate
There are plans to change the system into something more sustainable and allows more collective responsibility to ensure it remains stable and sustainable. But what about how the system stands currently?
A post-code lottery
There is an uneven distribution of health care providers in Japan as most clinics are private and it is down to the business to where it should open. As a general trend clinics are only found within built up areas and clinics that specialise in something are extremely rare outside cities. While researching this article, I came across a singular diabetes specialist in Nabari and Iga but there are many clinics that specialise in diabetes in Osaka.
Another example is palliative care which is expected to be the responsibility of the household. An advertisement on the train (of all places) gave commuters information about a palliative care clinic in Osaka and people were reading this and taking that information in.
Cost of healthcare for foreign nationals living in Japan
If you live in Japan, you are required to join the health care system and I will always say one thing: do it. The current system will cover 70% of the costs of any necessary treatment plan e.g. dentistry, internal and external medicine etc. A recent trip to the dentist should have cost me just offer 10,000 JPY but under this system I paid around 3000 JPY instead.
This has a few positives especially for Americans living in Japan. This is a form of insurance that everyone is required to have and if you’re filling US taxes, this does count in the eyes of the IRS.
My monthly cost is just under 2000 JPY and just one visit to the dentist or doctor would be the equivalent to 4 or 5 months work of insurance. It is brilliant for the end user but not for the system. The amount of money that the government spends under this system is astronomical. This is a better system than the UK as everyone has a more direct input into the running costs of health care in Japan, but there is still money being pumped into the system.
A patients choice is at the heart of the Japanese healthcare system and people are encouraged to give suggestions to policy makers in Tokyo. People have the right to chose which clinic, which hospitals they would like to go to regardless of insurance status, disease or background. There may be a fee incurred but people have that right.
Please note there is also voluntary private health insurance available which helps cover things that national health insurance dies not including: loss of income insurance, transportation, food etc.
There is no difference between primary and secondary care in Japan, even historically. This means that you can go to a clinic or a hospital without a referral, a small clinic may be extremely specialized in an obscure disease but they are located in the smallest town imaginable or have no specialist available within a city.
In Japan there are over 8,400 hospitals and over 100,000 clinics and 80% are privately owned. The system is split into several major sectors: internal medicine, external medicine, dentistry, gynecology, emergency medicine, pediatric medicine and pharmaceutical.
Even emergency care is split into primary care (on call doctors and prefecture run care), secondary care (hospitalization is required) and tertiary care (advanced or more grievous care).
The general pathway for this system is 119 (ambulance) assistance, then hospitalization, the removal to a specialist facility e.g. ICU.
Where to go?
As a general rule of thumb, the guidelines about where to go are:
- External medicine: injuries and problems of the limbs
- Internal medicine: anything else e.g. vaccines, non-commutable diseases (cancer, COPD, cancer etc)
- Dentistry: teeth….
- Gynecology: females
- Pediatric medicine: Children
- pharmaceutical : drugs
- Emergency medicine: ambulance
There is a lot more information about the Japanese health care system and I can, and really want to, go into so much more detail but this is an overview and a general guide.
Thank you for reading and happy exploring.