Emergency Medical Care In Japan [Archive]

Pachipro

Jun 5, 2007, 07:28

I have Diverticulitis (http://en.wikipedia.org/wiki/Diverticulitis) which sometimes becomes inflamed and I have to go to the doctor to receive antibiotics and the pain subsides within 24 hrs. My last problem with it occured about 4 yrs ago.

Well, while I was in Japan these past few weeks it became inflamed and within 24 hrs I developed a slight fever and knew I would have to go see a doctor or go to the hospital. I was a little concerned as I had no national health insurance, but it had to be done regardless of the cost.

My wife called a doctor in the neighborhood and an appointment was made for an hour later. It was a Saturday morning and I figured it would probably be crowded. I had not received medical care in Japan since the 80's and, not knowing the cost, we took 60,000 yen with us as, in the US, with no health insurance, the cost would probably be at least $200 if not more.

We walked the 10 minutes to the small clinic and upon entering, after removing our shoes and using the slippers (pink for females, blue for males) I was amazed that there were only two patients there, an eldery gentleman and a woman with a baby. Surprising for a Saturday morning. The nurse behind the counter took my basic information and asked that I take a seat and the doctor would see me shortly. Unlike the US there were no pages of info to fill out.

Within 10 minutes the doctor called us in and I noticed his diploma on the wall from Tokyo University. I explained my situation to him in Japanese with help from my wife and what kind of penicillin I usually take for the symptoms. He understood what I was talking about, checked his computer for reference and asked that I lie down. Locating the pain on the left side of my abdomen he asked that I take a urine test. I left the cup on the counter in the restroom and as soon as I returned to the room he said that my urine was ok. Now that was fast!

He said that he would give me a 5 day prescription for antibiotics and pain killers and that if the pain did not subside within 24 hrs that I was to return. We went to the counter and we were given the medicine right there! No pharmacy to go to! Our bill was calculated and it was presented to us.

To my astonishment the total bill for the visit, urine test and two prescriptions was 4,610 yen!! Approximately $38 at the current exchange rate! And that was with no National Health Insurance! My wife and I looked at each other with wide open eyes. I asked her if this was the normal cost and she asked the nurse. Yes it was! Unbelievably reasonable. Way lower than either of us expected.

I calculated the cost of what this would have cost me in the US WITH insurance. The co-pays for the doctor, urine test, and two prescriptions would have come out to about $60 and, with no insurance, the cost would have been at least $200! This just goes to show how unreasonable medical costs are in the US.

Anyway, within a couple of days I was fine and my visit to Japan was not interupted at all as, I was still able to function thanks to the pain killers and, I am very grateful that in Japan you are not ripped off for emergency medical care even if you have no health insurance!

Therefore, if you are visiting Japan and become ill don't fear that it will cost you an arm and a leg if you have to receive care.

KirinMan

Jun 5, 2007, 08:24

Thanks for sharing that. While many people, rightfully so in some cases, debunk the overall health system here, overall the care and professionalism of the doctors and hospitals is fine and one shouldn't need to worry about getting treatment if necessary.

I hope that you stay well.

bakaKanadajin

Jun 5, 2007, 08:24

Yes I had a similar experience. Actually when I went I was the only one there. He saw me very quickly and although I didn't need any medication I could see in the receptionists office that a wide array of 'kusuri' was readily available.

One complaint I heard from my friend though (who unfortunately always has a lot of minor health problems) is that compared to the American stuff, the drugs in Japan are a little weak. The allergy medication and enczema (sp?) cream isn't the greatest for example.

The flipside of your experience is that although you were given what you needed quickly, there exists a risk for certain other things. For example, (at the risk of sounding gawdy) when my lady friend decided to use the contraceptive pill it was issued without doing any liver diagnostics, which is usually mandatory from my understanding because those with weak livers have a hard time processing the pill and this can lead to complications.

For the non-emergency stuff, there's also a general 'let's wait and see' attitude. I noticed this during my visit and another of my friends had a similar experience which they found more frustrating due to the nature of their problem.

Overall though, in terms of situations like that which you've described here, and also your basic burn-wrapping and cut-mending, I've found the wait times in Japan are very agreeable.

KirinMan

Jun 5, 2007, 08:35

One complaint I heard from my friend though (who unfortunately always has a lot of minor health problems) is that compared to the American stuff, the drugs in Japan are a little weak. The allergy medication and enczema (sp?) cream isn't the greatest for example.

There is a reason for this as well, doctors here will generally prescribe the medication that has the lowest "active" ingredients as to prevent the patient from, particularly those with chronic problems, building up an immunity to the drug.

If a patient knows the medication name, here in Japan, that they know to work best for themselves they can request the doctor to prescribe if for them. The key however is knowing the drug name here in Japan.

One other reason for "some" not all of the doctors prescribing "weaker" medications is that the patient will need to come back and visit the doctor again for follow up treatment. $$$$$

Because of the costs involved in visiting a hospital here it is actually cheaper in most cases to visit the hospital for even things like the common cold, most pharmacies medications are weaker than what is prescribed from a hospital and cost more than a typical hospital visit.

However going to hospitals in many cases takes quite a bit of time, hence using the pharmacy instead of the doctor. Another option for those that are aware of them are the "kanpo yaku" 漢方薬　かんぽうやく、traditional Chinese medicine or herbal/organic medications that can be found at many specialized pharmacies

Glenski

Jun 5, 2007, 10:30

What I don't understand is why so many medications have to be supplemented with another one to ease stomach discomfort? Can't they make something to treat ailments without affecting the stomach, too? Or is it just another chunk of change in the doctor's pockets?

To the OP, I hope you don't mind my asking, but how can you live in Japan and have a Japanese wife, yet NOT have health insurance? MY wife would be astonished and pushing us for it. Doesn't she have any coverage, either?

KirinMan

Jun 5, 2007, 11:02

What I don't understand is why so many medications have to be supplemented with another one to ease stomach discomfort? Can't they make something to treat ailments without affecting the stomach, too? Or is it just another chunk of change in the doctor's pockets?

That's a great question, one thing I do know is that the pharmaceutical companies here do not spend even close to the same amount of money on research and development of new drugs like the giants do in Europe and the US.

There seems to be a great reluctance here to introduce new medications that would help patients but would increase the costs to the system as a whole.

bakaKanadajin

Jun 5, 2007, 12:37

Why don't they spend the big bucks? Perhaps Japan's pharmaceutical industry isn't as aggressive and politically connected as the Wests. In the USA for example the pharmaceutical industrial machine is huge money, I'd put it up there with the auto makers and weapons industry. Lobbyists and soft money ensure certain companies control the market in terms of newly released drugs. Nothing gets passed without the FDA's blessing and what does get passed is not always the best thing for our health. FDA regulations also prevent some naturopathic remedies from being patented so as to give pharmaceutial companies the opportunity to create a marketable and patentable derivative or alternative. There have been some re-calls, and many drugs will at the very least give you some very serious side-effects.

I think Japan's health industry is more concerned with the whole naturopathically derived lotions and potions approach. Lots of Barley Greens, Noni juice, teas, bacterial cultures to aid digestion, vitamin drinks, vegetable/fruit drinks, etc. as opposed to chemical-laden multi-vitamins, pepto bismol (what the heck is tha stuff anyway?) and other assorted items.

If you walk into a Japanese 薬や there are definitely many different commercial medications available, but there are also a large number of what appear to be herbal and naturopathic remedies as well. They do not appear to be marketed as 'fringe' products, both appear to receive equal commercial treatment and market share.

Ewok85

Jun 5, 2007, 12:41

To the OP, I hope you don't mind my asking, but how can you live in Japan and have a Japanese wife, yet NOT have health insurance? MY wife would be astonished and pushing us for it. Doesn't she have any coverage, either?

"I had not received medical care in Japan since the 80's" is a clue - I used to pay around 14,000/mth for Shakai Hoken health insurance - thats 168,000 a year, and if Pachipro hasn't had to go to a doctor since the 80's (lets say 1987) thats 20 years, meaning 3,360,000 in his pocket. You would have to be in hospital for a month and receive surgery to get that sort of bill.

While this is a good story, its nothing special. Pachipro knew what was wrong, the doctor did nothing but prescribe a basic drug, and everything was fine. I know numerous people who are both Japanese and foreign who have had serious (including fatal) issues with the health system. Just because your local doctor can slap on a bandaid or give you some antibiotics does not mean the entire system is hunky dorey.

ArmandV

Jun 5, 2007, 13:19

To the OP, I hope you don't mind my asking, but how can you live in Japan and have a Japanese wife, yet NOT have health insurance? MY wife would be astonished and pushing us for it. Doesn't she have any coverage, either?

Pachipro used to live in Japan. He was just there for a visit when he became ill. He may have medical insurance that isn't usable in foreign countries. That's why travelers are urged to get travel insurance that would cover sudden illnesses or accidents.

Ewok85

Jun 5, 2007, 13:51

Well I'm completely off :P

KirinMan

Jun 5, 2007, 13:56

You would have to be in hospital for a month and receive surgery to get that sort of bill.

You make your point however the cost for a month is very much overexaggerated. Dont want people here to get the idea that things cost that much.

They dont. Like I said though you made your point.

Just because your local doctor can slap on a bandaid or give you some antibiotics does not mean the entire system is hunky dorey.

While there are problems with the system as it is, things are not all "that" bad either.

I dont know or have ever heard of any place in the world that has "perfect" health care. Seems that it, health care system problems, is a world wide thing.

KirinMan

Jun 5, 2007, 14:15

Why don't they spend the big bucks?
Because as the system stands they can not charge the same prices for their products that western corporations do to make a profit, which also covers their research costs as well.

Perhaps Japan's pharmaceutical industry isn't as aggressive and politically connected as the Wests

Actually it is very well connected, they manage to keep out foreign competition.

Ewok85

Jun 5, 2007, 14:24

I dont know or have ever heard of any place in the world that has "perfect" health care. Seems that it, health care system problems, is a world wide thing.

But its within these problems that the strengths of the system show - America is often criticised as being expensive, but the level of care and competence is very high, as well as patients being well protected by the legal system that is in place. Can't say the same about Japan on all of those points however.

KirinMan

Jun 5, 2007, 14:27

But its within these problems that the strengths of the system show - America is often criticised as being expensive, but the level of care and competence is very high, as well as patients being well protected by the legal system that is in place. Can't say the same about Japan on all of those points however.

True to a point, but, how many millions or tens of millions of people in the US can not afford health insurance?

Health care in the US is for those that have money and not everyone.

At least here in Japan you dont have to break the bank to go and see a doctor and darn near every person living here can get affordable health insurance, even those with zero income.

Payment is based on one's income.

Ewok85

Jun 5, 2007, 15:24

Payment is based on one's income.

Payment for the insurance perhaps, but everyone is charged the same* when it comes time to see a doctor or buy drugs, and those unable to pay for care are still refused it in Japan.

KirinMan

Jun 5, 2007, 15:51

Payment for the insurance perhaps, but everyone is charged the same* when it comes time to see a doctor or buy drugs, and those unable to pay for care are still refused it in Japan.

Out of curiosity here why do you have the opinion that those that are unable to pay for care are refused it here in Japan?

thistle

Jun 5, 2007, 16:16

The cost of medical care is quite reasonable here, and as it costs us (a family of four) 25,000 min. a month for health insurance, Iam thinking of just not taking it out any longer. It is a rare occurence for any of us to go to a hospital anymore, and I have a heart prescription I have to get every 2 months, but that would be 10,000 every 2 months, so I am thinking why bother!
Many japanese companies cover the health insurance, but it is not in my company.

caster51

Jun 5, 2007, 19:45

My yonger brother have worked as a exchenge docter at Mayo Clinic in Jakcsonville.

his most surprise was a day inspection hospitalization of there.
all stuff was perfect.
however, its expense was $10,000 a day

Ewok85

Jun 5, 2007, 22:32

Out of curiosity here why do you have the opinion that those that are unable to pay for care are refused it here in Japan?

Being married to a nurse working for a major Japanese hospital would be one reason.

ArmandV

Jun 5, 2007, 23:05

...and those unable to pay for care are still refused it in Japan.

Maybe folks in the U.S. ought to keep this in mind the next time they have a problem with the health system and pitch a fit.

Goldiegirl

Jun 5, 2007, 23:57

What health system in the US? Do you mean the kind if your job offers insurance or private insurance where you get get ripped off for $600.00 a month or nothing? The health care provided in the US providing you can pay for it is top notch, but I'd still take less and have affordable health care. I went to the hospital in Tokyo and paid so little that my I didn't have to use my international health insurance because my visit was less than my deductable!

ArmandV

Jun 6, 2007, 00:03

What health system in the US?

If someone has no insurance, they can still get health care via county and state medical facilities (depending upon where you're located).

Pachipro

Jun 6, 2007, 00:05

To the OP, I hope you don't mind my asking, but how can you live in Japan and have a Japanese wife, yet NOT have health insurance? MY wife would be astonished and pushing us for it. Doesn't she have any coverage, either?
I do not live in Japan any longer Glenski. I lived there through out the 70's and 80's. I return once or twice a year for visits and will move there permanently around 2009-10.

When I lived there I DID have the national health insurance after I started my own business. For the four years I was a student I did not have any. I paid about 8,000 yen/month for me and the wife. Once I had severe headaches that wouldn't go away. I went to the hospital in Japan and was scheduled for an MRI of the brain. Three days later I was in and the results were shown to me shortly thereafter, the same day! Luckily I didn't have anything wrong with my brain and the headaches disappeared shortly thereafter. Total cost to me: about 4,500 yen!

In my opinion, I believe the national health care system in Japan is among the best in the world for a socalized system even though it may have it's problems (see below). Here in the US we hear too many horror stories about the systems in Canada and the UK where a person is put on a waiting list for non-emergency surgery that could sometimes take months!

As a matter of fact I heard on the news yesterday that in the UK, if you are a smoker and are scheduled for major surgery, that you must quit smoking for 4 weeks before it will be performed as they said that smokers take longer to heal and this costs the state more money. Also, before the surgery can be performed, a blood test must be taken to prove that the patient hasn't smoked in four weeks.

Payment for the insurance perhaps, but everyone is charged the same* when it comes time to see a doctor or buy drugs, and those unable to pay for care are still refused it in Japan.
Not really true. Maybe things have changed. Two cases in point:

1. While a student in Japan back in the 70's I had no national health insurance and I came down with an absessed tooth. A Japanese friend suggested a dentist in Omiya that would take care of it at almost no cost. It was a long trip, but he took care of it and charged me 3,000 yen for two visits! He spoke English well and when I quried him about it, he said, "No problem. I just put you under someone else's name."

2. A friend of mine who was also a student at the same university came down with acute appendicitis and went to the hospital. He mentioned to the doctor that he had no national health insurance and the doctor said, "No problem. You have it now." Total cost to him for the surgery and a weeks hospital stay: 2,800 yen!

Whether this still happens in Japan today I do not know, but something tells me that it still does. Maybe the Japanese are refused if they cannot pay, but for me and my friend, foreigners no less, we were taken care of and for that I am grateful.

Goldiegirl

Jun 6, 2007, 00:50

Yes in some cases you can get "free" care at taxpayers expense, but when you are in a situation like mine you get screw*d. I own a home, but do not have a job that provides insurance. I have to pay a HUGE monthly bill for insurance; if I want "free" care, I can give up my home and become a burden on the taxpayers. I am in a no win situation. I will take socialized medicine, or some version thereof, with it's problems. I appreciated the care I received in Japan and the cost was reasonable. The same can be said for my care in Scotland.

Ranpyon

Jun 6, 2007, 01:06

Interesting topic ^_^

I have a question about this matter, because I'm going to move to Japan in less than a month ^^;; and I still don't know very well how the insurance thing goes.
My mother is very worried about it, and she's yelling at me all the time because of it lol
I got a pre-college Visa, and I'm going to stay in Japan for a year.
What should I do? Get a private insurance here in Italy or try the Japanese one?
I'm really confused x___x

ArmandV

Jun 6, 2007, 01:11

if I want "free" care, I can give up my home and become a burden on the taxpayers. I am in a no win situation. I will take socialized medicine, or some version thereof, with it's problems.

Who do you think pays for "socialized medicine" and medical care? There's no such thing as free care. No matter how you slice it (no pun intended), it comes out of someone's pocket.

Goldiegirl

Jun 6, 2007, 01:27

You are correct, but it allows everyone to get care. The big drug companies and medical companies in the US don't want socialized care because then they couldn't charge ridiculous prices for services. I am more than willing to pay a reasonable amout for care, whether it was through a direct tax or perhaps a monthly payment based on your income etc. Nothing is for free, I am not asking for free anything...just FAIR! I got fair and reasonable treatment in Japan, I would think the US could offer it's citizens that much!

ArmandV

Jun 6, 2007, 01:34

Nothing is for free, I am not asking for free anything...just FAIR! I got fair and reasonable treatment in Japan, I would think the US could offer it's citizens that much!

Well, as some of us in Los Angeles would say: Life isn't fair. The fair's in Pomona. :lol:

Pachipro

Jun 6, 2007, 02:50

Ranpyon: You are only 18 and if you're in good health I wouldn't worry about it. Besides, you're only going to be there for a year. However, if your health is bad I'd opt for the national health insurance. It wouldn't hurt.

KirinMan

Jun 6, 2007, 05:52

Being married to a nurse working for a major Japanese hospital would be one reason.
FYI I was a facilities manager for 3 hospitals here in Japan for roughly 10 yrs. That also doesn't include the doctor in the family.:relief: He works at a different hospital.

One thing to remember indigent people can get assistance for living expenses from their local governments, plus depending on the hospital, as there are National hospitals as well, people that need medical care can get it.

Payment for the insurance perhaps, but everyone is charged the same* when it comes time to see a doctor or buy drugs, and those unable to pay for care are still refused it in Japan.

It all depends on the hospital in question, sure there are private hospitals that will probably refuse you, however if you have the insurance papers they will treat you, they don't ask you if you can pay when you present the insurance card, they take it give you the care necessary then charge you.

You made it sound like even if you have insurance they won't take care of you that is not true.

Also Hospitals are also very good at accepting payment plans for people who do not have the money, they WILL treat you if you have insurance.

I don't want readers here thinking that if they have insurance and are unable to pay for services or care that services will be refused. That is most definitely not the case.

There are hospitals that will provide humanitarian services for the patients.
If a person doesnt have insurance then of course it is understandable that the hospitals will refuse care. That's a totally different subject.

KirinMan

Jun 6, 2007, 08:06

I would like to clarify something here, Ewok's statement previously on this thread read;
Originally Posted by Ewok85
Payment for the insurance perhaps, but everyone is charged the same* when it comes time to see a doctor or buy drugs, and those unable to pay for care are still refused it in Japan.

The system here consists of both private, and public hospitals. There are Prefectural Hospital's, City Hospital's, Town Hospital's and Private Hospitals as well. Plus countless numbers of smaller clinics and specialized clinics as well. People are encouraged to use their local area hospitals as the money paid into the National Insurance, a portion of it anyway would then stay in the area and not go to another city or town.

Edited to add this; There are also University or teaching hospitals as well.

All of which accept the Japanese National and or Social Health Insurance. In Ewok's statement here he writes that "payment for insurance", everyone can get the insurance, and if they do not have the money to pay for the medical care, even if holding the insurance card, could be refused medical care. It depends all upon the hospital that the patient goes to.

BUT no hospital that I have ever heard of here has asked people with insurance, ahead of time, if they can or are able to pay. That doesnt mean they dont exist though, so it is possible, but rather improbable from the information I have.

Even people with money in theory could be refused service at private hospitals, that is the hospitals perogative, however unlikely that would be.

It also depends upon the treatment that the person is seeking as well.

DoctorP

Jun 6, 2007, 08:25

What Obeika says is true. They are also very adament about before you leave, working out a definite payment plan.

My son had surgery for a ruptured appendix. Once our stay was over, we had to work out with them how we planned to pay. (not really any different than in the US) They almost insisted on a recurring payment and really balked at the idea when I suggested cash ($3,500) in full. Even with the insurance, the hospital isn't always paid directly or immediately. Sometimes you are required to arrange payment, then the insurance will catch up to you later.

We received two checks. One from the government insurance, and another from private insurance that I carry for the family.

KirinMan

Jun 6, 2007, 10:32

Thanks for sharing that CC1 you reminded me of something else as well.

If by chance you have an extended stay in the hospital, they will give you a bill at the end of each calendar month for the care you received.

Some services are not covered by insurance, for example meals, diapers, charges for private or semi-private rooms, etc etc.

It makes it easier on the patient to keep up with the bills instead of getting one huge bill at the end of the hospital stay.

I don't remember the exact figure either but if one has a bill that is greater than 65,000 yen in any one given calendar month, please don't anyone quote me on that figure it may have changed somewhat, some of the costs are refundable from the Social Ins, or National Ins. plans, minus of course the "non" medical related bills.

One needs to take the paid bill to the local town or city office and fill out the necessary paperwork for the refund.

DoctorP

Jun 6, 2007, 11:15

The one thing that really irked me with my son's hospital stay was that you have to buy those little prepaid cards for the TV and the refrigerator. That really angered me...but I understand it is a means of revenue for the hospital.

The weird part is that you are free to bring in your own TV or laptop and use at your will...you just have to pay to use theirs!

I borrowed a laptop for my son and took him bags full of DVD's to help pass the time along with PC games. (only 10 years old) He would stay all day alone, then I would show up at night and spend the night there.

KirinMan

Jun 6, 2007, 17:31

The weird part is that you are free to bring in your own TV or laptop and use at your will...you just have to pay to use theirs!

When I was in the hospital I brought my own TV and fan and the nurses were surprised at my "gall" at not adhering to what they thought was acceptable. I was like you, there was no way I was going to pay roughly 5 thousand yen a day for over 6 months just to watch TV.

I told them they were nuts and asked them to do the math.

2 months later a memorandum came down to all patients, which was also included in the inpatient guidebook/information, electrical applicances such as TV's, VCR's, DVD players, laptops, fans etc etc would be allowed, however a monthly electricity charge would be included with the monthly bill.

The TV and fan were about 3,000 per month. They still made out like bandits but at least I didnt have to pay nearly 700,000 yen to watch the damn TV.

caster51

Jun 6, 2007, 19:15

there was no way I was going to pay roughly 5 thousand yen a day for over 6 months just to watch TV.

usually it costs 1yen/ a min.

DoctorP

Jun 6, 2007, 23:51

2 months later a memorandum came down to all patients, which was also included in the inpatient guidebook/information, electrical applicances such as TV's, VCR's, DVD players, laptops, fans etc etc would be allowed, however a monthly electricity charge would be included with the monthly bill.
The TV and fan were about 3,000 per month. They still made out like bandits but at least I didnt have to pay nearly 700,000 yen to watch the damn TV.

We were at Chubu, and there was no extra charge for the electricity. But he was only there for 2 weeks, not 6 months.

Pachipro

Jun 7, 2007, 00:19

Obeika and Ewok (or anyone who knows), you both seem to know a heck of a lot when it comes to medical care in Japan and it has been very informative. Thank you. Maybe you can help me out on this:

I relayed my story on the cheap cost of my "emergency" in Japan with no health insurance to a collegue and he would just not believe that a doctor/clinic could charge so little as "normal" cost with no insurance. His argument was that, since the doctor incurred alot of expenses going to university and a hospital/clinic/doctor has much overhead, how the hell do they stay in business? He claims I am BSing him or that I somehow received the cost for an insured person. He has a point and I never thought about it.

My comment to him was that, although the "full price" health care is very cheap and reasonable compared to the US and a patient need not be in fear of losing their home or declaring bankruptcy for major surgery or an emergency like in the US, that the private doctor/clinic/ hospital is probably reimbursed by the government for the remainder of the "full" cost that I paid or that maybe the doctor/hospital/clinic is subsidized by the government. I said that I would check on that and get back to him.

Do you know if this is true and, how does it work for the doctor/hospital/clinic when they treat an uninsured person at such a low cost? In my case, I went to a private general practitioner.

KirinMan

Jun 7, 2007, 05:24

The way charges are incurred during a doctors visit entail a rather complicated, but computerized point system. Each point being equal to XX number of yen. All points are then added up for the services rendered and you get your final bill.

So your urine test was XX number of points, the medicine XX number of points so on and so forth. Plus his consultation and since it was the first time that you were at that clinic they made a file on you correct, a "karute" which they take a few hundred yen for administrative purposes.　　The charges are uniform throughout Japan.

Pure speculation here but I am willing to make a bet that he charged you full price. I personally would have been shocked if I received a bill for "4,610 yen" for the services or treatment that you received.

If you had insurance you would have paid 1/3 of that price or roughly 1,500 yen which sounds reasonable.

This is also speculation as well however believe it or not, but that is my educated guess here that the doc charged you full price, nothing discounted.
Costs are held down by the government by only allowing doctors and hospitals to charge XX number of points for each service.

The doctor/clinic/hospital has to be able to balance the services/treatement rendered to bill the "individual patients" insurance provider, which also includes, in the case of the National Insurance, the government.

The hospitals also have semi-yearly or yearly audits as well to ensure that the books aren't getting "cooked" and the government/insurance unions are not getting ripped off.

Do you have the receipt for payment from the doc?

Now for a doctor treating an uninsured patient I am not sure but I dont think he can claim reimbursement from the government, and that he does it as either charity or charges full price.

Edited to add....Now people may also understand why in some/many? cases here in Japan the doctors want their patients to return for follow up checkups. They make their money on volume and not necessarily on quality. However there are popular hospitals and clinics where the care is outstanding and by word of mouth patients flock there because of the skill and professionalism of the doctor(s)

Ewok85

Jun 7, 2007, 08:45

KirinMan

Jun 7, 2007, 08:58

My wife has anemia, as well as a few other problems, and it always annoys me to no degree when she goes through a bad spell and the doctors refuse to give her more than a few days medication when she is having symptoms that they know will last for at least two weeks, and have the gall to tell her to "come back" if she needs more - despite the fact that she can barely walk.
Lately shes been good but we had some bad times last year and one doctor was close to breaking me with his attitude.

I would suggest that your wife contact the local Doctors association and find a hospital or clinic that better serves her needs. Talk to them and they should be able to recommend a doctor that she feels more comfortable with seeing.

Also as you wrote earlier she is a nurse so odds are she is probably aware of what doctors can or can not prescribe when it comes to her medication.
Depending on the illness doctors can prescribe up to I think it is 30 days of medication at one time. However they are limited by guidlines here and as much as some of the doctors may want to supply her with more medication by law they can not. It is one of the poor points of the system.

Saitama Medical Care Network (http://www.lifenet.gr.jp/)
If your profile is correct that is a link, in Japanese, to a medical network, there may be some information there that would be useful in finding a doctor or hospital that could assist her needs better.

I sincerely hope your wife gets/stays healthy.

Ewok85

Jun 7, 2007, 11:20

We're all sorted now, there was just a while when her blood count got so low she would pass out if she exerted herself, such as going up or down stairs. She's aware of the restrictions on medication and thought it was pretty ridiculous too (and gets her medication from her hospital as well as having some at home).

What really got to me was the doctor telling her to come back another day because in his words "I can't understand you, so I can't help you" (she was so weak she wasn't able to talk). I was ready to deck the guy, I couldn't believe it. Never gone near him again.

KirinMan

Jun 7, 2007, 11:48

Ewok85

Jun 7, 2007, 17:47

He was somewhere in his 60's, but that is no excuse for negligent practices.

KirinMan

Jun 7, 2007, 18:27

He was somewhere in his 60's, but that is no excuse for negligent practices.

Well if you feel he was negligent then report him to the local Doctors board, you have that option open to you.

But his age explains a lot he is of an age where doctors here in Japan were looked at like god's. There were not that many and the ones that could afford the education were treated with a huge amount of respect and it was rare that a patient would EVER think of telling a doctor what they felt was the problem. I'm sorry I dont have a lot of time right now and I will fill in the background a bit later, it mat give you an insight into his gruffness and arrogant behavior. Believe me he isnt the "only" one like that.

Ewok85

Jun 7, 2007, 22:32

Pachipro

Jun 7, 2007, 23:47

Thank you Obeika for your information. It makes a little more sense to me now. Still the cost, even though the full price may seem expensive to you, made my head spin with glee considering costs here in the US! I felt as if I won the lottery or something! Quite a contrast in what I felt and what you would have felt if you were charged the same price for the same services.

KirinMan

Jun 8, 2007, 23:01

I've had chances to socialise with doctors that my wife works with as well as so many nurses it makes my head spin (they are all i.n.s.a.n.e. I must be too, I marred the craziest of them all), mostly the younger crowd but they are all pretty good people.

Ok let me finish what I wanted to write in my earlier reply;

Back in the late 1950's and 1960's though to the early 1990's doctors here in Japan were viewed as being infallable. Whatever they said was "right", nearly no one questioned their procedures or manners. Much of this stems from the fact that there were not enough doctors per captia as necessary.
Plus the Japanese culture itself plays a part in how the "average" Japanese person looks at an "educated" person. And on the ladder of education a doctor is about as high as one can get.

I trust you know the "value" that Japanese people put on education. The schools that an indivdual graduates from is more important than what they actually may know. People veiwed doctors and their opinions as being the "final" say. Once again no one questioned them. It is also a cultural thing as well.

No one questioned their, the doctors, decisions and many became legends in their own minds.

Now step forward to 2007, there are still many doctors practicing today that grew up in the era of infallability. They are unacustomed to having patients question their diagonosis or even ask questions about the treatments that they propose. They are also extrememly arrogant and look down upon younger or less experienced doctors than themselves.

Doctors never had to worry about the "sales" aspect of their profession, they never had to concern themselves about whether or not patients would come to their clinics or hospitals. They were "gods"

Now younger doctors, particularly ones in their early to mid 40's and younger realize that the system is becoming more geared towards the patient and their needs and not what the doctor's think or feel is pertinent. They are more aware of the "business" side of being a doctor and their own infallability.

The younger doctors also know that patients now a days are more interested in their own "condition" and no longer accept blindly what their doctor tells them is their "problem". Plus patients now have more access to information than before and can ask pertinent questions about their own conditions, many times to the chagrin of the (older) doctors themselves.

This is not to say that all older doctors are arrogant sob's but to say that the younger doctors here are more willing to listen to their patients and what their needs are than any time in the past.

FrustratedDave

Jun 8, 2007, 23:42

Pachipro

Jun 8, 2007, 23:53

And Ewok85, at the risk of commenting on a Doctor I do not know( he could well have been rude and inconsiderate) not all Doctors are like that as I have many friends who are Doctors and are very considerate towards "gaijin" and they are also well into thier sixties.
The doctor that treated me was, I'd guess, in his late 40's; was very polite and considerate of my condition, and was not rude or arrogant whatsoever as I had expected from past experience. I was very pleased with the treatment I received from him and his genuine concern for my condition.

KirinMan

Jun 8, 2007, 23:55

Obeika, your blatant disrespect for that hospital rules is why the medical system is getting worse all the time. If you think treating patients for free is fine then so be it, but the government does not emburse hospitals as much as you would like to believe. So of corse they are going to want you to pay for things like TV and electricity. Just b/c we don't expect that at home does not mean we can bring those ideas here. If you don't want to pay those prices , don't watch TV.

Excuse me where did I write anywhere that I "blantantly" disregarded any so called rules? Just because I choose not to purchase a television card is in no way a disregard for any rules.

Those "rules" that you claim are set by individual hospitals and not by the government. Why is it necessary to expect a patient to pay an exorbitant amount of money just to watch a TV?

There is no where either that I said that the government or any hospital will or should treat a patient for free.

It was because I "knew" what was allowable or otherwise that allowed me as a patient not to get ripped off by the hospital that I was a patient at.
In the long run I ended up saving long term patients quite a bit of money, the hospitals in question were only concerned with their making a profit no matter where the money came from.

The hospital "rules" that you claim are only there to create a profit for said hospital. There is no law that says otherwise.

I was in traction for nearly one entire month, and there was nothing else to do but watch the damn TV or count the number holes in the ceiling tiles. I paid their monthly electricity bill, and we were both satitisfied at the outcome.

You sit/lay in a hospital bed with nothing else to do but watch a TV and then come back here and tell me that I should be forced to pay exorbitant prices for a damn TV card.

Dont watch TV, ok next time you have the chance sit in traction with ABSOLUTELY nothing to do, now where to go, or nowhere to move, with diapers on your ass because you can't friggin' move a friggin' inch because if you did you would be paralyzed for friggin' life.

Do that for almost a month and then tell me not to watch TV. There is no "law" that says I broke any rules.

Next time I'll send you the bill for the TV. I've been there dude it aint fun.

FrustratedDave

Jun 9, 2007, 00:08

Excuse me where did I write anywhere that I "blantantly" disregarded any so called rules? Just because I choose not to purchase a television card is in no way a disregard for any rules.
Those "rules" that you claim are set by individual hospitals and not by the government. Why is it necessary to expect a patient to pay an exorbitant amount of money just to watch a TV?There is no where either that I said that the government or any hospital will or should treat a patient for free.
It was because I "knew" what was allowable or otherwise that allowed me as a patient not to get ripped off by the hospital that I was a patient at.
In the long run I ended up saving long term patients quite a bit of money, the hospitals in question were only concerned with their making a profit no matter where the money came from.
The hospital "rules" that you claim are only there to create a profit for said hospital. There is no law that says otherwise.
You were a manager of 3 hospitals and you don't understand why they charge for TV's? The reason why they charge for the TV is to make up lost funds that the government does not pay in regards medical related costs. I hate to be the one to tell you this ,but hospitals need to make money to help people and if you can't see that after all the experience that you have had, I don't what else to say?

Why is it that thousands of hospitals have closed their doors over the last 5 years? Is it b/c they are makeing loads of profit like you say? No , it is not and there will probably be many more hospitals close over the next 5 years.

You can believe what you want, but there is a lot of hospitals in Japan that are struggling to stay in business and if that is not a concern I don't know what is.

BTW, I have been in hospital for 3 months and I know what it is like, but like everyone else I paid for what I used. I am not special and I don't expect to be treated special.

KirinMan

Jun 9, 2007, 00:15

Wow .... I am in the medical proffesion here in Japan and I know the difficulties of running of a hospital in this day and age and I can't believe the naieve biased oppinions of some of you. Sure not every Doctor here in Japan is an expert in his/her field , but neither is all the Doctors at home.
Obeika, your blatant disrespect for that hospital rules is why the medical system is getting worse all the time. If you think treating patients for free is fine then so be it, but the government does not emburse hospitals as much as you would like to believe. So of corse they are going to want you to pay for things like TV and electricity. Just b/c we don't expect that at home does not mean we can bring those ideas here. If you don't want to pay those prices , don't watch TV、read a book.
And Ewok85, at the risk of commenting on a Doctor I do not know( he could well have been rude and inconsiderate) not all Doctors are like that as I have many friends who are Doctors and are very considerate towards "gaijin" and they are also well into thier sixties.

You want to get into a discussion about doctors or hospitals? Particularly ones, doctors, that are older? I gave an accurate background of what doctors and how they act and think are. There are going to be exceptions to every rule however it is a fact that the majority of elderly docs were trained and raised in a totaly different atmosphere than the docs of today.

Let's talk....I gave an acurate description of what many doctors here in Japan are like. I've worked in the medical field here for nearly 10 years, I have medical professionals in my family.

We arent talking about doctors at home, we are talking about doctors HERE in Japan. Nothing more nothing less.

FrustratedDave

Jun 9, 2007, 00:25

Hey , I never said anything about your description about the way doctors were taught years ago and how they are taught now. I am part of that system and what you say has some truth to it. However, everyone instantly refers to there own background on what they feel is fair and what is not. Eg ,your unwillingness to pay for a TV supplied by thye hospital.

I didn't mean to personaly attack you, but I am sick the complaints I hear b/c it is not what "we" are used to.

If you want to talk, I am open for discussion.

KirinMan

Jun 9, 2007, 00:36

You were a manager of 3 hospitals and you don't understand why they charge for TV's? The reason why they charge for the TV is to make up lost funds that the government does not pay in regards medical related costs. I hate to be the one to tell you this ,but hospitals need to make money to help people and if you can't see that after all the experience that you have had, I don't what else to say?

Why is it that thousands of hospitals have closed their doors over the last 5 years? Is it b/c they are makeing loads of profit like you say? No , it is not and there will probably be many more hospitals close over the next 5 years.
You can believe what you want, but there is a lot of hospitals in Japan that are struggling to stay in business and if that is not a concern I don't know what is.

BTW, I have been in hospital for 3 months and I know what it is like, but like everyone else I paid for what I used. I am not special and I don't expect to be treated special.

Dont assume I dont know the reasons for what a hospital charges what they do, Ive been on both sides of the fence, a patient and an employee. I dont follow along blindly do you?

You want to justify the charges that a hospital charges? I dont. I know very well why they charge what they do, and just because I "know" doesnt mean I agree.

So just because a particular hospital cant meet its bills it gives them the right to rip off their patients in other ways, sorry I dont think so, many hospitals here are on the brink of bankruptcy because of poor management and over spending, why should I as a taxpayer be forced to prop them up?
I suppose you follow along with the crowd just because.....

Want to make comparisons....I had my tonsils taken out here when I was 25, a hospital stay of 10 days or so, next I was an inpatient for 1 month for a bad back in traction, next I had fusion surgery where I had 8 steel screws with 2 steel rods drilled into my spinal column, which happened to be a 6 month hospital stay. Plus I had the rods and screws removed because the screws fractured my spinal column. Geez what's next... I could go on but I wont. Well one more I had bone grafts taken from my pelvis and inserted into to my spinal column to hold my spine in place. Plus a HUGE number of tests that go along with the preparation to the surgery.

I've had to undergo the indignity of wearing a diaper at 30 years old or so because I couldn't walk. I was in a wheelchair for over a month WAITING for the doctors to find the time to do the surgery, which took over 8 friggin hours. Ive had to pay to have my own blood held at the Japanese Red Cross to be returned into my body during said surgery. Ive been in an ICU unit here for over 10 days because of complications that arose from said surgery. I had pinched nerves in my leg because of the incompatence of the doctor that performed the surgery.

I could go on....but I wont...Dave Ive BEEN on both sides of the fence here in reagards to hospitals. Believe it or not I know what I am talking about.

Hey , I never said anything about your description about the way doctors were taught years ago and how they are taught now. I am part of that system and what you say has some truth to it. However, everyone instantly refers to there own background on what they feel is fair and what is not. Eg ,your unwillingness to pay for a TV supplied by thye hospital.

I didn't mean to personaly attack you, but I am sick the complaints I hear b/c it is not what "we" are used to.
If you want to talk, I am open for discussion.

I want to apologize if I misunderstood you, I think you and I are pretty much reading from the same book, just different pages.

I agree with your staement about the complaints about "it isnt what I'm used to."
Cheers and lets work together here to get people to understand what things are like here if they have "problems".

Please accept my apologizes if I came across towards you wrong. That really wasnt my intent.

FrustratedDave

Jun 9, 2007, 00:53

I am not going to comment on you being an employee of a hospital, b/c in my experience employees rarely know anything to do with the cost and risk involved in running a hospital.

I sympathize with your rough ordeal and am sorry you had to go through that, but like I said before not every hospital and doctor in Japan are incompetent, on a whole the medical system is very good. I have many good doctor friends/co-workers that would also be very supprised by your experience.

You are obviously bitter with the treatment you recieved and nothing I say will sway you from that, so I respect your oppinion and you thoughts on this matter.

Dave

I also want to appologise as I did let my emotions get the better of me. The reason is b/c I have to deal with similar problems quite regulary. You seem to have a lot in common with me in reagrds with your experience in Japan and I would love to talk to you about many of the other frustrating things that I find difficult to understand( I do try to understand them though).