How Japan works: part 1 - Healthcare

As most of my readers are US-based and are about to have their health care reform repealed faster than two-day old curry following a tequila shot contest, I thought I would explain how health care works in the People's Republic of Japan.

Each month the modest sum of about 3% of my paycheck is withdrawn for my national health insurance. This rate is adjusted to income levels so if you regularly bathe in a golden tub, you are probably paying more. As a lowly English teacher, it works out to about $100 a month (although given that the dollar is as strong as my average poker hand, it's more like $130).

In exchange for this contribution, the government picks up 70% of the medical bills I rack up. This includes dental. Some of the bills I have faced include:

molar filling: $14
benign tumor removal from leg: $150
two wisdom teeth removed plus medicine: $58
doctor consultation: $4
regular teeth cleaning: $11

These prices all strike me as profoundly reasonable.

And for those of you now thinking 'Yes, but didn't you face Soviet-breadline-style waits in dark and dank bunkers of depressive socialism?' I would point to the fact that the last hospital I visited had automated check-in and a player piano plucking out Elton John tunes in the lobby and my average dental appointment wait time has been negative 5 minutes. (that is, if I am early, they are ready to point blue lasers at my cavities and fill them with space-age polymers).

And while my initial consultation involved a rather lengthy wait, when was the last time your scheduled doctors appointment occurred withing an hour of you walking through the door?

That's right! despite what Glen Beck's weepy chalkboard-directed diatribes may indicate, a national health care system does not necessarily require you to address your physician as 'comrade' and submit to dentistry-by-hammer (or hammer and sickle).

Not that all is perfect here of course. One friend had knee surgery and was told to endure without sufficient pain killers. And another doctor who looked like he had enjoyed his (and my) share of bourbon over the astronomical number of years he had been stuffing his maw with rice balls, insisted on jabbing a needle into a lump he was positive was filled with liquid (it was not) despite my assurances that it was in fact solid (it was).

However, I have the choice (yes, that's right, I can choose where to get my medical treatment since hospitals and clinics are largely private - they are simply reimbursed by the government) to avoid certain facilities and spend my yen at the hospital with the robot-piano and HAL-tastic check in procedures.

The key to happy treatment seems to be youth.

The older doctors have a bedside manner that would make Hannibal Lecter blush and the unwavering insistence in their convictions reminiscent of a typical American Idol audition contestant. However, the younger doctors are much better and willing to talk to you, listen to your input, and explain the procedure (as well as use as much anesthetic as you need).

Getting better every year!