Healthcare in Japan

It's been a busy month lately – between after school work, cramming for the JLPT, and writing a whopping six articles with my freelance job, it's been hectic! On top of this I've been dealing with health issues. In only four weeks I managed to go to the doctor five times and the hospital four times! Having health issues in a foreign country is definitely a stressful ordeal, no matter what ailment, but ongoing troubles without any known cause is the pits!

Japanese health insurance.

Let me give you a little background on healthcare in Japan. This isn't my first time making liberal use of my health insurance, so I'm pretty familiar with how things run. Japan has universal healthcare, which you must enroll in by visiting your local city hall. It's around $200 US dollars a month, but the actual amount you pay at doctor's offices is very affordable. The only thing that has costed me more than $30 dollars (teeth cleaning) was my first visit to the hospital, a whopping $75 bucks! I have had to shell out more for a CT scan and recently my first MRI, but they were both under $70 dollars. There is no standardized co-pay here, which makes for a much less stressful doctor's visit, which is probably why they are so busy.

Everyone in Japan during health check season.

Japan takes health seriously, and there are mandatory health checks for your job as well as at school – mine even included an EKG! Most people are very healthy here, due to the naturally healthful Japanese diet as well as the necessity of walking and biking to get around without cars, which aren't very common here. However there are lots of smokers, and drinking is HUGE due to the social obligation of after work parties. The one thing that the Japanese definitely fail at is their teeth – despite teaching kids to brush their teeth after meals! The adults aren't too bad, but the children are the worst! Some of these kids have big brown stains on their front teeth, or their front teeth are sticking out – the whole front area is a total traffic jam on the 405 freeway! And with all the tea, soy sauce, and curry they eat, there's a lot of yellow staining as well. Orthodontics is on the down-low, and you won't see many students with braces. Be warned that not all dentist places are legit in Japan – check before you go, or ask a local to recommend a clinic to you. Also, the dentist does the cleaning while the assistant just hands him things.

Overall, the healthcare isn't that bad, but I'm sorry to say that it sure hasn't lived up to my expectations! In my second year in Japan my ear issues started with a sore throat and ears, so I went to my local clinic. The doctor looked in my throat but did not look in my ears, decided it was a cold, and prescribed me like five medicines – why do they do this?! You will often end up with seven different drugs to take for just a common cold! Also beware of the Chinese medicines they so often prescribe – they are powdery medicine that tastes terrible! As a result of him neglecting to look in my ears, I developed a double ear infection that lasted three weeks.

A typical ENT clinic in Japan: examination chair, hearing test both, and weird gas you're supposed to inhale after you've been poked and prodded, hopefully to staunch internal bleeding.

Then there's the problem of ENT clinics, here, known as jibika. What a nightmare! Seriously, it is like stepping back into the stone age. Instead of simply prescribing you some antibiotics as a normal, modern doctor would do, the elderly woman poked a stick deep inside my ear and twisted it round painfully – it felt like she punctured my ear drum! Then she poured in some medicine and had me breathe in some gas through my nose. I went back a few times and was declared to be fine – and a week later I had the pain again! Another jibika proved to be the same system, but he at least cleaned out my ears to remove wax and prescribed me some medicine without poking around. I just can't understand why they don't use antibiotics here – they only seem to prescribe them if you request (or demand) them! How archaic! A recent clinic also had me hold an ultraviolet light to my ear – not sure what this is supposed to do, but anyway it did not help my problems. Eventually it got so terrible I went to another doctor to demand antibiotics and was eventually referred to a hospital – where they tried to turn me away! Apparently they thought there was no one who could help me if I'd already been to the ENT several times.

Stocked and ready to puncture your ear drums!

How frustrating! I've definitely learned the necessity of asserting your needs. I had a letter of invitation (shoukai jou) which you need to go to the big hospitals in Japan, but they still didn't help me until I made a tearful scene. Eventually they sent me to blood specialist – who knew that existed? – because they couldn't think to just send me to another ear doctor or at least a neurologist. All this doctor could do for me was order a blood test and an MRI! Finally after two rounds of antibiotics and on and off pain and ringing in my ears, I had the MRI, which was a bit of a scary experience, only to find that there still seems to be nothing wrong with me so the only explanation could be that it's just stress. Well that helps a lot.

I have also found that there seem to be different standards of what's normal here – a simple low blood pressure reading was perfectly normal back in America! And I even received a plus one in the BMI section on my health check up this year (the nerve!! They didn't factor in curves and muscle, or just general gaijin-ness.) Foreign women who are pregnant while in Japan also experience severe bullying from the doctor not to gain barely any weight! You're also in for a surprise with women's health: with the birth rate so low in Japan, birth control doesn't come cheap, and they are riddled with side effects. No matter how much you complain about the side effects, the doctor just prescribes you more meds for the side effects and makes you keep taking the same stuff. I definitely feel like doctors don't listen to me here!

I hate to say it, but I am rather unsatisfied with the healthcare in Japan. I feel that doctors need to listen to the needs of the patient more and get with the times and update their technology and care. Still, I'm sure there are plenty of things difficult with health care back in America, and doctor visits are much more expensive if you make a habit out of it. So be prepared for both the good and bad when going through health problems in Japan, and try your best to be patient and stand up for your needs.