Photo: @u_aousg
health

Japan’s healthcare system summed up in photo of hospital bill for father’s heart surgery

43 Comments
By Scott Wilson, SoraNews24

Japan’s medical system may have some quirks to it, but one thing is undeniable: the fact that it’s very affordable.

As someone from the U.S., where medical insurance is at best a massive headache and at worst a bankruptcy-inducing hellhole, Japan’s medical system is fantastic. The waits are short, the treatments are great, and of course, the prices are fair.

This was shown most recently, and effectively, by Twitter user @u_aousg who posted a photo of the hospital bill from their father’s heart surgery. Here’s what they wrote:

▼ “This is from my father’s emergency heart surgery. Looking at it, all I can feel is thankfulness for our health insurance system. We were going to dinner just before he was hospitalized.”

Screen Shot 2020-09-28 at 8.02.48.png

The number next to the light-blue box is the total medical cost: 7,017,190 yen, and the number beneath it is how much the patient had to pay: 53,760 yen. Just a small difference of about 13,000 percent.

For those who have never used Japan’s medical system before, for typical doctor visits, 70 percent of the bill is either paid by the government or the patient’s employer, and the patient covers the remaining 30 percent. However, for more expensive procedures such as heart surgery, there are certain limits to how much a person can pay, ensuring that they don’t go bankrupt from visiting the hospital.

For those from countries with free healthcare, Japan’s may seem expensive. But for those from countries where people avoid going to the doctor or calling the ambulance fearing the cost, Japan’s system is downright amazing.

@u_aousg also mentioned that one of the reasons they posted this was because they are worried about the future of Japan’s healthcare. With the new prime minister taking office, there has been talk of changing or replacing the system, which they hope will not happen, and they want to spread the word to others.

For now anyway, it seems like the majority of Japanese netizens agree with them:

“I am so thankful for our medical system. Terrifying to think what it’d be like without it.”

“People may have their gripes about our insurance system, but compared to other countries we’re blessed.”

“I feel like my monthly insurance payments are high, but looking at this, I can see that it’s important.”

“My daughter had heart surgery at age one, which would’ve cost 8,000,000 yen without coverage. Thankfully everything only came to 100,000 yen instead. If this were a country without good insurance, I would’ve been too scared to go to the hospital.”

“This would’ve cost one million dollars in America.”

▼ Someone else shared their own hospital bill, reduced from 10,011,865 yen to 78,900 yen.

Screen Shot 2020-09-28 at 8.04.38.png

While it’s nice to see the heartwarming take on Japan’s medical system, unfortunately the opposite is also true: Japanese people going abroad and being horrified at what they get billed at hospitals. Just like one woman who had quite a shock giving birth in the U.S.

Source: Twitter/@u_aousg via Hachima Kiko

Read more stories from SoraNews24.

-- How to get free healthcare in Japan without insurance

-- 6 surprising things about having a baby in Japan

-- “Otoko no ko” Satsuki tells her story, explains how Japan’s hospitals aren’t trans-ready

© SoraNews24

©2020 GPlusMedia Inc.

43 Comments
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That is affordable for such major surgery compared to the US, but it should be entirely free as it is in other nations with universal healthcare.

-6 ( +14 / -20 )

I suspect having a small user payment (which as the story proves is capped) is a good thing in a culture where people do not self-medicate for minor conditions.

People shouldn't go to the doctors for aspirins or to have a little scratch disinfected.

13 ( +15 / -2 )

That is a good! People can have major surgery without worrying about becoming bankrupt!

9 ( +13 / -4 )

For those from countries with free healthcare, Japan’s may seem expensive. 

It is. Imagine you are old and poor, on a low pension, struggling to survive and with multiple health problems, you simply can't afford to get treatment. That is the situation for many in Japan. The UK system is much, much better.

12 ( +16 / -4 )

Did they mention the part where the ambulance had to go to seven different hospitals before A&E accepted a man in critical condition? Or do we only get to hear the stories with the feel-good factor?

Comparing with US health care for the ordinary folks is setting the bar quite low.

12 ( +14 / -2 )

the question is: until when the system gonna last with a gray hair demography

1 ( +3 / -2 )

I paid more than twice that to have a polyp removed from my larynx. How are national health charges calculated - are they based on age, income... anyone know?

9 ( +9 / -0 )

When people say 'it is so cheap compared to overseas' I don't think anyone gets discounted or free healthcare as a foreign tourist overseas.

3 ( +3 / -0 )

I think our health insurance is capped at 60,000 (during one time hospital admission and treatment), Anything above it will be paid by insurance.

1 ( +1 / -0 )

I paid a shed load of money for various investigations and consultations recently, we used all our COVID money from the government plus savings to pay the bill, at a time when money is tight due to the virus.

In the U.K. it would have cost me nothing.

7 ( +10 / -3 )

a culture where people do not self-medicate for minor conditions.

Well someone is buying all those cold medicines/ache relievers/blood sugar reducers/cholesterol busters/general pick-me-ups that are advertised endlessly on the telly.

5 ( +6 / -1 )

I paid 325,000 yen out of a total bill of 5 million yen. That was for a 2 months hospital stay at a university research hospital, 12 hours of brain surgery, multiple MRIs, various catheter surgeries inside the brain, etc. No real complaints.

Not sure how the upper cap limit for my co-payment was decided, but they needed my income details first, so it probably had something to do with income level.

6 ( +7 / -1 )

About 15 years ago I has a series of CAT scans, MRIs, and X-Rays followed up with multiple IV's and blood work. From memory the bill came in at over 350,000 yen with my portion coming in at about 35,000. I come from a country with free universal healthcare, but often with considerable wait times depending on the procedure. In Japan there was no waiting.

Overall I was very unwell, and quite happy to pay to get speedy and effective help.

Making things free, comes with the side effect of people taking them for granted and not valuing them.

0 ( +3 / -3 )

from the U.S., where medical insurance is at best a massive headache

While i can attest to the affordability and better structure of the Japanese medical system, i can agree with this statement. JPMorgan Healthcare was amazing. Just had to pick between A, B, or C. With the small copay and of wide coverage and preventative care of the health system it was great. Preventative care was always fully covered. Many more things. Your experience with Healthcare heavily depended on your company's care plan. My aunts medical plan as a hospital worker in a union she's been in for 40 years is far cheaper than any coverage in Japan. I was always jealous when her medical expenses amounted to pennies or few dollars at most.

-1 ( +2 / -3 )

@Luddite - Yes, it would have free in the UK, your point is valid. However, even for Cancer Screening (if this was, I do hope you are ok) - in the last 6 months there is every chance you might not have had all the appointments as yet. I feel you are once again just being negative about Japan for the sake of it. Both systems are good IN the right circumstances and yes, here, having to pay something does deter people seeing the doctor for a cold or a scratch.

1 ( +3 / -2 )

Cost me 153,000 yen using the health card to have an operation in tokyo with a two night stay

2 ( +2 / -0 )

I guess this is incredible to you if you're American..? Meh, better than paying in full of course, but as others have said here, healthcare is a human right, and at the current price, some people still can't afford it.

2 ( +3 / -1 )

Right, in NZ and most developed countries this would be free. So....

For the amount of tax we pay in Japan we get almost nothing.

Schooling isn't free

Medical care isn't free

Roads aren't free

Getting anything done at the city hall costs.

Getting anything done with the police costs.

Tell me again where my taxes are going.

7 ( +9 / -2 )

"It is. Imagine you are old and poor, on a low pension, struggling to survive and with multiple health problems",

The fee would be have 500 yen. It is based your income.

-3 ( +1 / -4 )

FYI:

National Health Insurance premiums are based on your income plus an additional amount for each dependent. After a certain age, you are also required to pay for nursing care insurance.

If you paid more than 100K yen for medicine, check up, and other out patient procedures covered by the NHI, you can apply for a tax refund.

2 ( +2 / -0 )

" Yes, it would have free in the UK"

As some wrote, nothing is free. You have to pay thru the payroll tax. LOL

-6 ( +3 / -9 )

Right, in NZ and most developed countries this would be free. 

Assuming the government agrees to it.There is, in the UK, a government agency that decides which treatments are worth covering, and for whom.

-4 ( +2 / -6 )

I think access to basic health care is a major reason why Japanese are so healthy.

1 ( +3 / -2 )

The fee would be have 500 yen. It is based your income.

I quit my job and became unemployed without income and my medical insurance was 98,000yen

per month. How ridiculous it was based on my previous year income as if I had the previous stashed

away for future social insurance payments, even two years after quitting and still unemployed I was still

paying medical insurance 11,000yen and 16,500yen from an income of zero yen.

The system is not as rosy as it is made to be, really harsh and unforgiving if you quit and end up unemployed

or with a job with a far lower income.

5 ( +5 / -0 )

That is affordable for such major surgery compared to the US, but it should be entirely free as it is in other nations with universal healthcare.

well of course. Compared to the US almost anywhere looks good.

Right, in NZ and most developed countries this would be free. So....

For the amount of tax we pay in Japan we get almost nothing.

Schooling isn't free

Medical care isn't free

Roads aren't free

Getting anything done at the city hall costs.

Getting anything done with the police costs.

Tell me again where my taxes are going.

Best comment I've read all day. Agree 100%

3 ( +6 / -3 )

The system is not as rosy as it is made to be, really harsh and unforgiving if you quit and end up unemployed

or with a job with a far lower income.

Agree.

2 ( +3 / -1 )

Even with having to pay a portion in Japan I very often see far too many people lined up at doctor's offices, and I have serious doubts some of them actually needed to be there. I am fine with the partial payments as opposed to patients paying nothing. However the only way it could go to nothing and not be a complete implosion is to lay some strict rules down to keep people and doctors from abusing the system, which they are already.

I would be willing to eat the extra health insurance costs for such a system, if such a system could even be made to work here. But could it? My hopes are not high.

2 ( +2 / -0 )

And drug costs are so much lower than the US. I needed a prescription steroidal inhaler for short time. I needed to get one on a trip to the US. The product is made in the US and was 1,300 yen in Japan, but $275 in the US.

I have nothing but good things to say about Japanese healthcare, compared to the US.

1 ( +4 / -3 )

Tell me again where my taxes are going.

Cherry-blossom viewing parties for the elite, US military bases, upkeep of imperial palaces and their occupants, purchase of US missile defence systems, roads to nowhere and empty concrete boxes.

Invalid CSRF

4 ( +4 / -0 )

In most north European countries it's free.

2 ( +2 / -0 )

drluciferToday  04:53 pm JST

 quit my job and became unemployed without income and my medical insurance was 98,000yen

per month. How ridiculous it was based on my previous year income as if I had the previous stashed

away for future social insurance payments, even two years after quitting and still unemployed I was still

paying medical insurance 11,000yen and 16,500yen from an income of zero yen.

The system is not as rosy as it is made to be, really harsh and unforgiving if you quit and end up

I concur- I've been unemployed for over two years, for health reasons, and have been unable to pay health insurance in that time. The fines keep building up and the city hall keep withholding my health insurance card- It's a veritable catch 22 situation.

City hall keep ADVISING me to get a job expressly to pay the bill. I keep having to explain to them that the very reason I became too ill to work was due to work, and I can't get better because I can't afford health care, let alone insurance. What is more, if I do work I will, more than likely, seriously risk my health.

I'm also in the high risk covid-19 category, but do they give a fig? do they b.....

Same conversation every four months...

Those healthcare bills are extremely fishy. I'm in my forties so the standard fee is 30% (3割?). insurance is usually refunded some time after the full bill has been fully paid. Methinks these patients have very good friends in high places to get such a huge reduction.

1 ( +1 / -0 )

The people saying it's 'free' or 'costs nothing' in their home countries are a good example of why democracy is so broken. The lying politicians must love voters like you.

Even leaving aside average income tax rates which are often higher in the UK and Europe, the consumption taxes in these countries range from 20-25%. You are pre-paying for healthcare every time you open your wallet. You have to weigh all sorts of factors and do a very detailed calculation to figure out whether someone in Japan would be better off under the 'free' healthcare systems in your country.

-6 ( +0 / -6 )

kiwikid:

Tell me again where my taxes are going.

To friends of the LDP.

3 ( +3 / -0 )

Although difficult to compare I am very sure, you all won’t find a better equipped and at the same time similar or more affordable health and health insurance system anywhere else quickly, if you consider the real costs, taxes , insurance rates etc. in the very most of all your home countries.

-1 ( +2 / -3 )

Even leaving aside average income tax rates which are often higher in the UK and Europe, the consumption taxes in these countries range from 20-25%. You are pre-paying for healthcare every time you open your wallet. 

@M3 - well for starters here in Australia consumption tax is 10%, and all major surgery is free.

Although difficult to compare I am very sure, you all won’t find a better equipped and at the same time similar or more affordable health and health insurance system anywhere else quickly, if you consider the real costs, taxes , insurance rates etc. in the very most of all your home countries.

@Sven - various posters have already listed many countries that disprove your point..

3 ( +4 / -1 )

I have nothing but good things to say about Japanese healthcare, compared to the US.

@Peter - well there's your first mistake.. that's like comparing the safety of a country to Afghanistan or the Congo.

The US has the worst healthcare system of any developed country, and in many cases worse than many developing countries, where a major illness can leave you homeless even if have health insurance. It's a complete rort and a travesty how the health insurance and the private healthcare industry are holding the lives of Americans at ransom, for profit.

4 ( +4 / -0 )

Japanese hospitals are second to none length of post op stay is almost too long, ct echo etc often are done the same day. Payments are capped and doctors are among the best in the world.

If your poor you don't pay, if you have money its capped at around 400,000 a month.

Maternity care unfortunately is the still only area where subsidies should be higher.

The argument that Japan puts money before the publics health is incorrect and ignorant.

-3 ( +1 / -4 )

@Heckleberry

@M3 - well for starters here in Australia consumption tax is 10%, and all major surgery is free.

It's certainly not free for everyone. Australia is probably more comparable to Japan in terms of value for money, but you also have significantly higher tax rates that kick in at lower levels of income. For example, 32.5% after earning just $37,000 (¥2,800,000). In Japan you need to be earning over ¥7,000,000 to be taxed at such a high nominal rate.

Using the ATO calulator and doing a few rough calculations, a single person in Australia earning the average Japanese salary of ¥5,000,000 (AUD$66,000) would pay about $14,313 (¥1,087,000) in income taxes and Medicare levies. In Japan they would pay around ¥891,000 in combined income taxes, local inhabitant taxes, and national health insurance premiums. So unless they incur more than ¥196,000 in out of pocket medical expenses every year, they are just as financially well off in Japan as they would be with 'free' healthcare in Australia. Governments can find ways of avoiding upfront payments, delaying the costs, or shifting the burden on wealthier taxpayers, but nothing is every free.

-3 ( +1 / -4 )

"Tell me again where my taxes are going." Corporate welfare, a bloated bureaucracy and support of superannuated LDP voters in the inaka.

2 ( +2 / -0 )

As 0rei0 brings up, anyone approaching retirement age should be aware that your national health costs for your first 2 years post retirement are based on the amount of income you had in your final year of work, or some sort of average of a longer period, and will be higher than they were when you were employed. Either have money stashed away when you retire or a plane ticket on hand.

1 ( +1 / -0 )

When people say 'it is so cheap compared to overseas' I don't think anyone gets discounted or free healthcare as a foreign tourist overseas.

I did in Australia.

0 ( +0 / -0 )

The people saying it's 'free' or 'costs nothing' in their home countries are a good example of why democracy is so broken. The lying politicians must love voters like you.

Even leaving aside average income tax rates which are often higher in the UK and Europe, the consumption taxes in these countries range from 20-25%. You are pre-paying for healthcare every time you open your wallet. You have to weigh all sorts of factors and do a very detailed calculation to figure out whether someone in Japan would be better off under the 'free' healthcare systems in your country.

The total amount spent on health care whether measured on a per person basis or as a percentage of GDP for most European nations and for Japap is one half to one third that spent by the people of the US. Only Switzerland, which like the US uses privately owned insurance companies to pay for health care, has costs anywhere near those of the US. The US system is overloaded with layers of administration, billing clerks, medical coders, and multiple levels of profit taking on the pharmaceutical side, at least 16 people in the system for every doctor and only 6 of those 16 work in a clinical setting (nurses, pharmacists, x-ray techs, lab techs, etc.). Doctors have medical coders trying to code each treatment to maximize payments while insurance companies have another army of coders trying to code the exact same treatment as something that pays out less. Then you have administrators who argue with the doctor over their billing. None of this produces better health care outcomes. All it does is increase costs. Another army of people administer Health Savings Accounts. Big US hospitals have hundreds working in their billing departments as each doctor and each insurance policy has different prices for the same treatment. In Europe the prices are all standard across the board and most big hospitals need less than 100 billing clerks. There is just much less administrative deadweight in single payer systems and as a result nations with single payer systems always in every case have lower health care costs, with equal or better health care outcomes, than nations using private insurance to administer and pay for health care delivery.

0 ( +0 / -0 )

Btw, the tax burden required to support European and Canadian style single payer health care systems is less than the combined cost working Americans and their employers pay for heath insurance in the US. If you had a taxpayer funded single payer system in the US the employer and employee insurance payments would go away and be replaced by a smaller tax. Yes "taxes will go up" as the hand wringers on the right love to point out, but they never mention your and your employers insurance bill goes away completely. It is a net savings.

2 ( +2 / -0 )

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