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What do you think are the good and bad points of the health insurance system in Japan?

18 Comments

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Its a good system....I've had a couple of heart operations and I'm not dead.

So, win/win for all.

8 ( +11 / -3 )

Bad, no one really knows how they calculate the premiums. Certainly not the muppets at the city hall.

Good: I can afford to get sick and ride and ambulance.

2 ( +7 / -5 )

The Japan system is good at providing broad access to the population at a reasonable cost and reasonable quality. It is very easy to sign up and to use. The care is overall decent and the insurance is accepted pretty much everywhere in Japan.

On the other hand, it is a common complaint that diagosis here could be better (e.g. it took me 5 doctors and a year of effort to get to a diagnosis and surgery; I diagnosed myself with google and was correct). Use of med tech is sparing and med tech is not as quickly/as much adopted as in certain other countries. Physio is behind other countries. Probably due to cost management, the techniques used are not always the most advanced (acceptable but not the latest), and certain quality of life issues are relatively more difficult to address here or need to be addressed outside the insurance system.

2 ( +5 / -3 )

I guess the best part is you are never without coverage. Lose your job the employer insurance? Just slide right into the national program. Working only part-time or on contract? Join the national program. Also, no rejection for preexisting conditions. Like Jack above said, broad access, reasonable cost, reasonable quality.

10 ( +10 / -0 )

I appreciate the free, yearly health checks as I think the possibility of finding problems early is a benefit.

7 ( +8 / -1 )

Like others have said, it's pretty affordable across a broad range of services.

On the downside, premiums are extortionate for the self employed unless you can find an industry fund you can join. Thankfully, my wife found one that allies with my field.

3 ( +5 / -2 )

During my five-year battle with cancer, I have been impressed with the level of healthcare and expertise I have received at a very low cost compared to countries without universal healthcare.

12 ( +13 / -1 )

On the downside, premiums are extortionate for the self employed

it’s very reasonable. and the co-pays are low.

on another note, if you lose your job or have trouble paying the full amount from some unforeseen reason, you can pay a greatly reduced amount and still have coverage. just need to ask.

my wife needed cancer surgery. private room for almost a week. total out of pocket for surgery and almost a week stay was under 90,000 yen.

3 ( +4 / -1 )

it’s very reasonable. and the co-pays are low.

The co-payments might be pretty reasonable, but the monthly premiums aren't.

5 ( +7 / -2 )

The monthly health insurance payments are lower than for private healthcare in the US.

3 ( +5 / -2 )

If we compare to other countries it gets a little strange.

At around ¥7 million income in Japan the rate of your premiums is around 8.8% to 10.2% depending on age.

This would be around the same in the UK, 10% and in Canada depending on the province 10% to 12%.

Now neither UK or Canada have a co-pay so there is one difference, but the UK does cover meds and dentist like Japan.

Canada nationality doesn't cover dental or meds some recent changes are being made but there are conditions.

So in general, the Japanese system is more flexible, covers more things and options but you need to pay the 30% co-pay. But again that amount is limited to X amount per month. Ex: my nearly 4 weeks in hospital with a 3 hour operation for my heart, 1 weak in ICU, 1 week in advanced care unit, 11 days in standard room and all treatments came to the max month of just under ¥40,000 out of pocket for me.

I call that a bargain, seeing my family in Canada are all constantly on waiting lists for everything from a simple ECG to CT scans!

4 ( +5 / -1 )

The UK NHS has dental services. According to media reports, not a good service these days.

Why are there no NHS dentists available?

"There are several reasons why so few dentists are taking on NHS patients. Fundamentally, it comes down to the cost of providing those services, government underfunding, and lack of qualified dentists."

There are not enough dentists for the number of patients. Many now go private.

NHS prescription charges

NHS

https://www.nhs.uk › NHS services › Prescriptions

The current prescription charge is £9.65 per item. Information: Prescription charges are for each item, not each prescription. That is about ¥1800 per item. It is about the same as here in Japan.

Japan's co-pay is only 20% if unemployed, poor, or retired. Welfare people pay zero.

Being retired I pay a max monthly hospital outpatient charge of ¥12,000 and a max monthly charge inpatient of ¥35,000. Not including the cost of a private room or meals.

1 ( +3 / -2 )

For the bad, the premiums for self-employed people like me are really high. When I was temporarily unemployed, the city office told me I could pay a low-reduced amount, but as soon as they found out I was employed again, they pushed me to pay them back at my previous year's income so it was really high relative to what income I was currently bringing in. It almost wiped me out and they were pretty forceful.

The good, the coverage is good for so many ailments and the co-pay is pretty low so there's never any hesitation to get myself checked out or treated. Just a side note, it used to be almost free back in the 1950s when my mom was young. She used pay just a few yen for coverage.

4 ( +5 / -1 )

The National Insurance monthly payments also cover the pensions when retired.

0 ( +2 / -2 )

The system is good enough. The doctors on the other hand....

-5 ( +2 / -7 )

It's good overall, one of the longest living people in the world.

The bad ? Some people abuse it sure, e.g. calling ambulance when you don't have to. Just with anything else, we shouldn't punish the majority for the misbehavior of minorities.

3 ( +4 / -1 )

Diagnostics and access to meds are pretty good. I would be very wary of surgery here, or anywhere.

-2 ( +2 / -4 )

This would be around the same in the UK, 10%

Are you referring to National Insurance payments? Only a small proportion of National Insurance payments go towards the NHS (most goes towards state pensions). The majority of NHS funding comes from general taxation.

1 ( +1 / -0 )

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