Japan eyes steps to avert medical issues with foreign tourists

Instead of using the new departure tax to employ retired bureaucrats, why not use it to pay for the medical costs of foreign visitors?

￥800,000 is the same in written English and Japanese. 

When spoken though it is "80 万円 Hachi-ju man-yen". Japanese people subconsciously ignore the comma and the meaning of it that they daily see and write there.

@Strangerland:

I have a lot of paperwork (Japanese) where the comma is on the fourth zero which actually throws me off if I glance at it quickly. I really wish it was always on the third.

@yubaru

¥80,0000 = 800,000 Yen in American English notation.

This thread is littered with incomprehensible numbered.

The comma goes between every three numbers guys.

help people! Be they the same nationality or not. The money at the end.....how much is too much to help a fellow human. Just print more.

There are about 300 million women of child-bearing age in China and a similar number in India. Let them all come to Japan as tourists to give birth for free!

We need more info on the 8 million to resolve this. I bet it was ¥80,0000 and not 8 million.

I wont bet on it being 80,000円, as I stated before, the cost is closer to 500,00,

Believe me I know, I have had three kids born here and there is NO WAY it was 80,000円。

HarukaToday  02:06 pm JST

@Bubblegum: 

I think you watch too many ER TV programs. But, the doctors in my family tell me patients often quote tv programs thinking they are correct. They are not. They are fantasy.

We need more info on the 8 million to resolve this. I bet it was ¥80,0000 and not 8 million.

Thanks Haruka for your assumption that I watch ER or other medical dramas.

Sadly your right I do, and personally i loved HOUSE, even though it is actually rubbish in many ways . As you said pure fantasy most of the time. LOL. But I do have three licences Medical nursing, Psychiatric nursing and Opthalmology, so I'm not sure why you assumed I watched too many ER programs.

I agree with you Cricky, print money...or charge the foreigners 2% sales tax (instead of 0%) and use the proceeds to cover other uninsured foreigners).

help people! Be they the same nationality or not. The money at the end.....how much is too much to help a fellow human. Just print more.

We need more info on the 8 million to resolve this. I bet it was ¥80,0000 and not 8 million.

How many zeros?

Forgetting the details but there was a Brit who crashed his plane on a golf course in Hyogo a year or so ago. The hospital refused to operate on him (broken... back?) because he could not tell them how he was going to source the funds to pay, and this was not a language problem.

But then again, in Japan not every hospital will take just anyone off the street, and every hospital asks in advance for your insurance paperwork. Very few places will take anyone on just trust alone.

@Bubblegum:

I think you watch too many ER TV programs. But, the doctors in my family tell me patients often quote tv programs thinking they are correct. They are not. They are fantasy.

We need more info on the 8 million to resolve this. I bet it was ¥80,0000 and not 8 million.

In one case, a woman who gave birth prematurely during her trip was unable to pay the 8 million yen ($75,000) bill and the medical institution concerned sought donations from foreign residents in Japan to cover the expenses, according to government sources.

Why from foreign residents...what responsibility do they have for foreign tourists like her? Should have asked the companies which benefited from her being here as a tourist instead.

Paying the bill is not the biggest problem foreigners. The biggest problem is finding which clinic you go to for your ailment. There's no such thing as a GP in Japan and every clinic specialises in one particular field. Then, there is the issue of hospitals with outpatient's facilities. Most hospitals do not treat outpatients and you need to be referred to see a doctor. There is also the issue of the medical history and allergies documents. I've never seen one in multi-languages and, even if there was, it is unlikely any of the staff would understand any specifics in a foreign language. And, let's not forget the prescribed medications. You usually get 4 or 5 different kinds of medications with very strict schedules for taking them, most of which are to counteract the effects of one or more of the other medications. I've never seen these directions in another language. Mt advice to foreign visitors is, don't get sick! If you do, go home!

Actually you don't need to be referred to a national hospital.

You can actually walk in.However because you are not referred to the hospital by your clinic there is usually an extra cost involved. This was introduced to reduce the amount of people who turn up at hospitals and using them as a GP clinic. I'm not sure why you think its difficult to distinguish the specialities of a clinic unless you can't read. However, you'll find that those docs are so specialised in their field that they can be better than a so called GP because they've had all the same basic medical training +++ before they specialising. Can't tell you the amount of times we had patients walks into A and E because the GPs treatment wasn't working or they missed something. On top of that, the specialised Doc will identify other problems you didn't even know you might have. And if you needed a GP, you probably didn't have anything that serious because you'd be off to see a specialist if you did. One good example is you've got a red eye, and you don't have infection but something serious needing an opthalmologist. You might even get an X ray on your back to rule out another condition you didn't even know you had. The relationship between the two is not something your GP would know, but the ophthalmologist would.

In regards to medical history in multiple languages. This is just not appropriate and I've never seen it in any hospital I have ever worked in. The medical records are for the staff, and to allow the staff to communicate with each other and to provide a legal documented history of what took place if things ever went to court in that country.

Medication always have a schedule, to A) reduce side effects B) to provide a good blood level balance of the drug over a 24 hour period and every drug has a side effect that may require another drug.But some of the meds you take also reduce other symptoms or effects you know nothing about. (Irrelevant of country),

Here's an example: Backache. Joe bloggs can get a pain killer .A) reduces his pain but he might also get a muscle relaxant to B) reduce muscle spasms contributing to his pain, therefore reducing his pain, and increasing his mobility and C) another med to protect his stomach lining. Of course he's free to say no to the stomach protecting drugs, and the muscle relaxant but he may be back saying his back still hurts, and he feels a bit sick. Otherwise he could have just gone to the drug store.

Why should they be given to you in the language you want? and should we do this for every single language? This isn't done in any hospital I have ever worked in, unless there is a member of staff who speaks that language. You might get general info in different languages about certain things, but to expect staff to do everything in everyones language is pretty unreasonable. We always asked patients to bring someone to the consultation so they can explain everything.

If you live in Japan, at least have the curtesy to read some of the language and understand it.

As for a tourist, there are helplines for people who need to attend hospital, you'll be treated, but you have to accept there will be some trade offs in communication. I don't think every US hospital/clinic will be giving everything in Japanese to a Japanese patient.

http://eng.amda-imic.com/modules/amda/index.php?content_id=1

We're talking here about non-residents. Tourists are not part of national insurance schemes that they don't contribute to.

Did you read any of the comments so far? Child birth is excluded from insurance, so the costs are borne by the mother and then a set amount is reimbursed by applying at your local municipal office.

The costs for child birth in public hospitals is set at the reimbursement rate, for a natural child birth, if it's a c-section the costs are higher.

So that is the guidline for charges for a childbirth, tourist or otherwise. There are some wild assumptions going on about why, but for a normal child birth there is no way it costs THAT much.

Once again, missing information in an article, rather important information, gets left out and leaves people to speculate the why. Better to include pertinent information FIRST, particularly when there is a slim chance they will do a follow up

Disillusioned you are so right, I had stomach ulcers the J doctor said go back to your home country it can be fixed in a month, all he could legally offer was a bag of drugs that reduced the symptoms. He knew it and was honest. My mother in law was being over prescribed it was obvious, finally found a doctor who had worked OS she is now on 1/10th and genki. Broke my knee cap they put a bandage on it? Had a root canal done dentist didn't clean it sinus infection a year of medicine and still have a problem. Now I go to Vietnam for dentists it's actually cheeper and they are better trained. This story is a beat up. Probably shouldn't travel while pregnant but the amount of visitors who require medical assistance is not such a drain on resources. When you consider the vast spending on projects that benifit no one.

@zichi

 Don't allow foreign visitors to travel to or enter the country without showing they have medical and health insurance.

Good idea. They could even offer it (well...demand they take it. haha) as they pass through immigration.

Every country has this problem with visitors. Probably none more so than the UK where healthcare is "free" (paid for by NI contributions from citizens)

Paying the bill is not the biggest problem foreigners. The biggest problem is finding which clinic you go to for your ailment. There's no such thing as a GP in Japan and every clinic specialises in one particular field. Then, there is the issue of hospitals with outpatient's facilities. Most hospitals do not treat outpatients and you need to be referred to see a doctor. There is also the issue of the medical history and allergies documents. I've never seen one in multi-languages and, even if there was, it is unlikely any of the staff would understand any specifics in a foreign language. And, let's not forget the prescribed medications. You usually get 4 or 5 different kinds of medications with very strict schedules for taking them, most of which are to counteract the effects of one or more of the other medications. I've never seen these directions in another language. Mt advice to foreign visitors is, don't get sick! If you do, go home!

Haruka:What? Prenatal care, birth and postnatal care even without insurance would only be about $5000 max here...a credit card could handle it.

So why would it cost so much.

Well, if this women went into premature labour she probably went to hospital by ambulance, and of course that is manned 24 hours a day 364 days a year.

She would need a surgeon, an anaesthetist, several registered nurses, not to mention specialised equipment or even the cleaner who actually cleans the whole place, not to mention all the support staff you don't even see. Clerks, cleaners, cooks, sterilisation department, blood department, porters, someone to translate, et al.

And you need these people on duty 24 hours a day, wether there is a patient needing treatment of not.

The baby would also need a specialised team on standby for treatment as the first surgeon may have to do some procedures on here. They are not just your normal register nurses. They are extremely specialised nurses requiring further training on top of their nursing qualifications. Of course we don't know if it was a caesarean but they may have done that as the quickest and safest way to safe the life of the baby and the mother.Once in NICU you would again have a team of doctors and nurses there. Usually One nurse per patient standing at the incubator 24 hours a day and another nurse who would be the runner getting equipment, not to mention the senior nurses just running the unit. You even have support staff as cleaners, who you somehow forget are part of the team. Not to mention expensive drugs which can cost thousand per dosage, and other equipment depending on how premature the baby was.Thats before you even cover basic medication, dressings, electricity, water, that you take for granted, but all need to be payed for.

Since the article doesn't have her medical records, or say how long she and the premature baby stayed, it's really not fair to comment on the cost, but they may have stayed in for sometime.

Thats why it doesn't cost $5000 max, or anywhere close.

maybeperhapsyesToday  As Yubaru said...and 8 million to give birth in Japan?!

Perhaps we now know why the birthrate is so low.

Nothing to do with the cost of giving birth as it is basically free. The cost is either A) payed by the family and returned via the city. B) if you don't have the cash a certificate is issued to the hospital that the costs are covered by the city. I think you will find highly educated countries all have a falling birthrate. As child mortality is low, our life expectancy is longer, have better job opportunities, want a higher standard of living, we don't need to have larger families, but can choose to deal having a family, give our children a better life because of the social and medical advances.

"In one case, a woman who gave birth prematurely during her trip was unable to pay the 8 million yen ($75,000) bill and the medical institution concerned sought donations from foreign residents in Japan to cover the expenses, according to government sources."

Im not sure if this is just terrible writing but, sought donations from foreign residents in Japan??

Did a list of "foreigners" in that ward get a request letter or something?

Unless its that persons family, you invited them, or are the contact on their visitor visa, why on earth would I pay for someone else medical fees simply because I'm "foreign"?

Travel insurance ALWAY people, should be a condition of travel in my opinion.

For the life of me I can not understand why child-birth is no covered by insurance, when it's reimbursed by taxpayers money.

Yubaru - We're talking here about non-residents. Tourists are not part of national insurance schemes that they don't contribute to.

Visitors have health insurance what covers child birth if the woman is pregnant or arriving without it, can buy it at the airport before being allowed in.

Zichi - Childbirth is a standard exclusion from travel insurance policies.

Make insurance compulsory for visitors. Have a national policy towards foreign visitors who need medical assistance. As for the 8,000,000 yen bill for giving birth, I'm assuming the premature baby needed to be in the SCBU for a while, hence the massive bill.

Id take out insurance against those who can’t or don’t pay on top of this.

That is the only explanation I can think of, because all women's births are not covered by the health insurance system and it usually costs about four hundred thousand yen, which is then reimbursed by the city.

It's reimbursed through the municipal office, but it comes from the insurance fund. For the life of me I can not understand why child-birth is no covered by insurance, when it's reimbursed by taxpayers money.

Hospital's also charge based upon the reimbursement. If you go to a private hospital it will cost more than the money coming back to you. I've had three kids born here in Japan, and the most "expensive" one still was only about 50,000 yen above the reimbursement.

Also, there is no way to know, as the article says nothing about the reason for the extreme cost.

I am always surprised by friends who frequently travel without travelers insurance although I forgot the last time I went back to the states. I made a quick call to correct the situation. Whew. Anyway, would it be too harsh to even prevent people from boarding the airplane without traveler's insurance? Or could airlines somehow be involved in facilitating the enrollment(or do they already), as many people travel from place to place and don't always know their next destination. I wonder if many people don't know that there is even the option of getting traveler's insurance?

Japanese travelers have medical issues when in other countries, these are covered. I believe NZ had a problem with a high number of Japanese giving birth there Duel passports the goal. But it certainly wasn't $75,000 a pop. Another panel of experts, taking years to conclude that foreign people may need medical attention and urge hospitals to take steps, with no funding to, well do their best. You may remember a mentally ill foreigner strapped to a bed for an excessive amount of time until death. So people would be mad to come here for medical treatment.

I agree the 8 million yen seems high, but is she had the baby prematurely and the baby was in an NICU unit for a while, as well as the Mom being in an ICU unit, the cost could skyrocket. That is the only explanation I can think of, because all women's births are not covered by the health insurance system and it usually costs about four hundred thousand yen, which is then reimbursed by the city.

"In one case, a woman who gave birth prematurely during her trip was unable to pay the 8 million yen ($75,000) bill..."

What? Prenatal care, birth and postnatal care even without insurance would only be about $5000 max here...a credit card could handle it.

"...differences in customs."

The simple curtain separating individuals which allows for zero privacy is going to be a thriller. But then again, most foreigners will not understand the Japanese being heard next to them, nor will the Japanese next to them on the other side of the curtain understand the broken English being attempted by medical staff.

"...sending back the body of a foreigner who died..."

That is what embassies do. It is easy and a no brainer.

"...to reduce the financial burden the institutions may have to bear when a problem occurs."

Any and everyone visiting should have a credit card. Plus, right outside of customs, there should be giant signs saying Buy Health Insurance Here! The government can issue subsidized insurance policies that only visitors can buy.

Visitors must be ready for common issues with health. One big one should be asthma attacks due to allowing smoking in restaurants. Another should be for panic attacks due to overcrowding in many areas. The system also needs to be ready for a giant earthquake etc.

I would like to be on this committee.

The day will come when a bill of health will be a required attachment to ones passport

There's going to be a meeting! Oh boy!

The working group, to be set up under a government task force on health care and medical policies, will be joined by officials of relevant ministries, the Japan Medical Association and hospital groups.

Lots and lots and lots of meetings!

(lifts chin off floor)

As Yubaru said...and 8 million to give birth in Japan?!

Perhaps we now know why the birthrate is so low.

@ monitors. The headline should read medical "billing" issues. There's no way the government can prevent foreigners or anyone from having medical issues.

In one case, a woman who gave birth prematurely during her trip was unable to pay the 8 million yen ($75,000) bill and the medical institution concerned sought donations from foreign residents in Japan to cover the expenses, according to government sources.

Where in the hell did she give birth? A five star hotel?