(previous chapter)

Medical Care

Introduction

        AIU
        70 Pine Street
        New York, NY 10270

If you require care while outside of Japan, the health insurance which you pay for through NTT may cover very little. In general, it appears that you will be reimbursed (if you save your receipts!) at the Japanese standard rate for services, which may be quite a bit different from what you actually paid. If you are travelling abroad, especially with small children, you should have some supplementary insurance.

Basic Insurance and Treatment

For normal outpatient services, the insurance will pay 90% of the costs for you, and 70% for your family. This includes the office fee, medicine, and any routine tests which are done. For these services you may visit any local hospital or clinic (take your insurance card). Musashino researchers have reported favorable experiences at the Red Cross Hospital near Musashi-Sakai (武蔵境) station (see map M-1). This hospital has many doctors who have studied abroad, so many speak quite good English. Seibo (聖母 Holy Mother) Hospital near Shimoochiai (下落合) station on the Seibu-Shinjuku line is a catholic hospital with many English speaking staff. The reimbursement rules also apply to dentists under the NTT sponsored insurance scheme. In this case a basic standard of treatment is covered. However, as you might expect, special requirements such as higher quality repair materials become expensive.

Appointments are not possible at Japanese medical clinics, and you must go and wait your turn. Most visits to normal clinics will take 2-3 hours, of which you will be with the doctor for only 5-10 minutes. It is better to arrive early in the morning. You will pay your bill and receive your prescription at the clinic, so take some money. A tax refund may be available if you spend more than 100,000-yen in one month on health care.

Hospitals in Japan

Standard tests like x-rays, blood tests, and others are fully covered by the insurance. Non-standard tests may not be fully covered, and in any case it is good policy to try to verify whether the tests are indeed necessary. Emergency treatment is not fully covered by insurance and the cost will depend on the hospital and the services received. This appears to be a nebulous area, and you may not know just what is covered until you get the bill.

Philosophy of Care

The overall method of treatment and the relationship between doctors and patients in Japan are in some ways quite different from that in Europe and the US. First of all, doctors tend to offer very little information to the patients they are treating. Explanation of treatments, description of the exact nature of drugs prescribed and even explanation of a patient's actual condition are less extensive than a Westerner may be accustomed to. Doctors are also not used to being asked a lot of questions by their patients. These differences, combined with the language barrier, can be quite frustrating to the foreign patient.

Another difference is that doctors tend to prescribe many drugs simultaneously, often targeting each drug for a specific symptom. Thus, most foreigners are suprised to be given 3 or 4 different drugs even for minor ailments such as a cold. In fact the treatment is often a sort of cover-all-bases philosophy, more extensive than most foreigners are used to (an example is the use of the chest x-ray in routine yearly checkups, a practice which is not common elsewhere).

The following four paragraphs are distilled from the comments of foreigners who have been hospitalized or otherwise used the medical system in Japan. These comments are not meant to be representative, but rather to give a flavor of what to expect from the medical system.

In general, the quality of doctors themselves is quite high. Many doctors know some English, and can understand medical terms, especially if you write them down (the pronunciation may be a little different). However, it pays to carry a dictionary with you when you go.

The first visit to a clinic can perhaps be a little alarming. Most Westerners are used to being alone in a very private room with their doctor, especially if removal of the clothes is called for. However, in Japan, the doctor is usually attended by a phalanx of nurses buzzing about, and you are often separated from other patients only by a curtain. The doctor may discuss your condition within earshot of several other people. Thus the concept of privacy is quite different from the West. However, after a few visits one gets used to this "team care" concept.

In general, the nurses appear to have less responsibility than their Western counterparts. In a hospital, the nurse generally will do only what is written on your chart by your doctor, no more, no less. This usually involves taking blood pressure and temperature every now and again. If a medication is upsetting you, or you need some special attention, you may have a hard time convincing the nurse unless your doctor told her in advance.

The concept of diet is also quite different in a Japanese hospital, where it appears that everyone receives the same meal, regardless of condition. Requests for special food, like bread or milk, generally cannot be met, and you (or a friend) will have to get it yourself.

Bilingual Doctors

The International Clinic in Roppongi (downtown Tokyo) has doctors from many countries, and if you really need to see a doctor from your own country you can try going there. However, again appointments are not available, and as the clinic appears to be designed for executives whose companies will pay for anything, you may find the prices quite high. The International Clinic does not accept insurance at this time.

Medications

Family Planning

(table of contents) (next chapter)

________________________________________________________________________