Most of you probably don't know, but I have been living/working in Japan for the past 5 years. Over this period, I have been without health insurance for 4 of those years - I was put into the national healthcare plan when I came over as a high school teacher, and when I finished my contract the school canceled my coverage. I have not been to a doctor since that time, terrified of how much it would cost.
Today, I went in, insurance-less, to the doctor for the first time. In light of our problems back home, I felt I should share this with all of you here.
Yesterday morning, I woke up feeling like someone punched me in the nose. As I was sober the night before, I am 100% sure this is not what actually happened. Understandably, this worried me. So I did what every uninsured American probably does when they feel unwell: checked WebMD's symptom checker. Everything from leukemia to staph to sinus infections came up. I decided to chug some echinacea tea and sleep it off, hoping I'd be better the next day.
The next day, my entire face was swollen and painful, and I was blowing my nose every 30 seconds. Shit. After another web search found someone suggesting whatever I had could spread to the brain if unchecked, I resigned myself to getting checked out. I still had my rent money (around 600 in USD) for the month in my wallet, and my landlady is nice enough that I could probably get an extension, I thought. If it was just sniffles I'd have stayed home, but my face already didn't even LOOK like me. I have to work on live TV next week, and it's not an all-caucasian remake of Rudolph, so I bit the bullet.
I found a hospital nearby that was still open in the evening (many places here, after mid-afternoon, you're screwed) and said I needed to be checked out, but I did not have insurance. The receptionist seemed a little concerned, but checked with other staff and then told me that if I paid in full, and brought photo ID with my name and address included, I could see the doctor. I asked if I needed an appointment.
"No, not at all," the receptionist said. "We're open until 7pm, just come in at any time. We'll be waiting for you." On a Friday night, in the middle of the 2nd biggest city in Japan, in the midst of a swine flu epidemic that is just now starting to calm down.
I came in, explained that I was the foreigner on the phone earlier, and they gave me a sheet to fill in, standard medical background stuff and a place to write down what was wrong that caused you to seek treatment. I filled it in, and after a bit of waiting was brought in to see the doctor, apparently the main guy since his last name is the one on the sign.
We talked a bit about my symptoms, when they started. He checked my throat and nose, asked about my mucus consistency, then showed me on a computer screen display of the throat/sinuses where and what was inflamed, and diagnosed it as an acute sinus infection that apparently is going around quite a bit right now. He promptly wrote me a prescription for 3 days worth of pills and told me to come back if there was no improvement. I thanked him and left.
I went back to the reception area, they gave me a card for the hospital, and 2 papers: 1 was the prescription sheet, one was my bill. Keep in mind this is the full price, as I am not insured (a Japanese under the national insurance would pay 1/3 of this).
3,900 yen. As of writing this, that's about $43. I paid them, said thank you, and left. The pharmacy was directly next door (for prescriptions in Japan, you either get them inside the hospital, or usually a place very close to it. OTC drugs are sold at regular drug stores). I headed in, gave them the paper, and they handed me another form to fill in. One of the staff very kindly walked me through it to make sure I understood everything. Incidentally, one of the questions was "do you have an interest in generic drugs?" I checked the "hell yes" box.
Almost the moment I handed back the form, the other pharmacist came out and apologized for making me wait. She brought out 3 different drugs (anti-biotic, an expectorant, and something for stomach problems) - each 3 days' worth. She explained when to take them and their use, then stuck them in envelopes in a plastic bag, along with a free handwarmer and a printout with pictures, descriptions, and use instructions of each medication. Then, she handed me the bill, apologizing for it being so expensive because I was uninsured.
3,100 yen. Or if you prefer, 34 dollars. In all, this trip to the doctor cost me less than $80 and took less than an hour (I arrived at the clinic at 6:15, I left the pharmacist drugs in hand at 7:05).
This is not a perfect country by any means. There are many things that I feel we do better in America. I have heard of (and seen) some terrible medical facilities here. But when I get 3 prescriptions filled in 5 minutes and they are SORRY they have to charge me a whopping 30 bucks for it, and I see people back home paying many times that, I have to wonder how we're managing to do things just this wrong.