One of the major reasons I was excited to come work as an English teacher in Japan was because I knew I was finally going to get universal healthcare. It’s something I wish the United States would get on board with, if I’m completely honest. I pay into Japan’s National Health System from my paycheck, meaning I don’t miss the money because I never touch it, and I get yearly checkups included with my job. I also get access to one of the better health care systems in the world, in a country where average life expectancy still tops the charts (Mouse over the green bar graph at the bottom. Hint: Japan’s all the way on the right). What’s not to love?
But I never thought I would use it for much more than occasional visits to the doctor’s for some cold medicine.
Things I’ll Miss #5: National Health Care
On June 8th, we ran the 5K race of the Sakuranbo-Higashine Marathon. I had trained more than I did in 2013 (read: I actually trained), and to my delight, I made it just under 30 minutes. A minute or so later, Kristin finished, and we made our way over to pick up our participation prizes: a T-shirt, rice balls, and fresh Yamagata cherries.
Then, a funny thing happened. My ankle started to hurt. Bad. The more I walked, the more it hurt, and soon I couldn’t walk without a lot of difficulty. The pain felt entirely muscular, and we were heading to the onsen afterward, so I figured I’d have a soak and loosen up whatever angry muscles were causing me trouble.
Regardless of the good long soak, I woke up the next day to pain worse than before, and I was having even more trouble walking. Not good. I needed medical attention.
When you need medical attention here, you don’t go sit in the hospital for days on end until an overworked doctor can look at you and say nothing’s wrong, then go home and suffer. Japan has private clinics, like the orthopedic clinic I went to, and you need a referral from said clinics if you’re going to go to the hospital. So first you have to go and wait at (or make an appointment with) the private clinic, get checked out, and, if a hospital visit is necessary, have them call to make an appointment for you, as well as write up a referral describing the situation.
I showed up at about 9 a.m. the Monday after the race to my orthopedic and didn’t get done with the exam process until noon. In that time, however, they examined my leg, took a series of X-rays of my ankle and then analyzed them before I ever left the building. The X-ray showed that nothing was wrong with my bone, but the doctor noticed a little gray something where there shouldn’t be anything but healthy bone. He recommended that I go get it checked out at the hospital and said he would write up a referral. My appointment at the nearby hospital was made for the next day, and I was given painkillers, medicine for my stomach in the event the painkillers messed with it, and some medicated pads to apply to my ankle.
The next day I drove to the hospital for my appointment, where the doctor had me undergo another X-ray, a CT, and finally an MRI. When my results came in, the doctor showed me this:
and told me it was a tumor on my bone. Most likely benign, but just to be sure, they wanted me to go see a specialist.
Tumor? Those don’t happen to you. They happen to people you hear about on the news, to characters in tragedies, to friends of friends. But never to you. Especially not when you’re only one month away from quitting your job to go travel the freaking world with the love of your life.
Through a lot of back-and-forth with my supervisor and the hospital, I arranged an appointment for the following Tuesday with a bone specialist in Niigata, the prefecture just south of Yamagata. The doctor writes me up a referral to the specialist at Niigata University and gives me a disc with all my test results on it to bring as well.
By the time Tuesday rolled around, I’d had several armchair diagnoses from posting the initial MRI image to Facebook: it’s benign because it has a clearly defined shape, it looks like a cyst, et cetera, et cetera. In the land of uncertainty, even the placebo effect is welcome, and I tried to hold on to the positivity as I made the drive down to Niigata.
The doctor welcomed me into his office within a few minutes after I arrived at the university. He pulled up several of the images on my CD, arranging them into four distinct panels. They were the images of my foot from various angles—one from the top, one from head-on, one from the side and if memory serves, one from the other side. He scrolled through the images of my leg several frames at a time. For anyone like me who had never had this sort of thing done, it was alternately fascinating and terrifying to watch.
In the head-on view, my bone was a little white circle or two at the center of my leg, when suddenly, BLORP—this weird bit appeared, growing a bit as the doctor scrolled further up my leg. He went back and forth a few times, looking at the different views, looking again at the MRI taken from above my leg, then back to the head-on view, then scrolling, then scrolling, stop. Scroll scroll scroll. Scroll back, back, back. The silence was getting to me, because I was watching what appeared to be a small explosion happening inside my bone, over and over. I had figured this was something on my bone. Now I realized it was inside my bone. This is getting crazy–or in Japanese, yabai.
Finally he swung around to face me, declaring my “tumor” was actually a Fibrous Cortical Defect–99.9% of which are benign and require no surgery to manage as they clear up over time. There’d be no more 5ks in my near future, but as long as I stuck to low-impact exercises like walking or biking I’d be good to go.
So how much did this whole week-long ordeal cost me? Thanks to Japan’s awesome health care system, not as much as it could have.
Breakdown of Health Care Costs for Jeff’s Ankle Adventure:
- X-ray (Real Cost Unknown)
- Painkillers (Real Cost Unknown)
- Meds in case the painkillers wreck my stomach (Real Cost Unknown)
- Medicated pads to help with the pain (Real Cost Unknown)
Total Cost to Me: ~¥2,000
Transportation Cost: Negligible; it’s minutes from my house.
Shonai Hospital (First Visit)
- First Time Examination Fee: ¥2,820
- X-ray: ¥1,670
- Film for X-ray prints (2): ¥370
- Charge for use of Contrast Media (for the MRI): ¥13,140
- Film for MRI Prints (10): ¥2,470
- Injection (of above Media for the MRI): ¥9,870
- CT Scan: ¥9,000
- Film for CT prints (5): ¥1,240
- Examination of X-rays, MRI, and CT Scan: ¥430
- Computer Examination (i.e. the Doctor examining my results with me): ¥4,500
Total Cost: ¥45,510
Total Cost to Me: ¥13,650
Transportation Cost: Negligible; parking is free if you’re a patient. I drove because my foot still hurt.
Shonai Hospital (Second Visit)
- Examination Fee: ¥730
- Information Review and Sharing: ¥2,500 (the referral, and getting my X-rays and scans onto a CD)
Total Cost: ¥3,230 Yen
Total Cost to Me: ¥970
Transportation Cost: None. I walked.
Niigata University Hospital
- First Time Fee: 282 “Points”
- Photo Examination/Diagnosis: 493 “Points”
- Total: 775 “Points,” multiplied against my insurance burden, here represented as 3 for 30%
Total Cost to Me: ¥2,330
Transportation Cost: ¥3,058 for a tank of gas to get to Niigata and back; ¥100 parking fee
Overall Cost to Me For All Visits and Diagnoses: ¥18, 950
Final Total, Including Transportation: ¥22,108
¥22,108 at (then current) rate of 102.9 yen to USD: $214.85
Using the only resource I could find on the web—a site called newchoicehealth.com—I received an estimate for a CT scan in my home state of New Jersey: $1,200. The MRI would be another $1,700. Uh–what?
I’m seriously going to miss the peace of mind (and wallet) that Japan’s health care system gives me. Throughout this whole thing, I felt safe, taken care of, and assured that the doctors knew what they were talking about every step of the way (Full Disclosure: Speaking Japanese helped with that last part). Wait times were less than ideal day-to-day, but in a week I knew that I wasn’t going to die or need surgery or lengthy treatments. All for about half the cost of a new PlayStation 4, I could protect my health, my well-being, and my ability to contribute to this blog and the life Kristin and I are going to live together as we travel.What’s the best health care experience you’ve ever had? Want more? Check out “#04: Cherry Picking” here!