I received the following email from my brother-in-law regarding his recent hospitalization in Japan. He has allowed me to quote it at length here; his comments speak for themselves.
As an American academic who moved several years ago to Britain, and who comes to Japan for research usually once a year, the issues of how health care is paid for is an issue close to my heart. When I was fully employed in the US my asthma problems almost bankrupted me - and I had insurance. In the UK, this is not an issue....and in Japan, my experience was even stranger.
Recently, I was hospitalized for 11 days at an excellent Japanese hospital. I chose a private room, had round the clock attentive nursing care, more than 30 IVs and other daily steroid drugs. The food was great too!
A team of doctors came in daily to diagnose and check me, the nurses came in 3 times a day for checking. I had blood drawn every two days will full scans done for all tests and levels. I had a 24 EKG performed where they strap a small computer to your body with electrodes to check your heart. I had a heart sonogram, internal sonograms of my liver, gall bladder, stomach and intestines. I had two sets of X-rays of my chest, and finally a 30 MRI of my chest as well.
As a friend of mine in the States noted to me on email recently - normally you would only enter a hospital in the US for this long if you were going to get a face transplant or were a siamese twin awaiting separation. The cost alone would cause one to be ill upon discharge. But because care is managed so differently in Japan than in the US, I left with a clean bill of health.
When I left the hotel I was presented with the bill. It was 401, 856 Japanese yen. At today's rate, that is about $4,444. There are two columns on the bill. One is for the room charge which was the yeoman's share, and given the fact that I chose a private room who could complain? I felt I would recuperate more quickly alone. The other column is packaged under the larger rubric of "medical charges" and was for a much smaller portion of the total bill.
The long and short of it is that the hospital itself could not tell me how much the MRI i was because they don't break down or itemize bills. It's almost the inverse of the American system. They have no idea because they don't charge for each individual service....the health industry in Japan (as opposed to the drug industry which is a different animal) is not precisely driven by the same mechanics of profit as in the US. I found this to be a fascinating difference in the way both countries approach the issue of health care. The doctors in Japan work at the hospital...so they don't get paid by the IV they inserted in my veins, nor did they receive any profit from ordering a specific battery of tests that augments their salaries or bonuses. And in the end, I did not suffer any huge financial setback that a similar stay in the states would have charged. As the debate about healthcare rages in the States, I still cannot fathom what would drive someone to assess that the current US system in any way is superior to the care that I received in Japan. Having lived in many countries around the world, including the US, Japan, the UK and elsewhere I would have to conclude, based on my own experiences, that the level of healthcare I received in the States was actually of much lower caliber than anywhere else.
I wonder in retrospect, given all the bloodwork, tests and physicians' diagnoses I received in Japan, would I still be financially solvent as an academic if I stayed in a US hospital for 11 days? One reason I would not see myself returning to the States for any career reason would be precisely along these lines. Why take the risk when socialized medicine takes generally better care of people over all?
What is it about Japan that enables them to provide such superior service? I tried this line of argument out on a group of conservatives and there is no clear response yet.