January 1, 2010

"VIP" Treatment Under Nationalized Health Care

Hatched by Sachi

A few days ago, my 77 year old father, who lives in Japan, fell and couldn't get up for more than an hour. He was taken to a hospital, where he still rests.

Last night my mother called to update me with a summary of his condition: He has a compressed disk, it seems (it's hard to translate from Japanese to English and from Mom-speak to ordinary human language). The condition is somewhat serious but not life threatening; he'll have to spend a few weeks in hospital. Too bad; New Year's is the biggest holiday season in Japan.

I'm sure everyone reading this post knows that Japan has socialized medicine (national health care, single-payer, however you want to call it). It's not as draconian as the NHS in the United Kingdom or the Canadian national and provincial health-care system; but it is universal -- everyone must pay for government insurance. Fortunately, those who are well off can also buy private insurance in addition... and they can use that instead of the government system (unlike in the UK or Canada).

In other words, Japan already has the system that proponents of ObamaCare eventually want to install here in America. So let's take a look at how it works in the real world.

After Mom reassured me about my father's condition, she started talking about last year around this time, when she had to have stomach surgery.

"Oh Sachi, the care I received was wonderful!" she said; "I stayed in a private room which was like in a nice hotel. It had a private bathroom. The nurses were nice. The doctors were wonderful. I spent nine days in the hospital and only paid ¥80,000!" [About 800 dollars]

"Really?" I asked; "government insurance actually covered all that?"

"Oh, of course not; I have three insurance policies," she proudly announced.

Before retirement, my father was a patent attorney. As a private business owner, he had to pay an exorbitant government insurance premium, both for himself and his three employees. But he always knew that would never be enough coverage, so he purchased two more private insurance policies. In other words, he spent more than twice as much on health insurance as a typical American spends now, pre-ObamaCare.

But even those extra policies wouldn't cover the VIP treatment my Mom got. I asked a few more questions, and she finally spilled the beans:

"I was supposed to be in a 4-person room. But I had a private room all to myself, thanks to your uncle."

Ah, my uncle the hospital administrator. I'd forgotten about him!

My mother's third or fourth youngest brother (I forget which) holds a high administrative position at a major university hospital. It seems he has a great deal of clout there, which has been a great help to our family in times of medical need.

My mother is quite the hypochondriac; she always complains about one ailment or another, usually imaginary. So whenever she is not satisfied with her general practitioner, she talks to my uncle. First thing you know, she's seeing a specialist -- skipping the long waiting list that those without such connections must endure under Japanese system.

On another occasion, Mom hurt her knee. My uncle "referred" his sister to a university hospital doctor who was Japan's most famous doctor for ligament tears. Patients from all over Kanto Plain (where Tokyo sits) would come to see him.

"He only takes 40 patients a day," mom said (only 40! Imagine that!) He doesn't accept appointments; so if you want to see him, you have to get there by 7:00 a.m, take a number, and... wait. And wait, and wait.

My mother strolled in at 9:00, the time the office officially opens; the waiting room was already full, and they had long stopped issuing any numbers. One lady told my mom that she had gotten up at four and had her daughter drive her for two hours to get to the hospital. She was lucky; she got number 38 and had waited three hours already. "There are no specialists in my city," the lady explained.

My mother-the-sister-of-one-of-the-nomenklatura presented her letter of introduction to the receptionist:

"Don’t worry, Ma'am, never mind the number. Just have a seat; we will call you."

My mother did not have to wait. The doctor was most courteous, a rarity in Japan, and he asked about my uncle. Then he gave Mom a thorough examination, spending far longer with her than other patients.

So my parents have the more expensive national health care for business owners (Dad pays higher taxes), Kokumin Hoken -- Citizens' Health Insurance; the lesser one is for ordinary salaryman, Shykai Hoken -- Society Health Insurance. In addition, they have not one but two private health insurance plans, a primary and a supplementary. On top of that, my mother's brother is a high-ranking official at a major hospital in Japan.

But Mom is not so foolish as to rely upon such insecure health-care planning as that; she has a back-up system that she also uses...

After such nice treatment as she got for her knee and her stomach, my mother never forgets to send "gifts," typically cash and premium liquor to the doctors, expensive chocolate to the nurses -- and of cours, something extra special to my uncle, her brother. She was laughing that after her hospitalization, she spent more money on gifts than the actual medical bill. That means over thousand dollars of, let's be honest, bribery.

Wonderful. The national health-care system works!

That's why my mother isn't worried about Dad's care; he's going to be treated better than anybody other than corporate CEOs and of course government officials. But even with that kind of influence, my father had to wait three days for his preliminary examination and to have X-rays taken. After all, it was a holiday week, the Emperor Akahito's birthday, and no doctor was willing to return to the hospital for anything other than a life or death situation. (And maybe not even then; how many extra private insurance plans is the fellow carrying?)

The day my father was taken to the hospital, the nurse told Mom to obtain several changes of clean pajamas, underwear, and towels for my father. Also soap, shampoo, and other toiletries, which were needed right away. Conveniently, the hospital has a kiosk that sells all kinds of items and is open 24 hours. Just a little markup over buying at a regular store, miles away... maybe 100% or so.

Oh, yes, I almost forgot, they told Mom to bring a thousand-dollar deposit. Cash.

My sister and mother take turns visiting Dad everyday. They have to pick up his dirty laundry, wash it and bring it back, because the hospital doesn't do that. But Dad's quite lucky that he stays in a nice hospital with three different insurance policies, under the auspices of his brother in law. My girlfriend’s father only had government insurance when he was hospitalized, and the hospital did not even turn on an air conditioner in the middle of August, with temperatures over a hundred degrees and humidity close to 100%.

My girlfriend visited her father as often as she could; she had to: Half the time, they didn't even empty his bedpan.

You see? National health care works great... so long as you're rich enough to afford the premium level of government insurance and to buy multiple additional private policies; so long as you have influential relatives; and so long as you're willing and able to brazenly bribe the doctors and bureaucrats who run the system.

"I am so glad we live in Japan," Mom said. "I worry about you in America, with no national health care!" Thanks, Mom, but I'm afraid "help" is on the way from President Barack H. Obama.

Are you looking forward to it as eagerly as I?

Cross-posted on Hot Air's rogues' gallery...

Hatched by Sachi on this day, January 1, 2010, at the time of 4:18 PM

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I’m taking a Christmas liberty here, publishing a blogpost written by my wife, Sachi, on our blog, Big Lizards. Ordinarily I only publish my own scribblings on Hot Air’s rogues’ gallery, no one else’s; but this is such a powerf... [Read More]

Tracked on January 1, 2010 6:03 PM


The following hissed in response by: BlueNight

I once had a tear in my esophagus which allowed air into the interstitial space. (Air between organs is BAD.) I got into the emergency room, was treated right away, spent the night there, and was out a day later.

I had no health insurance. I paid around $400, in installments, directly to the hospital.


The above hissed in response by: BlueNight [TypeKey Profile Page] at January 2, 2010 12:03 AM

The following hissed in response by: Stosh2

Your post reminded me of the time I lived in Japan and needed to go to the doctor for an earache that wouldn't go away. My landlady suggested her doctor.

I went to the doctor's office and had my first treatment. It was the most bizarre medical treatment I ever had for an earache. After the doctor inspected my ear, I had to hold it over what looked to be a spun aluminum globe with part of it cut away. Inside the globe was some sort of buzzing, flickering infared lamp (I think). I was to hold me ear over the contraption until the doctor told me to stop. The doctor then put a piece of cotton in my ear and told me not to take it out.

Before I left, he told me to come back in two days time. I asked to make an appointment. His assistant gave a tired smile and proudly informed me that no appointemnt was necessary - as if making appointemnts was foolish and an inconvenience for everyone. I asked when I should come to the office. The assistant replied, "Any time!" I said OK, but was dubious. I discussed this with my landlady and she said to get there as early as possible and wait in line. People usually began showing up hours before the office opened. So I did that.

I missed more than a half day of work for each appointment - for a simple earache. My boss, who tolerated no tardiness or absences, just accepted it with a 'it can't be helped' shrug.

The cotton the doctor put in my ear (and told me not to remove) got wet at the sento, so I took it out, earning myself the severest dressing down I've ever had in my entire adult life from the doctor for it.

After three aluminium globe / infrared treatments, lots of privately financed cotton balls so the doctor wouldn't yell at me again and no improvement, I decided to ask help from a friend who had connections.

I got an immediate appointment at the finest private hospital in Tokyo with the head of internal medicine. (My friend was quite well connected.)

This doctor immediately identified the problem which my first doctor most certainly must have seen - an infection in the outer ear (caused by the inappropriate use of a toothpick). He removed the wooden splinter and the earache went away. 300 yen, please.

In my experience, obtaining efficient effective medical treatment in a socilaized medical system absooutely takes 'knowing someone'.

I chose not to interact with the Japanese medical system after that. I also reformed my toothpick technique immediately.

The above hissed in response by: Stosh2 [TypeKey Profile Page] at January 2, 2010 2:56 PM

The following hissed in response by: Sachi


Thanks for sharing your story. I remember receiving aluminium globe/infrared treatments myself, but that was for rash. I still have no idea what they were supposed to do.

There are good doctors in Japan; it's just a matter of finding them.

[Dafydd cannot resist adding: "Earache, my eye!"]


The above hissed in response by: Sachi [TypeKey Profile Page] at January 2, 2010 10:33 PM

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