Japan Healthcare System
Japanese citizens have a longer life expectancy than anyone else, possibly because of the country’s excellent healthcare service. The system puts a high priority on preventative care instead of reactive care, seen in other healthcare systems. The Japanese Healthcare System also offers free screening tests for certain illnesses and superb prenatal programs.
However, despite the high emphasis on preventive care, Japanese physicians and nurses are not required to go through license renewals. They do not even have to participate in continuing education.
Japanese citizens do not usually have one dedicated family physician as you might find in Canada or the United States. There are comparatively very few general practitioners since most physicians have a sub-specialty. You go directly to the specialist you need for your illness.
Many other countries have an urban-rural divide wherein physicians flock to the cities and prefer working in urban areas over rural locations. But in Japan, the opposite can be observed.
There is an uneven distribution of physicians benefiting rural areas over urban ones. Physicians prefer being assigned to rural areas, saying they experience a higher quality of life outside of metropolitan areas and a less stressful work environment.
The Japanese medical system is provided through universal healthcare. The first form of public healthcare in Japan began in 1927 with an employee health plan. By 1961, it had evolved into a system of universal coverage available to locals, foreigners, and expats.
Related: Health Insurance in Japan
Japanese citizens have a longer life expectancy than anyone else, possibly because of the country’s excellent healthcare service. The system puts a high priority on preventative care instead of reactive care, seen in other healthcare systems. The Japanese Healthcare System also offers free screening tests for certain illnesses and superb prenatal programs.
However, despite the high emphasis on preventive care, Japanese physicians and nurses are not required to go through license renewals. They do not even have to participate in continuing education.
Japanese citizens do not usually have one dedicated family physician as you might find in Canada or the United States. There are comparatively very few general practitioners since most physicians have a sub-specialty. You go directly to the specialist you need for your illness.
Many other countries have an urban-rural divide wherein physicians flock to the cities and prefer working in urban areas over rural locations. But in Japan, the opposite can be observed.
There is an uneven distribution of physicians benefiting rural areas over urban ones. Physicians prefer being assigned to rural areas, saying they experience a higher quality of life outside of metropolitan areas and a less stressful work environment.
The Japanese medical system is provided through universal healthcare. The first form of public healthcare in Japan began in 1927 with an employee health plan. By 1961, it had evolved into a system of universal coverage available to locals, foreigners, and expats.
Related: Health Insurance in Japan
Costs and Fees in the Japanese Healthcare System
Japan’s public healthcare system is known as SHI or Social Health Insurance. SHI applies to everyone who is employed full-time with a medium or large company. Approximately 5% is deducted from salaries to pay for SHI, and employers match this cost.
Everyone who does not qualify under SHI receives cover through the Japan National Health Insurance (NHI) plan. Those eligible for the NHI plan are self-employed individuals such as expats and digital nomads. It also extends to those who work for small businesses and unemployed people. The amount you pay into the NHI is based on your income.
In general, the government pays for 70% of healthcare costs associated with medical appointments, hospital visits, and even prescriptions. Patients pay for the remaining 30% of the healthcare costs, which is better than paying for the total cost of medical service. However, this ratio may change in favor of the patient, depending on their income level.
The cost of medical appointments and hospital visits is determined by a government committee that includes physicians among its members. Every two years, fees are adjusted based on the committee’s recommendations. This allows the government to respond appropriately to changes in the economy to ensure healthcare remains affordable.
Japan’s 47 regions are responsible for implementing the rules, regulations, and fees schedule. They also have the flexibility to establish their local budget to reflect and respond to regional health concerns.
The regional municipalities also administer “nursing care.” This service costs an additional 2% contribution required of citizens over 40. This cost covers the expenses associated with long-term care and nursing homes.
Adjusting the schedule fee also prevents physician fraud and over-recommending certain services to claim the associated fee. If the committee determines that particular tests are being over-recommended, it will drop the cost of that test to make it less lucrative to the prescribing physician.
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Eligibility and Administration for Healthcare in Japan
If you are employed full-time by a medium or large-sized business and are thus eligible for coverage through SHI, you will find the process of accessing healthcare in Japan relatively easy. Employers take care of the paperwork for you too!
If you are eligible for NHI, for instance, as an expat who has just arrived and is waiting the mandated one year to enroll in SHI, you may find the process more tedious to complete. You have to visit your regional NHI office to take care of the paperwork. If you move, you will have to re-register with your new nearest regional office.
Healthcare Options for Expats and Foreigners in Japan
Health insurance in Japan for foreigners with residence cards and are staying in the country for more than three months can be accessed through the NHI. Those who work with a larger company can apply for the SHI.
However, expats who are waiting for their NHI papers to be processed are in limbo. They would have no coverage unless they brought their private international health insurance to Japan. Japan’s health insurance system does not cover tourists and other short-term travelers to the country. They should have their own Japan travel insurance coverage for medical emergencies.
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The Differences Between Private and Public Care
In Japan, for-profit organizations are not permitted to run hospitals and clinics. By law, Japanese hospitals are considered non-profit. Physicians make governing and administrative decisions in hospitals. Clinics must also be owned and operated by physicians. The for-profit healthcare industry is primarily focused on elective and cosmetic procedures.
Approximately 90% of eligible citizens and residents are enrolled in the public healthcare system. The majority of people also have secondary private health insurance in Japan. In general, private insurance plays a supplementary role, offering additional life and critical illness benefits. It also offsets the cost of other procedures such as orthodontics. The 30% cost which the patients have to shoulder during medical visits can also be covered by private carriers.
Pros and Cons of the Japanese Healthcare System
While physical healthcare standards are superb, Japan is not as progressive in terms of mental healthcare. Practices like isolation or restraints, long discounted as primary treatment tools in other countries, are relatively common in Japan. Accessing mental health treatment remains stigmatized, particularly among women.
Japan also struggles with hospital wait times. The majority of the population does not have a family physician. Instead, they visit specialists directly whenever they feel sick. But patients are unsure where to turn when they suffer from multiple symptoms. Even if their discomfort is minor, they turn to hospitals, where numerous specialists work. As such, doctors and nurses tend to non-urgent cases in hospital emergency rooms.
The issue of wait times and capacity is a serious one. There have been tragic cases of patients who needed urgent care but were turned away by multiple hospitals before finally succumbing to their ailments. Sadly, the issue of wait times and hospital capacity will not change any time soon.
Japanese citizens have the longest life expectancy globally, and the country’s healthcare system is constantly looking at ways to serve its large and aging population better. By 2050, 40% of the Japanese people will be over 65 years old. Thus, the government must establish a better healthcare system.
Language barriers are a significant problem for patients who are non-native Japanese speakers. While many hospitals often have English language staff, this is not always the case in Japan. Many expats who have lived in other countries assume they will face language barriers in rural areas but are unprepared for unilingual urban staff.
Embassies, consulates, and other expats can recommend multilingual facilities. Your employer or travel agent can also recommend local services in English. University-based hospitals and clinics usually have English-speaking staff. However, hiring an interpreter is an intelligent move for appointments.
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Read More: Health Insurance in Japan
