Be specific, wait time is rationing.

Actually, some wait time is not rationing, and rationing as you find even in the US isn’t happening in Japan.

Go to any medical venue in the United States, and unless you are expiring on the spot, there is no guarantee you’ll get immediate service, even if you have a great insurance policy.

You don’t have horror stories like you probably have heard in some European countries where someone waits weeks or months for some common procedure. That doesn’t happen.

I had several procedures over the course of six years, including one complex course of action that required various (expensive in the US) scans and tests, and subsequent treatment over the course of nine months. I also became a parent while living in Japan and dealt with childhood related medical issues for my child.

The emergency rooms at Japanese hospitals aren’t that much different than in the US (though most were far more modern than the ones I have been in in the USA). You wait, get called by a nurse, taken to a room and examined by a doctor. He’ll follow through just like in the USA.

Here are a few differences I found:

  • You are not rushed out of the hospital. Women who have babies typically stay in the hospital for two weeks.
  • When you are discharged, they typically want you back in to make sure there aren’t complications.
  • You don’t have padded expenses, like hotel-like single rooms being the norm. You typically share a room with three other people. You don’t see a bunch of dubious bills that pad itemized expenses. That sort of crap will get the Japanese feds investigating the hospital.
  • You have a mix of western style medicine and modern eastern medicine. The eastern medicine isn’t funky prayers and spiderwebs, but an expanded variety of pharma products you are unlikely to get in the west.
  • Of the medicine you do take, they do not over medicate. You don’t have addicts walking out of the hospital.

It works for a variety of reasons.

The first is that costs are controlled. A procedure can be charged as X. Drugs cost Y. And yet, for some reason, doctors still make an excellent living there. Big pharma is happy to sell in Japan too. They even have a supplementary insurance industry as well.

Insurance doesn’t cover cosmetic stuff. That’s why you see lots of young Japanese people with healthy, but not perfectly straight teeth (like Americans love). You can still get it, but you better have supplementary insurance or be willing to pay out of pocket. Even then, procedures cost X.

You don’t have massive over-medication. They will determine what is appropriate for pain control, with a little leeway if you are particularly wimpy.

There isn’t egregious earnings. Doctors can have their own practices if they want, but what they charge has limits. Doctors in hospitals are team players and don’t have the super star model like in the USA. They are still among the highest paid professionals, but more importantly to the Japanese, they are among the most respected.

And that leads to the legal side of it. You don’t have absurd lawsuits. Doctors make mistakes, sure. There are processes to deal with that. While you can’t ‘fix’ death, if someone is victimized by a doctor, they aren’t at risk of going bankrupt paying their medical bills.

It works pretty well in Japan because they don’t deal with the absurdities that are a part of the three headed monster of US health care.

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