The Japanese Way: Health Insurance System Offers Cheaper Medical Care

NY1 Health Reporter Erin Billups traveled to Japan to file this special series on Japanese nutrition and healthcare.

By: Erin Billups Text size: +-

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Reporting from Japan for this NY1 series on Japanese nutrition and healthcare, Health Reporter Erin Billups filed a fourth installment taking a look at how Japan's much older healthcare system is working for its citizens.

All Japanese citizens are legally guaranteed health coverage at anytime, anyplace, by any doctor, without referral. The rich and poor have access to the same doctors.

'There is no way to negotiate the cost of medical care at each hospital, but everything is fixed, price is fixed,' said Dr. Yoshihiro Ishikawa, professor and chair at Yokohama City University School of Medicine.

There's essentially one health insurance system that is administered either through your local government or a co-op your employer buys into, like the one Hiroyuki Shoji's production company is a part of.

'Under the guidelines of the local government, any co-op you choose, the cost remains the same,' said Hiroyuki Shoji, president of Gonshiro Garp Production Company, through a translator.

Shoji recently underwent an appendix removal with a five-day stay in the hospital. The total cost was $4,400.

He's required to pay 30 percent of the cost out of pocket, just over $1,300.

In the U.S. that same procedure would cost an average of $14,000, and that's not including the hospital stay.

'Cost, we don't need do worry about,' said Shoji.

The Fujioka sisters run their own bakery. Because they're self-employed, they're required to get their health insurance directly from the government at the cost of about $100 a month.

'Thirty percent is my co-pay, the out of pocket cost. We do not have any particular illness, so mostly when we go to dentist we use national health card,' said Megumi Fujioka, co-owner of Konohana Bakery.

Have you ever had worry or concern not having healthcare insurance?

'As for me, no I don't,' said Fujioka.

But even with greater access than what you would find in the U.S., health care experts like Dr. Ishikawa admit greater access comes with its own problems, long wait times at doctors' offices, and good but not the best, quality of care.

'No any other place on this Earth on the planet, you can get better medical care I mean compared with the United States, that's for sure,' said Ishikawa.

While the system works well for them now, there is concern about whether it is sustainable for future generations.