Doctor Doctor! (病院へ行こう!)

“Hello, my name is Ben and I’m an asthmatic.”

(Group voice) “Hello Ben.”

“Well, I’ve been without a puff of my meds for going on two weeks now…”

(Collective nods and murmurs of acknowledgement)

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Yesterday was spent on a near all-day medical adventure that culminated with the filling of my very first Japanese drug prescription.

I arrived at the Ehime University Hospital at 9:30 in the morning. I began by filling out a registration form with my name and contact information. In Japan, the patient must also circle the specific medical area for which they are seeking treatment that day. There are separate symptom cards for internal medicine and for everything else (such as, eyes, pediatrics, etc.).

I selected the long string of kanji that referred to the lungs and respiratory system on the internal medicine card. Check-in was as easy as handing the receptionist my info form and national health insurance card. I was then instructed to take a seat and wait.

During your first hospital visit, you are given a unique magnetized data card that stores your name and contact information. Thus, repeat visits simply require you to scan your card at one of many automated check-in machines. The machine accesses your file and spits out a slip, telling you when and where your appointment will be held.

I was instructed to go to the internal medicine wing and sit in the “waiting room.” The area wasn’t so much a traditional “room” as it was a series of chairs and benches lined up in the hallway. I must admit that it was a little odd to see so many people of all different shapes, sizes, and ages queued up in such a small space. The entire hospital seemed flooded with outpatients. My boss later told me that hospitals in Japan usually get crowded on Mondays and after holidays.

When it was my turn to be seen, my name was called and I was brought into exam room #14 and greeted by Dr. Chika Sato. She was very friendly and had read over the note provided by my American asthma doctor explaining my symptoms and current medications. She didn’t understand one of the English words that my doctor had written in his description. Turns out, neither did I. Humorously, we both laughed and took out our electronic dictionaries in order to gain a better understanding of the vocabulary word, me fishing around in English, her in Japanese.

She asked me some generalized questions about my asthma, listened to my breathing with a stethoscope and conducted a peak flow reading. It was just like a trip to the asthma doctor back home, albeit entirely in Japanese. Based on my experience, going to the doctor in Japan without a working understanding of the language would prove to be very difficult, as no one generally speaks English. If you must go and are not fluent conversing in Japanese, it might be best to bring along someone to act as an interpreter.

Dr. Sato said my saturation was a little low and told me to come back in a month for a follow-up visit. With that, she wrote me my prescriptions, smiled, and said I could go.

I made my way to the payment counter and subsequently experienced the biggest sticker shock of my life. I paid a whopping $9.52 for my entire checkup at the hospital. Since Japanese national health care pays for 70% of any medical care or prescriptions, this means that the grand total for the visit was only a little over 30 bucks. In America, this exact same asthma checkup at my local clinic would have run me into the hundreds of dollars, even with insurance coverage. I guess this explains the general lack of Ferrari driving dermatologists cruising around the streets of Shikoku.

The hospital automatically faxes your prescriptions to a pharmacy of your choice for easy pickup. I had mine sent to the pharmacy conveniently located across the street. All that was left was to stroll over and pick up my medication.

My current asthma medicine is the Advair Diskus (500/50 strength) manufactured by Glaxo Smith Kline. It is a combination of the two drugs Serevent and Flovent that I used to take via separate inhalers as a child.

Prior to leaving for Japan, I visited my neighborhood pharmacy to fill a prescription of Advair to take with me. Since I was without medical insurance, the pharmacist told me that the price for a single inhaler with a one-month supply of medication would be over $300. After some button pressing on the computer, he was able to bring the price down to somewhere in the ballpark of $280.

The price was simply too high for me to pay. I walked out of the pharmacy without my medication and left for Japan a few days later. I had no choice. In this case, I could only feel genuinely grateful that I didn’t have to take the medication everyday in order to live.

Yesterday I purchased an Advair Diskus asthma inhaler in Japan. The dosage and manufacturer are identical. The only difference is literally that the Japanese product has kanji characters on the label. I paid $26.14 for a one month supply. I couldn’t stop shaking my head as I paid. I was truly in disbelief.

I brought up the subject with my boss. She said that the $9.52 I paid for my hospital check-up was actually pretty high by Japanese standards. I genuinely burst out laughing. According to her, even cancer drugs typically run less than $100 per prescription. $100 for medicine is so astronomically high by Japanese standards that the hospital will often conference and give you advance warning if it is likely you will have to pay that much.

In summary, I am a foreigner living in Japan. Despite being a foreigner, the government has granted me the exact same universal health care coverage afforded to citizens. Yesterday I was able to receive a hospital checkup and fill my prescription for well under $40 USD.

To all those who still oppose the idea of universal health care coverage for all Americans, all I can say is,

It’s time for America to cut the bullshit and get on board!

B.E.W.