Japanese doctors sorry to make uninsured pay $80 for check-up and medicine

[samsmart]

Daily Kos: State of the Nation

Yesterday morning, I woke up feeling like someone punched me in the nose. As I was sober the night before, I am 100% sure this is not what actually happened. Understandably, this worried me. So I did what every uninsured American probably does when they feel unwell: checked WebMD's symptom checker. Everything from leukemia to staph to sinus infections came up. I decided to chug some echinacea tea and sleep it off, hoping I'd be better the next day.

The next day, my entire face was swollen and painful, and I was blowing my nose every 30 seconds. ****. After another web search found someone suggesting whatever I had could spread to the brain if unchecked, I resigned myself to getting checked out. I still had my rent money (around 600 in USD) for the month in my wallet, and my landlady is nice enough that I could probably get an extension, I thought. If it was just sniffles I'd have stayed home, but my face already didn't even LOOK like me. I have to work on live TV next week, and it's not an all-caucasian remake of Rudolph, so I bit the bullet.

I found a hospital nearby that was still open in the evening (many places here, after mid-afternoon, you're screwed) and said I needed to be checked out, but I did not have insurance. The receptionist seemed a little concerned, but checked with other staff and then told me that if I paid in full, and brought photo ID with my name and address included, I could see the doctor. I asked if I needed an appointment.

"No, not at all," the receptionist said. "We're open until 7pm, just come in at any time. We'll be waiting for you." On a Friday night, in the middle of the 2nd biggest city in Japan, in the midst of a swine flu epidemic that is just now starting to calm down.

I came in, explained that I was the foreigner on the phone earlier, and they gave me a sheet to fill in, standard medical background stuff and a place to write down what was wrong that caused you to seek treatment. I filled it in, and after a bit of waiting was brought in to see the doctor, apparently the main guy since his last name is the one on the sign.

We talked a bit about my symptoms, when they started. He checked my throat and nose, asked about my mucus consistency, then showed me on a computer screen display of the throat/sinuses where and what was inflamed, and diagnosed it as an acute sinus infection that apparently is going around quite a bit right now. He promptly wrote me a prescription for 3 days worth of pills and told me to come back if there was no improvement. I thanked him and left.

I went back to the reception area, they gave me a card for the hospital, and 2 papers: 1 was the prescription sheet, one was my bill. Keep in mind this is the full price, as I am not insured (a Japanese under the national insurance would pay 1/3 of this).

3,900 yen. As of writing this, that's about $43. I paid them, said thank you, and left. The pharmacy was directly next door (for prescriptions in Japan, you either get them inside the hospital, or usually a place very close to it. OTC drugs are sold at regular drug stores). I headed in, gave them the paper, and they handed me another form to fill in. One of the staff very kindly walked me through it to make sure I understood everything. Incidentally, one of the questions was "do you have an interest in generic drugs?" I checked the "hell yes" box.

Almost the moment I handed back the form, the other pharmacist came out and apologized for making me wait. She brought out 3 different drugs　(anti-biotic, an expectorant, and something for stomach problems) - each 3 days' worth. She explained when to take them and their use, then stuck them in envelopes in a plastic bag, along with a free handwarmer and a printout with pictures, descriptions, and use instructions of each medication. Then, she handed me the bill, apologizing for it being so expensive because I was uninsured.

3,100 yen. Or if you prefer, 34 dollars. In all, this trip to the doctor cost me less than $80 and took less than an hour (I arrived at the clinic at 6:15, I left the pharmacist drugs in hand at 7:05).

This is not a perfect country by any means. There are many things that I feel we do better in America. I have heard of (and seen) some terrible medical facilities here. But when I get 3 prescriptions filled in 5 minutes and they are SORRY they have to charge me a whopping 30 bucks for it, and I see people back home paying many times that, I have to wonder how we're managing to do things just this wrong.

 

[lizzie]

That is exactly my own experience here in the States when one is willing to pay a small amount out of pocket for a simple service.
A couple of years ago, I had a minor medical problem that needed attention (antibiotics). I have medical insurance through my employer, but I rarely see a doctor, and I don't have a general care practitioner. If I had wanted to be seen, I could easily have gone to the ER where I work. That would have entailed waiting for probably a couple of hours, filling out insurance forms, paying part of the deductible (which has not been even an issue since I don't generally go to doctors anyway), and an ER visit probably would have cost at least 500 dollars.
I decided to go to a minor emergency clinic about 6 miles from my home. I walked in, filled out a form, paid my fee (70 dollars), was sent back to the office, was seen within 5 minutes, was given a prescription, and was out the door in 15 minutes. I went next door and filled my antibiotic prescription for 4 dollars (no insurance coverage required).
So, a 15 minute office visit for 70 dollars, a 4 dollar antibiotic, and back home. No muss, no fuss. Well worth the money and time savings.

Imo, doctors should not feel bad for expecting people to pay for a simple straightforward service. Doing business in that manner would help contain costs and probably improve quality.