Monthly Archives: September 2014

Week 3: 病院 (Hospitals)

http://japanhealthinfo.com/japanese-healthcare-services/japanese-hospitals/

Hospitals are an important part of the Japanese healthcare system, and this article from Japan Health Info, a site dedicated to explaining the Japanese health system to expatriates, is fully detailed in its description of how hospitals are usually run in the country. As found in the NPR article from Week 1, hospital stays can be long, but, occasionally, going to the hospital might be even more convenient than going to a clinic to get treatment. First consultations are usually made in the morning, and appointments are not required, while afternoon appointments are usually only for returning patients. Unless a person has an emergency, they cannot use the hospital on the weekends or public holidays, and even then, there is a chance that the hospital might not accept the patient. Japan’s health insurance usually pays 70% of bills, while 30% is left to the patient. On top of that, patients without doctors’ referrals are often charged fees (usually ¥2,000-5,000). Wait times are generally long enough to require number cards for both the consultation itself and for payment, the latter of which is cash-only much of the time.

This week’s vocabulary:

救急車 (きゅうきゅうしゃ): ambulance
ぎゃー!ひどい義理で、血液が見た!救急車を呼んでくれ!
Ahh! I have bad diarrhea, and I saw blood! Call an ambulance!

内科医 (ないかい): physician (internal medicine)
いつもフラフラですか? 心臓の大切なことですから、内科医に行けばいいの?
Are you always feeling tired/groggy? For the sake of your heart, you should probably see a physician about that.

医療費 (いりょうひ): medical bill/expenses
田中さんは高血圧のトリートメントが高いでしょう。なぜ医療費を早く払えますか?
I think Mr. Tanaka’s high blood pressure treatment is expensive. How come he is able to pay his medical bills so quickly?

待合室 (まちあいしつ): waiting room
1時間後: お待たせしました。待ち合わせのために、待合室をお出し下さい。
One hour later: I am sorry to have kept you waiting. Please leave the waiting room for your appointment.

患者 (かんじゃ): patient
面白い患者に会いました。かれは老人で、本当に健康的の事をいつも忘れてしまいましたが、これからも死にませんでした。
I met an interesting patient. He was an old man, and would always forget about healthy things, but has not died even now.

REFLECTION
In spite of Japan’s high standard of care and a healthcare system that (in theory) provides good care for all citizens, its hospitals are another matter. They do not seem to compare favorably to those in a Western countries. The hours might seem archaic, fees are high, payment must be in cash only most of the time, and there are certainly long stays. Although these and other areas might be particularly unfavorable, there is, actually, also much to like about the system. The fact that Japan’s health insurance pays for the bulk of the cost would also be unthinkable in the US, and in Japan, specialists can usually be seen directly, rather than, say, after a wellness check. The inconveniences do seem to factor highly into public perception of the system, however, with a major recent story of a man dying after being rejected 36 times from 25 different hospitals gaining particular notoriety. Indeed, thousands of hospital patients have been rejected at least three times from hospital treatment. That is certainly a concerning low point in an otherwise cheap and decent healthcare system, at least thus far.

Other sources on the subject:
http://zoomingjapan.com/life-in-japan/hospitals-and-medical-care/
http://newsfeed.time.com/2013/03/06/75-year-old-japanese-man-dies-after-hospitals-reject-him-36-times/

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Week 2: 漢方薬 (Chinese Herbal Medicine)

http://www.kracie.co.jp/eng/business/ph_kampo.html

Although Japan uses Westernized medicine like most world powers of its size, one particular method of treatment distinguishes them from the rest: Chinese herbal medicine, or 漢方 (かんぽう)。This website from the Japanese conglomerate Kracie, one of the leaders in the Japanese kampō industry, discusses many of the basic aspects of how it works. The word 漢方 is a portmanteau of 漢, or the Han Chinese, who introduced the Japanese to this kind of medicine in the fifth/sixth centuries, and 方, used as “method” in this case, because Western medicine was called 蘭方 (らんぽう), literally “Dutch medicine” thanks to Japan’s colonial history with that country.
Kampō medicines are usually made with natural herbs that are infused in boiling water. Pharmaceutical companies such as Kracie do this in laboratories and compound the extracts into usable forms. Japan is the only country where doctors can legally prescribe kampō alongside, or as an alternative to, Western medicine, and Japan’s health insurance covers both types. The approach to kampō is more holistic in nature, focusing on the whole body and mind while alleviating symptoms.

This week’s vocabulary:
薬局 (やっきょく) pharmacy
ひどい風邪があります。薬局へ行って、風邪薬を買ったらどうですか?
I’ve got a bad cold. How about I go to the pharmacy and get some cold medicine?
生薬 (しょうやく) herbal medicine
あの漢方薬は生薬の一つです。
That kampō medicine is one kind of herbal medicine.
医大 (いだい) medical school
彼はいい医大に行きたいけど、成績が悪くなりましたね。しかし、東大の生徒だから…
He wants to go to a good medical school, but his grades have gotten worse. But he’s a student at Tokyo U…
がん cancer
福島県の人口はがんの同数が増えましたでしょう。
The incidence of cancer in Fukushima’s population has increased, hasn’t it?
QOL – キューオーエル quality of life
QOLを高ける方は、毎日健康的の事をしなければいけない。
People who want to increase their quality of life must do healthy things every day.

REFLECTION
Perhaps the strong focus on both Western medicine and Eastern medicine in Japan might be one reason why the Japanese live so long. Even in diseases as complex as cancer and HIV, the use of kampō medicines, either alone or, more commonly, in tandem with drugs developed under the Western tradition, is fairly common in Japan. Contrast this with the US, which certainly has people who use supplements and alternative medicine. The FDA, however, does not regulate what they call “supplements” (that is, herbal medicines and vitamins) on the same level as other drugs, and most insurance companies do not cover them, either. It’s certainly an interesting dichotomy, to say the least, and I wonder what would happen if Western societies considered to use Eastern medicines, like kampō, in their own health regimes. Maybe they might be effective with a low risk of side effects, or maybe they don’t do much of anything. Either way, kampō still has its place in Japan not just as medical treatment, but as another Chinese cultural product adapted and ingrained into Japanese culture.

Other sources on the subject:

http://www.itmonline.org/arts/kampo.htm
http://www.keio-kampo.jp/vc/index.html

Week 1: 健康のシステム (The Health System)

http://www.npr.org/templates/story/story.php?storyId=89626309

This article/piece from NPR discusses several major key points of the Japanese healthcare system, giving some reasons why it is such a successful one as far as world powers are concerned. Health insurance is mandatory, and the government pays it for you if you are poor, but most hospitals and almost all doctor’s offices are privately owned and operated. The Japanese Health Ministry, on the other hand, regulates fixed prices on procedures and medications in a way similar to that of the National Health Service in Britain. Insurers cannot deny claims. In spite of this, doctors are not paid well in Japan compared to other countries, hospital stays are long, and, surprisingly, hospitals are in a financial crisis.

This week’s vocabulary:

健康保険 (けんこうほけん): health insurance
健康保険があれば、どれでもの事故でも大丈夫です。
If you have health insurance, you’ll be fine in any sort of accident.

保険金 (ほけんきん): insurance money
かれは保険金を請求したいですけど、あの事故で大怪我をしなかったでしょうか?
He wants to claim insurance money, but he didn’t suffer any serious injuries in that accident, right?

退院 (たいいん): discharged from the hospital
おじいさんが最近退院しましたから、もっと強くなったね。
My grandfather was recently discharged from the hospital, and seems to have become even stronger than before.

検査 (けんさ): examination/scan (such as an MRI or PET scan)
肝臓がんの検査はいんせいでした。よかったですね!
The liver cancer test came back negative. That’s a relief!

手術 (しゅじゅつ): operation/procedure
手術の準備のために、24時間まで少しも飲むことが全然いけません。
To prepare for the surgery, you absolutely mustn’t drink anything for the next 24 hours.

REFLECTION
I was surprised to see that the Japanese healthcare system serves as a sort of opposite to American healthcare. The Japanese system seems to place most of its expenditures toward affordable healthcare for all instead of only some, and the insurance companies do not serve as enforcers, unlike in the American system, but rather as beneficiaries in addition to the government. For the record, $10-a-night hospital stays would be unthinkable in the US, but then again, so would two-week ones unless someone is severely ill. This sort of dichotomy is especially interesting coming from a country known for hard-line stances on work and school attendance. Although the Japanese, as in other societies, know that healthcare is not a universal good (even with the Health Ministry’s fixed pricing schemes, some drugs are still extremely expensive), they do manage to keep it at least somewhat free and beneficial. Although imperfect, and possibly not sustainable in the near future because of an aging population, it still serves as a good example of an effective universal healthcare system.

Other sources on the subject:
http://japanhealthinfo.com/japanese-healthcare-services/japanese-health-insurance/
http://www.economist.com/node/21528660
http://www.washingtonpost.com/wp-dyn/content/article/2009/09/06/AR2009090601630.html

始めまして

My name is Will, and I’m a sophomore at Austin College currently living in the Japanese House. As someone who has always had a passion for health, medicine and the like, as well as one for East Asian languages and cultures, I have always wondered why Japan has had such a high life expectancy. In particular, I want to see how the Japanese as a society use healthcare in their everyday lives. What I do know is that the healthcare system is universal (in other words, mandatory insurance), there is much reliance on self-medication, and certain diseases, such as obesity and mental illness, have a stigma attached to it that impacts their treatment in this society.

Thus, I have decided to use this blog as a portfolio dedicated to this extended research project. I hope you enjoy my look at Japan’s healthcare system, as well as how the Japanese live healthily.