Family Doctor over Cost
My experience suggests a holistic clinician in local clinic
Being squashed out of the operation room by the deodorant smell for half a day in the floor of cement walls, a man of corporate consultancy lie almost dead on the narrow and chilly steel bed. The solid posture stays on until a nurse come to knock the door at night. When the clock hits 7:00 pm, a sound of preparing something reaches the ears though undecorated hall. The eyes are directed to a bowl of cold soup and a set dish on rectangle plastic plate with chopsticks. It never comes to the knowledge of what is coming until being served. City dwellers are used to the urban yummy taste of international selection in Tokyo. But the vegetable on the plate is, by any standard, terribly cooked on hospital kitchen. It is by far the worst food one could ever get in Tokyo. If anybody rates the hospital with food service, any hospitals in Tokyo will rank below the average. Nobody wants to go to hospital to eat. And yet, the situation of health care in Japan is not bad in other dimensions such as cost and quality. The United States faces major challenges of high price hospitals bills as a story of the Economist unfolds the reality on the publication date of June 29th, 2019. In America, even the rich households are deeply concerned about the high level of health care bills, a British newspaper laments. My brief story of Medium attempts to sketch the implications of medical service in Tokyo on a basis my personal experiences in metropolitan hospitals in Tokyo. This story is a response to the question; what ordinary individuals can do with the health care in Japan? The best scheme is to acquaint with a good home doctor from public medical center.
A story of the Economist illustrates a recent executive decision of transparent pricing to bring down the health care cost. The executive order to require the hospitals to disclose the negotiated price with insurance companies is expected to spur the competition. Currently, given a choice between a five-year freeze of medical burden and a 10% raise in income, 61% of Americans prefer the former choice. One in eight borrowed some form of money to pay for the sicknesses. Surprisingly even among the households with the income of $180,000 a year or more, a third is concerned about the burden of health care to put the households in bankruptcy.
In one metropolitan area, the price difference from the bottom to the top saw 39-fold spread in a given service from the data of three major insurance companies. Considering that some outlier prices are excluded from the survey, and yet the difference number is too farther apart to confirm the wide discrepancy of medical providers in the United States. Unless it is urgent such as a broken leg or a heart attack, people will briskly use the executive order to price-shop, looking for alternate choice to find a cheaper care from lower-price hospitals.
But buyers of health care have fewer choices of medical provision than ever before. A recent boom of consolidation in the hospital industry pushed itself into a highly concentrated market. Little bargaining is available for insured people with limited access to the health care. To make things even complicated, the quality of the medical service is not entirely linked with the price difference of the hospital bills, Ms. Lynn Quincy of Altarum, a health-care consultancy says.
The Japanese hospitals in Tokyo are typically rated high in terms of low cost and quality service. But popular ones are extremely packed with people from all over the country. Therefore, patients wait for the waiting room half a day to receive a very slow cure from the professionals. It takes a month to see a doctor in a very popular hospital such as Toranomon Hospital in downtown Tokyo. Big hospitals require a reference letter from a home doctor of the local clinic in Japan. The universal healthcare system gives all residents the chance to see any doctors in any clinic, and so the first administrative action is to see a doctor near your home. When a doctor see you and says that the disease cannot be treated at local clinic, she will write a letter of reference with her medical network, usually from the same medical institution or the association of her fields. Some meet other doctors in the similar field on weekends to discuss the advanced medical practice, although to my knowledge, the meeting location can be anywhere, including a world-class golf course in the local country club such as Onjuku near the coast of the Pacific Ocean. Evidence suggests that most doctors unanimously drive BMW as a show-off to the golf course.
The full-time employment pushed me around my schedule to the extended hours of working from 9:00 am to 9:00 pm on the pressure-pack job at consultancy and IT firms in Tokyo. For a long decade in 2000, my family collected twenty-one business-card sized plastics, which led my household to buy a card holder available at 100 coin shop near my home. With itchy eyes, the Japanese go to the clinic. Doctors welcome patients with plum tree allergy in the spring. Dental clinic is usually overcrowded with regular customers, not patient, to clean their teeth every three months, which avoids a rise of care cost due to the regulation that within three months, not additional charge incur from visit. Otherwise the doctor will charge more as if the patient sees him for the first time.
To suppress medical cost, receive a best quality, and hopefully speedy service, my experience suggests that the readers acquaint a good home doctor from major public medical academy in Tokyo. The number of such doctor is limited since each prefecture on average has only one public medical institution. In the Tokyo metropolitan area, it is probably better to find one from University of Tokyo, Chiba University, or Tsukuba University. Usually a clinic exhibits a doctorate diploma with a wooden frame on the wall. Some clinic boasts the certificate with a photo with smile at reception desk in the front door.
No local clinic has beds to accommodate patients overnight before the surgery. The smell is less strong in local clinic. But whenever possible, it is suggested that you don’t see a home doctor except a holistic care taker who will escalate the emergency to the remote hospital. Even with a tasty five-star full-course French wine and escargot followed by an elegant smell of perfumes, it is my wish that you don’t want to visit a hospital as often as I did. Is this all? Not quite: living in a big city of Tokyo, your writer warmly prays that you go to find a good family doctor, often described as general practitioner as a reliable gatekeeper, from public medical center. Spending a lot of time in hospitals with deodorant smell and low standard meal is not an idea of having a good time. Without any doubt, that idea is something you don’t want to sleep on.