My Japanese Carolina Experience


So here I am, up well past my bedtime strolling through the internet when a friend of mine points me to this example of “Single Payer Health Care”.

It is the story of a man in Japan who is describing his experience with the Japanese style of health care; Single Payer to be specific.  In it, our hero is suffering from strep throat and is taking the time to describe to us how treatment went in Japan.  His story begins with a  fever and a sore throat and … well, I’ll let him take it from there:

I walked into the hospital and was seen by a bi-lingual physician almost immediately (maybe a 5 minute wait after showing my National Health Care Card)

Now, the sticking point with this whole Universal Health Care, Single Payer Health Care or Socialized Medicine is the concept of rationing.  Ya see, we have far far fewer medical practitioners than we have demand for free medical care.  Serious, imagine if any medical procedure or treatment were free, do you think the system would be overwhelmed or underwhelmed?  Right, me too.  So, we do what we do in all markets [well almomst all markets.  In most markets, we are much freer than in the medical care market, but that is for another post] and that is ration by cost.  That is, we let people determine, based on how much they are willing to pay, when they will seek medical care.  We ration the available care by allowing the consumer the choice.

So anyway, brother was seen almost immeadiately.  Well, maybe a 5 minute wait after showing his Nation Health Care Card.  While perhaps only a minor point, I would like to know how long it took him to show his card AFTER walking the door fot he facility.  Anyway, the drama unfolds….

examined my throat, asked when it had began and took my temperature. He decided that a throat culture was necessary and it was sent to the lab. In the meantime he prescribed a painkiller and antibiotic …..

Now, everything seems cool so far.  Doc, bi-lingual Doc at that, correctly concludes that a throat culture is required.  Good man.  AND we get drugs prescribed too.  So far, so good.

…and asked me to come back in 2 days.

Yowza!  And here is the rub.  THIS is the rationing.  THIS is what HAS to take place.  Because the demand for care out strips the supply of care, we HAVE to ration it.  And when we let people think that we are providing FREE care, we have to ration it by …… wait for it [pardon the pun] TIME.

When I went back to the hospital they informed me that I had a severe case of Strep throat and I needed a much stronger antibiotic, which was prescribed immediately.

So, the SECOND trip to the hospital found the cause of the trouble and they prescribed the correct drug to treat.  Excellent.  Though I should point out the catch phrase “prescribed immediately.   As if.  Actually, it was prescribed immeadiately AFTER a 48 hour [and five minute] wait.  So, how much did this most excellent of all services cost our protagonist?  Why, it’s FREE you say.  He doesn’t have to pay a thing!  Right?  Wrong!

Turns out our hero has to actually cough up [punny again, I know] the small small fee of ….. $385 a MONTH!  Let’s see, 385 bucks a month is $4, 620 a year.  A YEAR.  Now, the story doesn’t tell us if this is before or after taxes, so let’s just pretend that it ‘s before.  As in, just like a normal tax.  This means, that unless our hero makes more than $46k a year, he is paying more than 10% for medical care.  Oh yeah, he also has to pay a 30% co-pay.  Yeah……not so free, huh?  Oh, and his wife is paying too!  So, let’s not pretend that this is free or without costs.  This is, quite simply, mandatory health insurance.

Further, as I kept reading the post I found a picture of what looks to be our author.  He is the one on the right.  Looking at the pic, I am guessing the man is younger than, oh, say, 30.  He is younger than 30.  Now, when I was younger than 30, AND when I am queried by folks that I come across who ask me about this sort of thing, I tell them at age 30 all you need is catastrophe insurance.  Why?  Because at ages younger than 30, you DON’T GO TO THE DOCTOR!090523_141001

In any event, lemme tell you about MY strep throat story in the good ol’ US of A.

One day I woke up with a very soar throat and mild fever, it persisted and got worse the following day.  I decided to call my primary care physician who said that she could meet me that afternoon.  I decided to accept her offer and made an appoint at DUKE MEDICAL CARE!  However, after having some coffee and getting ready to go to the office, I decided that I wanted to stop at the grocery store to buy some fruit for the day.  As I left the grocery I noticed the pharmacy across the street.  I remembered that they have a clinic.  I stopped.  I also had about a 5 minute wait.  The Doc took my temp and swabbed my throat.  She said that I would need to have the sample tested; I said I would wait.  I asked how long, she said 10 minutes.  I browsed the store, bought some birthday cards, bought some supplies for my home office and even a present for each of my kids.  By the time I was done shopping, the results were in; strep.  The correct medicine was presented to me with zero wait and I was on my way.

I called DUKE MEDICINE to cancel and my doc said “That was good thinking.”

Total cost?  Zero dollars.  Of course I do have to pay about the same as Mr. Progressive Tokyo here, but, you know, that covers me, my wife and two young children.

Funny.  Capitalsim and the free market.

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2 comments
  1. Pino:

    You are presenting the $385 a month cost in Japan but not describing the costs here. Insurance premiums here run about the same amount. To give a personal example, I’m a state employee, the monthly state contribution for my health insurance for the coming year is $377.22 per month ( http://www.shpnc.org/pdf/hbr-ae-non-beacon-retirees-schools-kit.pdf ). That insurance requires a $25 copay for a primary physician visit and has a $600 deductible (if I had used an urgent care facility like the person you described, the copay would be $75). It didn’t seem like there were ANY out of pocket expenses in your example.

    Also, a portion of the FICA tax goes toward Medicare. Currently that tax is 2.9 percent with half being paid by workers and half being paid by employers.

    All-in-all, a total payment of $385 sounds like a bargain, no?

  2. pino said:

    Dave,

    I did, it was at the end, and yes, rather oblique. I mentioned that I pay about the same as the young man, but that it covers my entire family.

    My prescriptions are typically covered and in my strep throat case, the medicine was less than 20 bucks.

    When you mention that he is in for only $385, you fail to take into account the 65 bucks for his wife. And on top of that, he still had to pay 65 dollars for the co-pay and the medicine. All that added up, he is in for 515 that month.

    Look, my point is not that my plan or your plan are better than his, it’s that his isn’t any better than mine.

    Further, if this young man had come to me for advice, this is what I would tell him.

    They want 385 a month from you. I recommend that you purchase catastrophe insurance at a cost of 50-75 bucks a month. This would cover him from the major health problems but would leave him exposed to smaller ailments. However, being young, he will almost certainly not need those smaller services.

    By banking the rest, he will be able to cover the huge deductible demanded by the catastrophe insurance and, and draw interest on the account.

    In short; avoid State care at all costs. Be responsible and take care of yourself.

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