Guaranteed Healthcare

I'm an American living overseas.  I live in Japan, where I run a small business.  As a resident, I'm required to participate in their Universal Health Care scheme.  Some might find that to be 'coercive' or 'un-American', but it's worth pointing out the flip side of this arrangement:  you cannot be turned down under any circumstances.  The form to enroll, say, one of my employees is 1 single page and all I need to fill out is their name, address, birthdate, Social Security #, salary info. (so the 'Social Insurance' office can calculate the rate and deduct it from the company account every month), along with my business name, address, my name & signature.  There is no field for 'pre-existing medical conditions'.  They don't even ask.  The completed paper is then submitted to the Social Insurance office and 10 minutes later, they issue a health insurance card that will get the holder into almost any hospital/clinic to see any doctor in Japan.

The hospitals & clinics are often privately owned, doctors are affluent, and if you really want coverage above and beyond the standard plan that everyone has, you have the *freedom* to purchase supplemental insurance from private insurance firms.  Japan has a vibrant health insurance market and in fact, many of the leading players are actually American firms, including Aflac.  I tried to attach a video of an Aflac Japan commerical for cancer insurance to this post but failed so I'll just provide the link:  http://www.youtube.com/watch?v=rH1Lvwqz5_M

Frankly speaking, I have no idea where the 'socialism', so decried by American opponents of Universal Health Care, is in the Japanese system, unless the new definition of socialism includes privately owned hospitals, private supplemental insurance, standard name brand pharmaceuticals, etc.

 It's important to note that the system is not 'free' as Americans seem to occasionally think.  People are required to pay for the coverage.  However, the cost is calculated on a sliding scale (very much like social security in the US) and it tops out after the income level of $11,000/month.  After that, the price remains flat - again, like Social Security in the US.  Interesting side note, it appears that they raised the income level on the scale in the past year or so; it used to top out at an income level around $10,000/month.  Generally speaking, if you're on the standard plan, like I am, you then have a co-pay of ~30% while the Universal System picks up the rest.  That may seem high, but in my experience, medical procedures cost less than in the US anyway, even though Japan is supposedly such an expensive country.  There are other features too... I'm told if you have medical expenses in a given month exceeding a certain amount ($5,000?) you can claim some of it back, for example.

I'll put an an abbreviated price list below and include a link to the actual price list (it's in Japanese) for your reference.  The important facts to remember are:

 1.  It's transparent and the price information is readily accessible, which means it's dead easy for business people like me and for users of the system.

2.  You can go to almost* any hospital/clinic/doctor/dentist you want.  There is no such thing as a 'network'.

3.  The rates increase slightly for people over 40 years of age (8.2% of monthly income vs. 9.33%)

   Please note that while the amount deducted from a person's paycheck depends on their salary, the price is the same whether they are single or are married with 10 children.  In other words, it's family friendly.  Generally speaking, companies contribute 1/2 of the total amount and employees contribute the other 1/2.  Companies are free to pay more, if they want.  Anyway, here's the rough price list, for someone under 40yo, converted to US$ (JPY100 = $1):

Monthly Income:     Monthly Cost to Employer:    Monthly Cost to Employee:     <$600                          $23.78                                    $23.78 
$1,000                         $40.18                                    $40.18
$2,000                         $82                                         $82
$3,000                         $123                                       $123
$4,000                         $168                                       $168
$5,000                         $205                                       $205
$6,000                         $241.9                                    $241.9
$7,000                         $291.1                                    $291.1
$8,000                         $323.9                                    $323.9
$9,000                         $381.3                                    $381.3
$10,000                       $422.3                                    $422.3
$11,000+                     $471.5                                    $471.5

Full price list available here:  http://www.sia.go.jp/seido/iryo/iryo18.htm  (See the links after the bold typed #'1'.  PDF & Excel version available; under 40 prices in the green column, over 40 prices in the Yellow column).  I'll try attaching the Excel file, also. 

 That's basically it!  I don't think I even spend 15 minutes a month on managing employee health insurance and I don't know of anyone who has ever gone to the doctor in Japan afraid they can't afford it.  I have never heard of anyone going bankrupt as a result of a medical emergency.

Japan pays less per capita (approx. 40% less) than America and still manages to cover everyone.  Oh, and drug prices are lower, too.  That'll have to wait for another post though.

I hope this information was useful.  I'm a huge fan of Univeral Health Care and like the Japanese system's transparency and ease-of-use.  Americans deserve this sort of health care.  It's good enough for McCain and the rest of our Congresspeople, after all.  I believe Americans - and American business - would love it.

* there is at least one clinic in Japan - an international clinic - that does not accept Japanese Health Insurance.  I've never felt compelled to go there and think it only exists for people who can't deal with the Japanese language.