Medical care in Japan is divided between big hospitals and smaller privately run clinics. Which you use will depend on where you live and what is ailing you, but generally the smaller clinics handle day to day health care or specialized procedures (like childbirth) with the bigger hospitals handling more serious complaints.
The quality of Japanese health care can be considered one of the best in the world, however it may seem somewhat excessive to the outside observer. A common cold may produce a whole plethora of needlessly prescribed drugs, hospitalization for minor complaints is common and strictly enforced and seemingly unnecessary regulations are widespread. On the other hand Japan's life expectancy is the highest in the world and its perinatal and infant mortality rates are the lowest in the world.
The health care system in Japan is based on insurance and most Japanese belong to either the employees' health insurance scheme subscribed to by their company or to the national health insurance plan (Kokumin Kenko Hoken). Both of these programs are easily obtainable and relatively cheap and will cover between 70-90% of most medical expenses. Although it is possible to get away without paying into these health insurance schemes, unless good overseas insurance cover is obtained it is highly recommended to join one or the other of the local schemes.
National health Insurance covers those not enrolled in an employee's insurance scheme and covers 70% of most medical expenses. You must possess a gaijin card to qualify and premiums are based on your local tax returns or 'juminzei '. To sign up go along to your local ward office, go to the Kenko Hoken desk and once your eligibility has been confirmed, you will receive an insurance booklet or card. You will need to show this when visiting any health institution where you wish to claim insurance, so look after it with great care. Only one is issued per family and copies or damaged originals will not be accepted.
Employee health insurance works in a similar way apart from the paperwork is generally done by your company. You will be required to pay half the premium, which is based on your earnings and will be deducted form your monthly salary, with your employer contributing the rest. The cover may be somewhat better than that given in the national Scheme, but as each scheme varies it is a good idea to check directly.
Not all medical expenses are covered by insurance so be aware before embarking on any costly treatments. Also check that the hospital or clinic you are visiting accepts the insurance you are enrolled in.
If you need to visit the doctor ensure you take some money and your insurance card with you. Normally you cannot make an appointment so you may have to wait a long time. Go directly to the reception 'uketsuke', show your card and try to explain roughly what the problem is. I have found that the majority of doctors in Japan do have some English (or German) ability and it is normally possible to make yourself understood. Bear in mind that the clinic you are visiting may specialise in something completely unrelated to your complaint so may not have all the necessary equipment etc. they will generally try to help you but if unable will normally arrange for you to go and see someone more appropriate.
Once diagnosis is complete you will normally be required to go back to the waiting room and wait to be summoned by the receptionist. You will then be required to pay the bill, arrange for another visit and may be also given some medicine. Alternatively they may give you a prescription which can be handed in to the in-house pharmacy or taken to an independent one, normally within a few doors of the hospital.
