Will Miss #251 - free ambulance service

In odd contrast to the previous post about paying for emergency rescue services, ambulances in Japan are free. If you've fallen and you can't get up, you get a free ride to the hospital. Considering that many people back home in America won't call an ambulance when they need one for fear of the cost, this is a rather refreshing situation. Of course, there is a down side, and that's that some people will call an ambulance in a non-emergency situation rather than take a cab because one is free and the other is not.

I think that free ambulances for those who need it is worth a little abuse on the part of those who don't, and I'll miss the fact that one need not worry about cost in the case of a medical emergency.

Won't Miss #223 - multi-stage dental work

The last time my husband and I went in for a dental check-up and teeth cleaning, he paid in cash and I used the Japanese national health insurance. For him, he got a good chat with the dentist and a full cleaning all at once for about 500 yen (about $5) more than I paid once the deductible was paid. For me, I got a (literally) 10 second glance in my mouth and my cleaning split into two appointments (one cleaning for upper teeth and one for lower). If you use national health insurance, your dental work takes on the longevity of deep psychotherapy. Once you start your relationship, it will take many, many appointments to complete the procedures and sometimes it seems as if they will never finish.

Because of the billing loopholes in the national health insurance and the uncertain nature of dental work and when it is actually done such that a patient can't know what is really happening, dentists string out procedures so that you have to make multiple appointments, sometimes over a series of months, and I won't miss it.

Won't Miss #71 - socialized medicine (the abuse)

The piece of clip art pictured in this post comes from the front of the national health insurance guide. It nicely depicts exactly the sort of people who benefit the most from the system, the elderly and people with kids. They benefit because they are the ones who fret the most about health issues and run off to the doctor the most often. The system in Japan has built a culture where people seem to have absolutely no common sense about where to draw the line on needing a doctor's assistance. People run to a doctor every time they stub a toe, get a heat rash, or have a headache. This means that waiting rooms are filled daily with bored elderly people who think they need to see a doctor every week and parents who fret when their kid has a loose bowel movement. Due to government cost controls, doctors provide fast food, repeat care instead of higher quality, single visit care. Many doctors spend only 3 minutes with each patient both because of the volume and because they can make more money this way. The system is so skewed that it costs more to buy an aspirin over the counter at a drug store than it does to get one from the doctor.

Though I would take the Japanese system over the American one any day of the week, I won't miss the way in which socialized medicine's low cost encourages people to abuse it and make those of us who rarely use it even more reluctant to take advantage of its benefits.

Will Miss #70 - socialized medicine (on the whole)

Japan has socialized medicine so no one has to worry about medical coverage. If you're working as a salaried employee, the deal is great because your company will pay 50% of the fees (which are about 10-15% of your annual income up to a cap of about $5500). This means there are no hassles for people with pre-existing conditions and people can get regular health maintenance checks. In fact, I'm certain that the socialized medical program in Japan is at least part of the reason people live so long.

I will miss having worry-free medical insurance.