No Money, No Care in America; No Appointments in Germany; Out in Three Minutes in Japan

The other day, I watched a video in which a commentator discussed Japan’s healthcare system.

He had apparently lived in both the United States and Germany and compared the healthcare systems of the two countries. It was quite interesting.

The United States is paradise for the wealthy. If you can afford high medical bills, you can receive some of the best healthcare in the world. If you do not have money, however, it is a different story. Even with insurance, patients can face high out-of-pocket costs, and medical expenses can sometimes ruin a household financially.

Germany, by contrast, generally covers most medical costs through public health insurance. Even people with low incomes can receive treatment without worrying about the cost. The problem, however, is the wait.

According to the commentator, when you try to make an appointment, you may be told that the first opening is two weeks away. The wait can be even longer for a specialist.

In other words, the problem in America is the amount of money in your wallet, while the problem in Germany is the amount of space on the calendar.

So what about Japan?

The commentator said that after returning to Japan, he once again realized how good the Japanese healthcare system was. It is true that in Japan, you can often visit a neighborhood clinic and see a doctor the same day. Patients generally pay only 10 to 30 percent of the cost themselves.

I see. Perhaps Japan is the ideal country, combining the best features of both systems.

Just as I began to think that, I remembered something another doctor had said on YouTube.

Wait an Hour for a Three-Minute Consultation

It is a familiar story at Japanese hospitals.

You check in and wait for an hour. When your name is finally called, the consultation lasts only three minutes. As you try to explain a little more about your symptoms, the doctor is already looking at the next patient’s chart.

As a patient, you wish the doctor would listen a little longer.

According to that doctor, however, hospitals have their own reasons.

In Japan, medical fees are set by the government, so providers cannot freely charge each patient a large amount. To remain financially viable, they need to see many patients in a limited amount of time.

In short, it is a high-volume, low-margin business.

At a gyudon beef bowl restaurant, cheap and fast service is welcome. But when healthcare is run on the same model, it leaves me with mixed feelings.

At a beef bowl restaurant, I would be delighted if my meal arrived in three minutes. At a hospital, however, I wait an hour only for everything to be over in three minutes.

The same three minutes can feel very different.

Every Country Balances the Books Somewhere

Comparing the three systems reveals the distinctive features of each country.

In the United States, you can receive advanced treatment if you have enough money, but you may be in serious trouble if you do not. In Germany, patients face relatively little financial burden, but appointments can be difficult to obtain. In Japan, care is comparatively affordable and quick to access, but doctors and medical institutions operate under severe financial pressure behind the scenes.

Ultimately, healthcare requires money, staff, and time.

It would be wonderful to create a system in which everyone could receive affordable care immediately and have enough time with a doctor. But someone, somewhere, would still have to bear the cost.

In Japan, part of that burden appears to be absorbed by the relentless pace of work in medical settings.

Patients say, “I want the doctor to examine me more carefully.” Doctors say, “Where am I supposed to find the time?”

I understand both sides.

But raising medical fees would create another debate over health insurance premiums, taxes, and patients’ out-of-pocket costs. In the end, someone has to open their wallet.

Is Japan’s Healthcare System Really Ideal?

I think very highly of Japan’s healthcare system.

When I feel ill, I can visit a nearby clinic. Medical costs are relatively low. Japan also has a high-cost medical expense benefit that caps how much a patient must pay. It is easy to take these things for granted, but by global standards, this is a privileged environment.

We hardly ever hear of someone being unable to undergo surgery because they cannot afford it.

Still, I wonder how much strain medical professionals endure to maintain that convenience.

Patients naturally want low fees, the ability to see a doctor without an appointment, and enough time for the doctor to listen carefully. But when all those demands are placed side by side, they begin to sound rather luxurious.

The video reminded me how good Japan’s healthcare system is, but it also made me think about where that quality comes from.

America lacks affordable care. Germany lacks open appointments. Japan lacks time for consultations.

Every country is short of something.

Even so, if I had to choose among these three countries, I would still choose Japan.

Waiting an hour for a three-minute consultation is frustrating, but it is still better than looking at an American medical bill and fainting for three minutes.