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Thursday, October 20, 2016

Japan's Health System

I'm not too concerned about health, as I have a problem with sweets as a weak spot. I know a ton of people love to learn about health and exercise though. I've brought in a good friend of mine who is starting a self-help blog about health, exercise and managing life. He has lived in Japan and has a great knowledge of the Japanese health system. He know all the ins and outs of what makes the Japanese healthy compared to other countries.
By: Nam Tong

Having lived in Japan for three years, I experienced Japan’s healthcare system and way of life. Being American, it made me question what I thought was “normal” or “healthy”. There’s a lot that Americans can learn from a Japanese perspective.

Obesity is an epidemic in America that is a prerequisite for a number of heart diseases and other problems. According to the World Health Organization, 32.6% of all US adults are obese, while Japan has one of the lowest obesity rates in the world (3.4%). You can really tell the difference when you’re walking around the country, and I would like to dispel the idea that this somehow comes down to genetics.

It’s not genetics. It’s the lifestyle, the food, and the way of thinking.


Let’s start off by talking about school. Every day, a community of moms and grandmas and government officials get together to make lunch for the students. A nutritionist is hired by the government in order to make sure the meal is “balanced”. It usually consists of either rice or bread, soup, salad, and some source of protein (fish, pork, beef, etc.). They try to use local ingredients, and the food is then sent out to elementary and middle schools. Lunch is a communal duty. Students are assigned roles to serve their fellow classmates. Every day, students pour soup and rice in bowls, put fish or pork on plates, and set everything on trays. Everyone is given the same meals. There are no vending machines and no dessert other than fruit or yogurt.
Students are also pressured to join an extracurricular activity. Most students practice about three hours a day after school. Some of the most popular extracurricular activities are softball, baseball, swimming, and judo. Because they practice about three hours every day, even on weekends, students are generally fit. Extracurricular activities also benefits the community because it gives students a way to connect together and have positive role models.
A Japanese junior high school.


Unlike the US Japan has universal healthcare. The concept is very foreign to a lot of Americans, and many have a very dim outlook on it. Well, I’d like to shed some light on universal healthcare; I love the Japanese health care system. When I was living in Japan, I loved not worrying whether or not I could pay for a doctor’s visit. I love that residents pay taxes for the benefit of everyone in the country. I love that the right to a doctor is a universal right in Japan, not those that can afford it. Health insurance is mandatory for all residents (citizen or not) and is provided by the National Health Insurance and the Employee’s Health Insurance. The insurance provider pays for 70% of the bill, while the individual only has to pay for 30%.

A Doctor’s Visit

This year I had a very severe flu, and it was the first time I had one in decades. I went to my local clinic two blocks away, and was accepted without an appointment. I handed my ID and National Health Insurance card to the nurse and waited in the lobby. Ten minutes later the doctor called my name, asked me some questions, did a medical check, and concluded that I had the flu. She told me she would give a prescription. It only took about 10 minutes. Back in the lobby I went to pay, and to my surprise the visit was only about 1,000 yen (about $10 USD). The nurse gave me a prescription note, and I simply walked next door to the pharmacy. At the pharmacy, I gave a different nurse my ID, health insurance card, and prescription note. A few minutes later, the pharmacist came to explain to me how and when to take each medicine. To my surprise again, it was only 500 yen ($5 USD)! For the price of lunch and a cup of coffee (1,500 yen or $15 USD), I was able to go see a doctor and get prescription medicine. No stress. No second guessing.

A Bigger Operation

Ever since I was in high school, I was told by my dentist that I needed to remove my wisdom teeth, but my family always put it. Because removing molars in the US would cost at least $1,000, we simply didn’t have the money. I knew that the operation was more affordable in Japan, so this year I decided to get them removed before I moved back to the US. Because my wisdom teeth have grown completely horizontal, I had my operation done at a large university hospital. I was given some sort of anesthetic, and I was awake the entire time. The operation went smoothly and only took about an hour to remove two molars on the left side. With health insurance the operation only costed 5,000 yen ($50 USD); the prescription painkillers were only about 2,000 yen ($20 USD). Two months later I came back to get the other two wisdom teeth removed. I had already left my teaching job and was planning to leave Japan, so I had the molars removed while I was uninsured. Long story short I had my operation, and my medical expenses were only about 20,000 yen ($200 USD) in total. Even without health insurance it was still affordable. I couldn’t believe it.

Not Everything is Perfect

Although the obesity rate is very low compared to the United States, I do believe that Japanese people are slowing gaining weight. According the World Health Organization, Japan’s overweight rate (BMI 25 or higher) is at 24.2%, while the US is at 67.3%. Although I don’t have any statistics to back me up, I’ve noticed more overweight people, especially children. That could be because there are so many convenience stores selling junk food and fast food restaurants available. It could also be because women are starting to have careers in Japan, so children don’t receive home-cooked meals.
McDonald's in Japan. They're everywhere!
Stress is a major problem in Japan. A considerable amount of Japanese people work overtime with or without pay. About 40% of all Japanese employees work at least 16 unpaid overtime hours a month. Overworking causes a lot of stress that affects mental and physical health. Japan has one of the highest suicide rates in the developed world. 70 people commit suicide every day in Japan, many is due to work-related stress. Students are also overstudying and over-practicing extracurricular activities. A lot of students do not have the time to even relax. From elementary school and onwards, students are taught to always be busy. Schools in Japan are incredibly competitive, so many parents feel pressured to emphasize studying. Suicide is the number one cause of death between the age of 10 & 19.

Key Takeaways

My experience in Japan has made me realize that I shouldn’t accept the norms in US. The US healthcare system does not have to be so complicated and expensive if people are open for alternatives. School lunches don’t have to be terrible if we had institutions that encourage community-building. Most importantly, life doesn’t have to revolve around a stressful working environment. I understand individual responsibility, but I honestly believe that obesity and our unhealthy way of living is a national problem. If America does not address this problem, then the next generation will be worse off than the previous generation.

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