Cheating Death: Japan

1. Cheating Death: Japan With Mac McCreary B.A. A guide to receiving healthcare in Japan

2. Basic Tools Against Death • Always have two things on you! • Residence Card (在留カード) • KenkoHokensho(Japanese Health Insurance Card) • Given to you by base school • Proves you have National InsuranceNeed it anytime you visit a doctor

3. Japanese National Health Insurance Automatically enrolled in National Health Insurance Cost split between CO and you Payment to the system automatically deducted from paycheck Insurance covers 70% of costs; you must pay remaining 30% Not covered: Dental, preventative health care

4. Other Basic Tools Learn Japanese; will improve every aspect of life Make good relations with your supervisor or co-workers Make Japanese Friends PAs and Senpai

5. Death’s First Challenge • Some kind of medical condition comes up • Mystery Constipation • Don’t know what to do • Decide to go to doctor!

6. Finding a Doctor • Be independent; Look online! • http://www.qq.pref.ibaraki.jp • Can find specialists and know English level • Ask a coworker for recommendations • Ask a friend (ALT or Japanese) • Ask a PA

7. When to Go? No appointments; first come first serve Be prepared to wait May take as long as half a day Pro-tip: Go before opening Check opening hours and vacation days before going

8. Sick Leave • ALTs special in having Sick Days • Most JTEs use nenkyu if sick • Wake up feeling horrible and can’t teach: • Call your supervisor; “I’m sick and going to see the doctor” • Go to the doctor • Keep proof you went to doctor to take sick leave • May need Doctor’s certificate (shindansho)

9. Sick Leave Cultural differences: The Gaman Spirit Sick leave can be a big source of tension Discuss sick leave with your supervisor now Make use of daikyu and weekends if possible

10. Going to the Doctor • What you need: • KenkoHokensho (health card) • Japanese ability, a person to help, dictionary • Some money • Registering at the clinic • Receive a Patient’s Card (shinsatsuken) • Registration can be done in advance to make things easier

11. Going to the Doctor • After registration; describe problem on form • Temperature and blood pressure • Wait…wait....wait some more • Doctor examines and gives consultation • Be patient with communication • Don’t be afraid to ask questions • Return to waiting room • Nurse will call, you will receive the bill and pay

12. Filling Prescriptions • Small pharmacy next to clinic or hospital dispensary • Give person at front desk both Hokensho and prescription • Receive medication and directions • May have 3 or 4 different medicines • Mix of western and eastern medicine • Different forms of medicine; pills, powders, pellets • Pay your 30% (a few 1000¥)

13. Death’s First Challenge Take medicine, after a few days everything better again If needed return to clinic; remember to take Hokensho and Patient’s Card Score: You 1 Death 0

14. Death’s Second Challenge • Eat a cookie with macadamia nuts… • Severe nut allergy!! • Emergency medical care!!

15. Emergency Care • Hospitals have more rigid hours • Absolutely need medical attention • Call your supervisor or friend or co-worker • Call 119 for ambulance (see what they did there…) • “Kyukyusha-onegaishimasu, say your address” • Triage and then to hospital if needed • Score: You 2 Death 0

16. Death’s Third Challenge • Running down stairs • Trip and fall • Broken bone? Other large accident or injury? • What to do with a serious accident or when a more complicated medical procedure is required?

17. Surgery and Hospitalization • Need another person to sign forms with you • Kyoto-sensei or Supervisor • Be prepared to pay a reasonable sum upfront • Save all receipts and forms • JET Accident Insurance

18. JET Accident Insurance • Tokio Marine & Nichido Fire Insurance • Covers the additional 30% • Call and inform them you had an accident • Get doctor’s certificate or have him complete forms • “Rescuer coverage; up to three people • Hospitalized for 3 days or more

19. Life Continues • Surgery is successful • Get “Recovery leave” • 20 consecutive days from when you start • Return to work; after a month can walk again • Better luck next time Death! • Go celebrate with friends; drink a little too much • Very questionable hookup… Is Death trying to get you again?

20. Getting Tested • Free anonymous testing at public health centers (hokenjo) • Questionable English levels • Abundance of clinics used to foreigners in Tokyo • Might not be free (￥5000 -￥8000) • http://www.hivkensa.com/ • Japan HIV Center • Rapid test less common than standard test (results after a week

21. Taigan no Kaji Get test results; All clean You 4 Death 0 “Problems exist other places but not here…” Make Japanese significant other Member of strange cult!! Deep depression!

22. Mental Health • Professional not as available • AJET Peer Support Group (PSG) • 050 5534 5566 • CLAIR JETline • 03 5213 1729 • Tokyo English Life Line (TELL) • 03 5774 0992 • PAs trained in counseling as well

23. Counseling Hotline Hours

24. Death Fails

25. Annual Medical Check Mandatory Around Summer Vacation Eyes, Ears, Weight, Height Urine and Blood Tests Chest X-ray and stomach poking Results confidential for the most part

26. Questions?