Health care in Japan

Keeping you safe

SummaryPolitical BackgroundCrime & KidnappingHealth CareCultural Considarations

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Summary

Travelers and expatriates face a low risk environment in Japan. Common sense precautions should suffice, but do note that the culture is different and that “common sense” may be too.
Crime rates are manageable and should not create real problems for those who stick to normal precautions.
Japan faces a less than benign international environment. China’s power and assertiveness is growing in the region, and tensions sometimes run high. The risk of conflict however is very low. North Korea is, as ever, acting in an unpredictable manner, but again the risk of conflict with Pyongyang is low.
Japan is located in an active seismic zone and earthquakes are common, sometimes violent. An extensive warning system is in place to forewarn if quakes trigger tsunamis which have been devastating in the recent past. Always adhere to and follow directions from local authorities, including during natural disasters. Make sure your health insurance or travel insurance covers natural disasters.
The 2011 tsunami caused the meltdown of several reactors at the Fukushima nuclear plant. Parts of the area are still off limits. Travelers and expatriates should not worry about the plant though, as long as they stay out of the exclusion zone; nor should they be concerned about eating local foods or seafood.

Political background

Japan is a parliamentary democracy. While the system is well entrenched there has been a tendency for party politics to be dominated by a few parties, and nationalist pride and sentiment is present if often unseen. Politics are peaceful and should pose no risk to travelers, though.
As always demonstrations and rallies should be avoided just to be on the safe side.

Crime & kidnapping

Travelers and expatriates should follow normal precautions as crime rates are low. While organized crime does exist it poses only a small risk to foreigners. Always note that when you are in a culture much different from your own, you may be more visible in general and to would-be malfeasants as well. The Japanese police are professional and trustworthy.

Health care

Japan boasts a world class health care system in terms of quality. Foreigners may gain access to this system in several ways, and this will largely depend on whether you are a traveler or an expatriate who stays for the longer haul.
If you need an ambulance dial 119 – it is wise to get assistance from a native speaker.
If you are staying for more than year, you must join one of the compulsory national health insurance systems. Japan has two national health insurance systems: Employer’s health insurance and National health insurance.
Employer’s health insurance is a system by which the employer and the employee share the health insurance premium 50/50, and which covers 80% of most medical expenses (although the health insurance only covers 70% of family members’ expenses). Most expatriates will likely fall under this health insurance scheme as they will have a local employer or be employed by a local branch of a parent company.
National health insurance is for residents and foreigners staying 1+ year who are not employed. Premiums and some conditions may depend on where you live, your income and other similar parameters. Again, few expats will fall under this health insurance system.

Travelers need full health insurance
If you are staying for a shorter period, essentially less than 1 year, you will need to take out a health insurance as you will not be covered by any national health insurance schemes. Make sure your health insurance provides full and adequate cover for all cases.
Expatriates are partially covered but should consider health insurance even so
While you will be covered by one of the national health insurance schemes (if your stay is 1+ year that is), note that there are some shortcomings in these health insurance systems. First the cover is capped at 80% (or 70% for dependents). Second, some types of advanced or complex treatment may not be fully covered, and these are often the most expensive ones. You should choose a health insurance which covers broadly.

Cultural Considerations

Briefly on culture
To people at home within a given culture, there will be a set of norms and values which governs everyday life, often in an almost subconscious manner. Think of how people tend to interact back home: How are relations between age-groups, genders, colleagues, religious groups, employers and employees, citizens and state etc. usually defined? Then consider that these relationships and the norms and even rules which govern then are very familiar to you – indeed you will probably consider them almost natural. This is the effect of culture upon people living within a group.

But the world is a diverse place, and cultures are very different around the globe. To complicate matters further cultures are anything but static; indeed, by their very nature they are always in flux. A country will often be home to different cultures as well, although it may sometimes be possible to identify a preponderant culture within a country.

Cultural differences and travel security
When you travel to a country or an area with a significantly different culture from your own this may affect your safety. This effect may take several different shapes.

The most basic effect is that of simply being different, of sticking out, familiar to any tourist in the world: The local population has little trouble identifying you as a traveler, tourist or expat. This raises your profile and increases your vulnerability, especially to street crime and scams, which may be serious in high-risk countries. While probably difficult to avoid, this basic fact should always be borne in mind. You will be more exposed and have less instinctive understanding of your surroundings that would the case back home.

Examples of specifics: Locals laws and customs
There may be more specific effects as well. Local laws will reflect the local culture, and this can have a very direct effect, e.g. bans on specific products, behavior or rules affecting interaction between people. Classic examples include a ban on consumption of alcohol or drugs, limits on driving, bans on homosexuality or laws governing interaction between unmarried couples. Clearly local laws must be obeyed as they apply to all.

Health care and health insurance may also be affected. This is most often the case when it comes to how much practical support relatives are expected to supply at a hospital or clinic (e.g. food and basic care), or how much access family members can have to a hospitalized dependent.

But specific effects may also be subtle. As a foreigner, it is easy to break local customs unwarily, which may cause offense or resentment. This can be embarrassing of course; however, to transgress deeply held convictions e.g. of a political or religious nature may trigger hostility. Travelers and expats should always refrain from any political debates with locals, and should at least make themselves familiar with local customs and religious beliefs.

When it comes to religion specifically sensitivity may be high. If confronted with locals, it is best to express agreement with their stated convictions in a discussion. Most often it is not a problem to belong to a different major faith or denomination, but it may be. It is almost always a bad idea to confess to atheism if confronted by zealots.

Always remember that, even though you may disagree vehemently with elements of the local culture, you are the visitor. Do not try to convince locals of “the errors of their ways” and never, ever proselyte.

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