Why Japan's Healthcare System Is One of the Best for Residents and Travelers
Ryoji ShimadaCONTENTS
Japan's healthcare system is widely praised for its accessibility, affordability, and efficiency. For foreigners living in Japan or visiting as tourists, understanding this system—and how it compares with countries like Canada and the United States—is essential. Below is a practical overview that includes personal experiences and key comparisons.
1. For Residents in Japan
Japan has a public health insurance system, and all residents are legally required to join either:
- Employees' Health Insurance (Shakai Hoken) for full-time workers, or
- National Health Insurance (Kokumin Kenko Hoken) for the self-employed or unemployed.
Insurance premiums are shared equally between employers and employees, and the amount varies based on your income. This means that the higher your salary, the more you contribute—even if you're young, healthy, and rarely visit the doctor. Monthly contributions exceeding 20,000 yen are not uncommon. While some may feel this is unfair, the system is based on solidarity: the healthy help support the sick.
When visiting a hospital or clinic, residents typically pay just 30% of the total cost, including medications. Thanks to Japan’s high-cost medical expense cap, even major treatments like surgery costing over 1.5 million yen may result in an actual payment of less than 100,000 yen.
I personally had surgery a few years ago. Although the total bill came to around 1.5 million yen, I only had to pay less than 100,000 yen out of pocket—an experience that made me appreciate Japan's system deeply.
2. Comparing with Canada and the U.S.
Canada also has a universal healthcare system, and basic medical services are free at the point of care. However, long wait times are a major issue due to doctor shortages and overcrowded facilities. It’s not unusual to wait weeks or months to see a specialist.
In contrast, the U.S. relies heavily on private insurance. Without insurance, treatment costs can be astronomical. Even with coverage, deductibles and co-payments are high, and patients may be charged thousands—even tens of thousands—of dollars for surgery or hospitalization.
Compared to both systems, Japan offers a better balance between cost, quality, and accessibility. Residents can access prompt, affordable care without sacrificing quality.
3. Medical Access Without Insurance
Foreign residents are required to enroll in health insurance. If you delay joining, you may be asked to pay retroactive premiums.
Still, uninsured tourists or short-term visitors can receive care at most clinics and hospitals by paying 100% of the cost up front.
For instance, I was guiding a family when their 12-year-old daughter developed an ear infection and lost partial hearing. We went to a local ENT clinic in Tokyo without an appointment and were seen within 15 minutes. The doctor performed a hearing test, cleaned the ear, and prescribed treatment. The consultation cost just under 11,000 yen, and the medications (antibiotics and nasal spray) were another 3,000 yen—totaling only about 13,000 yen. That level of affordable, high-quality care is hard to imagine in many other countries.
4. Medical Care for Tourists
Japan’s healthcare system is remarkably accessible for travelers. In urban areas, many clinics have English-speaking staff or provide written explanations in English. You don’t need to wait for weeks to see a doctor, and the overall care experience is efficient and kind.
5. A System Worth Admiring
A friend of mine—a Japanese doctor currently doing research at UCLA—told me that Japan’s system is “one of the most complete and equitable in the world.”
It’s transparent, affordable, and high in quality. For both residents and visitors, Japan’s healthcare system is a reliable foundation for living well.
