＜When you become sick＞ By Dr. Yamamura Junpei

　　　　＜When you become sick＞

Q: Why are medical expenses high?
A: In Japan, there is a medical insurance system, and supposing you do not have health insurance, medical expenses will become high.

Q: How is the structure of the health insurance and medical care system.
A: All Japanese nationals have health insurance. It roughly divides into health insurance and there are two kinds of it.
ⅰ） National Health Insurance – anyone with a residence permit can enter this scheme. This includes those with regular work permits, those who have been granted refugee status, and spouses of Japanese citizens etc.
ⅱ）Social Health Insurance – all companies are required to participate in this scheme; and foreign employees can hold this insurance regardless of their immigration status. However the fact is that many small-scale companies fail to join the scheme.
Under the medical insurance system, 1 point is calculated as 10 yen. For example, for:
 a medical examination (first examination): 270 points = 2,700 yen
 a chest x-ray: 167 points = 1,670 yen
 an ECG: 150 points = 1,500 yen.
To take as an example, if the cost of treatment – examination, tests, medicine etc, reaches a total of 1000 points (10,000 yen)
① If the patient holds medical insurance, the patient bears 20-30% – 2000-3000 yen, of the total cost.
However,
② If the patient does not hold medical insurance, it is an unregulated medical examination and the fee per point will depend on the medical institution.
If 1 point = 10 yen, the fee will be 10,000 yen. A generous medical center.
If 1 point = 15 yen, the fee will be 15,000 yen. A comparatively generous medical center.
If 1 point = 20 yen, the fee will be 20,000 yen. A regular medical center.
If 1 point = 30 yen, the fee will be 30,000 yen. A deplorable medical center – possibly this rate is designed to discourage foreign patients.
Accordingly it is important to take the following precautions:
 Ask beforehand at the medical center reception, what the cost per point is at that institution. If one point is more that 15 yen, negotiate for a reduction to 10 yen. If this is agreed, promise that you will certainly pay your bill.
 If the medical costs are likely to be expensive, consult with a social worker or the medical director about paying in installments.
Q: Which medical facilities accept a foreigner well?
A: The next medical facilities accept.
 Minatomachi Medical Center (Yokohama city) – the center operates a system where for a monthly fee of 2000 yen, you can become a member of the mutual aid society. Members pay 30% of the costs for treatment incurred at the center. Tel: 045 453 3673.
The Center has also established the Minatomachi Dental Clinic – for telephone reservations phone 045 453 3858.
 Nakai-Eki-Mae Clinic (Shinjuku ward): attended by many Burmese residents. Tel: 03 3365 1627.
 Machiyahara Hospital (Machida city): Hernia and hemorrhoids operation costs are approximately 18-200,000 yen. Tel: 0427 95 1668.
 Himawari Medical Center (Koto Ku). Tel: 03 5609 1823
 Horikiri Chuo Hospital (Katsushita Ku). Tel: 03 3602 3135
Q: What kind of illness is there generally?
A: By most, slight illness, such as cold / bronchitis, gastritis, and lumbago, is not different from Japanese people. However it must be careful of the following diseases.
* Tuberculosis, Hepatitis and HIV ― Foreigners from Asian and African countries are suffering from them.
* Apoplexy, myocardial infarction, and cancer ― It is influenced by aging (length of stay) and the meal factor.
* Psychiatric disorder ― There is uneasiness of worries and forced repatriation in the thought and family to transcultural stress and a mother country.
* Pregnancy ― Delivery expense requires about 400,000 to 500,000 yen.
* Child disease ― There are much cold, asthma, etc. Although the vaccination is to carry out at each health center, an opportunity to receive in fact should be rare. Probably, it will be better to ask a health center directly.

Q：If you contract tuberculosis (TB), What should you do?
A: Please ask medical facilities. Under the Tuberculosis Prevention Law, hospitalization and treatment while hospitalised is free. The cost of outpatient treatment is also minimal.

Q：Where is HIV antibody test carried out?
A: Free and anonymous aids tests are provided at each health center.

Q: When it becomes a serious illness
A: The kouryobyou act and a medical-expenses supplementation system by local government are utilized, and hospitalization expense　for a patient with a serious illness can be paid.
In the event of transporting a patient to home country, this depends on negotiations between the hospital, the Minatomachi Medical Center, the relevant embassy, the airline, medical centers in the home country, and NGOs etc. However, in the case of Burmese people, it is difficult to rely on the embassy and medical institutions in the hoｍe country.

Q: When you are injured during work, what should you do? Workers’ Accident Insurance
A: In the event that a person becomes sick or is injured at work, the company is required to pay compensation. Many Burmese work in restaurants, and thus are likely to be prone to the following workplace injuries: being cut by a knife; back injury from lifting heavy equipment and goods; slipping and suffering bruising or head injuries etc.
The following organizations correspond about consultation of a workplace accident.
Tokyo ○ FWUBC　　　　　　　　　　 Tel:
○ JAM　　　　　　　　　 Tel:03－－
○ Labour Safety Centre Tel: 03 3683 9765
○ Zentouitsu Tel: 03 3836 9061
Kanagawa Prefecture
○ Kanagawa Occupational Accident and Illness Center Tel: 04 5573 4289

Q: Where is the free medical checkup for a foreigner carried out?
A: Free medical examinations for all foreigners
a) Held every year by the Minatomachi Medical Center and local councils
In approximately: February – Yokohama (Tsurumi Health Center)
May – Kawasaki (Kaizuka Church)
October – Yamato city
November – Yokohama China town
b) 　Held by APFS and SHARE twice annually – in Summer
c) Health consultation for Asylum seekers – held twice monthly, at CTIC

Please take a medical checkup once every year, in order to prevent illness.