Seeing a Doctor in Japan

For the past two days, I had been feeling an uncomfortable sensation around my heart—every few minutes, it felt like my heart was being squeezed. It wasn’t painful, and there were no other abnormal symptoms. I initially thought it was just temporary, but since it persisted for over a day without improvement, and because it involves the heart after all, I decided to go see a doctor.

Both the reception staff and the doctor were quite friendly, and the symptom was surprisingly easy to describe: “ギュッと握られている感じがする” (it feels like my heart is being gripped tightly). The doctor asked if it was painful and how long the episodes lasted, and then I was sent for various tests: an electrocardiogram (ECG), a chest X-ray, and blood work. I had done some research online before the checkup, and my symptoms seemed to align most closely with angina pectoris (known as kyōshinshō in Japanese).

The doctor looked at the ECG and X-ray and remarked, “結構綺麗ですね” (It looks quite good). However, since an ECG only captures the heart’s condition at that exact moment, and the X-ray showed no major issues, we could temporarily rule out anything immediately critical. The doctor mentioned that severe stress could also trigger this sensation. While I have been under a bit more stress lately, it didn’t seem intense enough to cause this. As a precaution, the doctor scheduled an echocardiogram for me to take a closer look at my blood vessels.

Finally, regarding the cost: 5,100 yen might seem expensive to people from Taiwan (and that is already with insurance coverage), but I actually think the price is quite fair, especially given how many tests were performed that day. Taiwan’s National Health Insurance is so cheap that it can easily lead to overutilization and waste, though that isn’t something that can be changed overnight.

Next, I’ll touch briefly on Japan’s health insurance system. It differs somewhat from Taiwan’s, being mainly divided into “National Health Insurance” and “Social Insurance.” National Health Insurance is administered by municipal governments, while Social Insurance is managed by health insurance associations. For example, I am currently insured through TJK (Tokyo Information Service Industry Health Insurance Association). Generally, employed individuals are enrolled in Social Insurance. In Japan, patients pay a standard 30% co-payment across the board, rather than paying according to tiered brackets like in Taiwan.

Another notable feature is that Japan places great emphasis on a tiered healthcare referral system. For minor conditions, you start at a local clinic; you only go to a large hospital if you need hospitalization or comprehensive, specialized examinations. Otherwise, walking into a large hospital directly incurs a substantial extra registration fee. Additionally, you can’t simply walk into an emergency room whenever you want; ERs generally only accept patients whose conditions have deteriorated acutely or who arrive by ambulance. I actually find this system quite practical—it prevents people with minor ailments from overcrowding emergency rooms, draining critical medical resources, or visiting major hospitals just to pick up prescriptions.

Recently, I read a Japanese news report: 50代に糖尿病で亡くなった男が残す痛切な筆録, which documented a man’s battle with diabetes through his journal. In the face of disease, human power truly feels so fragile. I hope everyone takes good care of their health.