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Thread: Japan, and Emergency Medical [Dis]Service planning?

  1. #1
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    Default Japan, and Emergency Medical [Dis]Service planning?

    I've heard too many horror stories about gaijin with acute trauma, getting shuttled around from ER to ER, only to be given the X-arm "Sorry our ER is closed" sign. I've gathered from these stories that one shouldn't bother calling 119, but take a cab instead.

    So in the spirit of DIY trauma care, has anybody here had any practical ideas of how to try to plan for getting emergency medical care when you need it?

    One thing I've thought about is getting pre-negotiated letter of agreement from my insurance provider, translated into Japanese, saying in effect "Keio University ER has agreed in advance to accept our payment for emergency treatment of this Tengu," and then keeping a copy of that letter in the pocket of my riding vest.

    As it is now, I keep my military ID card there, and hopefully if I ever have to get scraped up off the pavement, they'd think twice about creating an international incident by turfing me from ER to ER.

    Latest problem I heard about was a leg broken whilst ice skating. The American lady was turned down at Keio University ER, which is normally pretty good with gaijin, and it took her four hours to find an ER that would take her.

    So if the assumption is that you're better off taking a cab, where does a gaijin injured in downtown Tokyo take a cab to?

    Also, if you ever have surplus pain meds, hang onto them. Because if you get a compound fracture when some yutz T-bones you, don't expect the taxi cab driver to have any morphine for you.

    One cool thing I've seen is that the ground pounders out at Zama safety office used to print helmet stickers, in English & Japanese, which said "In case of emergency trauma, don't fuck with the helmet."

  2. #2

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    Great idea!!
    Keio is almost next door to Hakkone if you crash in the mountains!
    You may find that a lot of these "turned away " stories are in fact "transfers" to get faster or better care.(Though there are some well documented fuck ups)
    You will never be refused emergency treatment for being gaijin.
    You stick to the taxis ( Top quality guys, never have a problem finding anything!!)
    I`ll risk the ambulance.

  3. #3

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    Personally, I don't feel any more concern about medical services living here,
    than I did when I was in Australia. It really is not that bad and it is so much
    better when you try to work with those trying to help you. The hospitals are
    sometimes short staffed but as far as i know they will take anyone irrespective
    of where they are from, and without checking if they can pay for help, if they
    have the resources available to do so.


    Jav
    Apexmoto Inc - Dyno tuning, engine/chassis/suspension upgrades, repairs, shaken, tires & changing with balancing, graphics printing, stickers, media blasting, painting & powder coating.

  4. #4
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    I got national health insurance not cos it's the cheapest but cos it's the least hassle. I would recommend keeping your insurance card with you at all times, especially when riding and if it's non-J then get a translation or something like you said and tape it to it.

    As for the shuffle arounds - pretty ridiculous situation and system. There was that guy who died recently and a wife's friend's father died 'on route' due to heart failure as several places refused him. That's 2 I know of in Japan here and that's 2 more than I know of anywhere else in the world. Stupid system IMHO - non-hospital based ambulance who picks you up then drives around begging little hospitals to take a new patient ...

    Here's our story ... the wife tried out one of those new 'exercise' machines, the ones you stand on and it wobbles you well, she passed out after a few minutes and cracked her head on a sharp edge - blood every where and a good gash in the scalp. An ambulance was called but she ended up being taken all the way from where she was to one near our house - 20km from the shopping mall :( I can think of about 10 'hospitals' around the 2 areas ... the mall paid for the CAT scan and stuff - but no cash payout :(

  5. #5
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    Those are some great ideas.

    I wonder how willing a taxi driver would be to pick up an injured gaijin from the site of a motor vehicle accident.

    Having the insurance information readily available along with some other basic information like blood type, and instructions on NOT removing the helmet, that's some good advice.

    I wonder what would happen if we give ambulance drivers instructions stating that we'll sue them if they use the word "gaijin" while searching for a hospital?
    Don't Panic

  6. #6
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    i dont think there are any advantages to taking a taxi. take an ambulance. they can call and find out who will take you. a taxi driver cant. in addition, it is my understanding that you will not be accepted after hours unless you arrive by ambulance.

    Tuesday, Feb. 24, 2009

    8.3% of Tokyo emergency cases refused by multiple hospitals

    Kyodo News
    Of 9,414 people in need of emergency treatment in Tokyo in a six-day period in December, 779, or 8.3 percent, were refused admittance by three or more hospitals, the Fire and Disaster Management Agency said Monday.

    According to the agency, 60 people were rejected by more than 10 hospitals, while three were refused by more than 23, indicating the emergency medical care system needs to be enhanced even in Tokyo, where it's believed to be the best in Japan.

    Hospital refusals of emergency cases have been drawing attention since a pregnant woman in Nara Prefecture was rejected by more than 10 hospitals and lost her unborn baby in 2007.

    Tokyo hospitals that turned away the emergency cases in December said their staff were involved in operations or dealing with other patients, or their beds were fully occupied, according to the agency.
    http://search.japantimes.co.jp/cgi-b...0090224a4.html

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    Quote Originally Posted by sprocket View Post
    ... and instructions on NOT removing the helmet, that's some good advice.
    Buddy of mine crashed in Izu. Lying on the ground, unconscious, bloody face, for all I know, with neck injuries. First thing the ambulance twit tried was to take his helmet off. I had to damn near kick the guy before he agreed to put on a neck brace and leave the helmet alone. Not sure how common this is, probably not very, but pretty scary.
    Egon

    Time flies like an arrow ... fruit flies like a banana.

  8. #8
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    Racers use special helmet liners with long straps that help rescuers pull off their helmet after a crash. Maybe it would be a good idea to wear one for ordinary riding, too?

    http://www.komine.ac/products.php?fu...&category_id=1

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  9. #9
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    How about actually training medics? There's a novel idea ...

  10. #10
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    Default Helmet Liner/Remover

    Quote Originally Posted by Guy Jinbaiquerre View Post
    Racers use special helmet liners with long straps that help rescuers pull off their helmet after a crash. Maybe it would be a good idea to wear one for ordinary riding, too?

    http://www.komine.ac/products.php?fu...&category_id=1

    Nice! Me wants one!

  11. #11

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    Quote Originally Posted by Kamikuza View Post
    How about actually training medics? There's a novel idea ...
    Don't think it would make much of a novel.....................

    Jav
    Apexmoto Inc - Dyno tuning, engine/chassis/suspension upgrades, repairs, shaken, tires & changing with balancing, graphics printing, stickers, media blasting, painting & powder coating.

  12. #12

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    Quote Originally Posted by Kamikuza View Post
    How about actually training medics? There's a novel idea ...

    Quote Originally Posted by Jav View Post
    Don't think it would make much of a novel.....................

    Jav
    Gotcha!!!!!!

  13. #13
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    Quote Originally Posted by Kamikuza View Post
    How about actually training medics? There's a novel idea ...
    Actually, the ambulance crew in Japan AREN'T proper paramedics. They're firemen with basic medical training. Still better than a taxi driver, but not much.

    The problem here is that many of the procedures that a paramedic would routinely perform in most countries is, in Japan, mandated by law to be performed only by a doctor or by a nurse under supervision of a doctor.

    As far as the hospitals, the root of the whole problem is that the payment schedule under the national health system hasn't been updated for decades, so hospitals are being paid for 2009 treatments on a (don't quote me on this, just for illustration purposes) 1979 price scale.

    Despite cranking the patient co-pay up from 10% to 20% and now 30%, hospitals are still getting short changed. In order to stay financially solvent, hospitals keep beds full as long as possible - bed/room charges aren't covered under national health - even when patients are often fully recovered. So, we end up with a rash of hospitals with no space because they need to keep every bed full.

    This is compounded by a shortage of doctors - another result of the payment schedule - it's actually not profitable to be a doctor in a large hospital any more. The only doctors making bank are the ones with private practices. Even then, the penny pinching by the government leads to some of these practices cutting corners - like the incident in Setagaya where a hospital was routinely re-using IV cannulas and ended up infecting an entire ward with MRSA and killing (if I recall) 6 of the patients. Don't take this as excusing the hospital in question - just pointing out the government's hand as a contributing factor there.

    Socialized medicine is a good idea, but requires careful management by informed people - not ham handed butchery by a bunch of vote-buying prats.

    Government interference. Gotta love it.
    1312.

  14. #14
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    DOH pwned by the Javster!

    Why doesn't that surprise me ET? Once again the law is so fuckin' stupid that it endangers lives ...

    Ah that explains it - when I had to stay in the hospital here, they kept me in for 3 times longer than they would have in other countries, and that was cos I bitched and moaned to get out! I thought it was cos they are namby-pamby over protective woosies ... then I got the bill

    Recently, I heard that with the population shortage the government is implementing bold new strategies - dumping more money into 'womens' clinics ... there several being built near us now

    Also note - don't get admitted to hospital near the end of the month - national insurance pays all expenses for a hospital stay over the first 80,000yen PER MONTH ... that's calender month, folks :banghead

  15. #15
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    Quote Originally Posted by EvilTwin View Post
    Socialized medicine is a good idea, but requires careful management by informed people
    That's why it's not a good idea.
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  16. #16
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    What are other options then Guy? I can't see how medicine as a business would be run any better :(

  17. #17
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    Quote Originally Posted by EvilTwin View Post
    Actually, the ambulance crew in Japan AREN'T proper paramedics. They're firemen with basic medical training. Still better than a taxi driver, but not much.

    The problem here is that many of the procedures that a paramedic would routinely perform in most countries is, in Japan, mandated by law to be performed only by a doctor or by a nurse under supervision of a doctor.

    As far as the hospitals, the root of the whole problem is that the payment schedule under the national health system hasn't been updated for decades, so hospitals are being paid for 2009 treatments on a (don't quote me on this, just for illustration purposes) 1979 price scale.

    Despite cranking the patient co-pay up from 10% to 20% and now 30%, hospitals are still getting short changed. In order to stay financially solvent, hospitals keep beds full as long as possible - bed/room charges aren't covered under national health - even when patients are often fully recovered. So, we end up with a rash of hospitals with no space because they need to keep every bed full.

    This is compounded by a shortage of doctors - another result of the payment schedule - it's actually not profitable to be a doctor in a large hospital any more. The only doctors making bank are the ones with private practices. Even then, the penny pinching by the government leads to some of these practices cutting corners - like the incident in Setagaya where a hospital was routinely re-using IV cannulas and ended up infecting an entire ward with MRSA and killing (if I recall) 6 of the patients. Don't take this as excusing the hospital in question - just pointing out the government's hand as a contributing factor there.

    Socialized medicine is a good idea, but requires careful management by informed people - not ham handed butchery by a bunch of vote-buying prats.

    Government interference. Gotta love it.
    i always thought ambulance drivers were just drivers with no training. i knew they were technically under the fire service though. not arguing here. you seem very well informed! very interesting.

  18. #18

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    Quote Originally Posted by haildamage View Post
    you seem very well informed! very interesting.
    Was thinking the same thing myself where does he get all this info?

  19. #19
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    Quote Originally Posted by Michael View Post
    Was thinking the same thing myself where does he get all this info?
    he's a fart smeller, uhhh i mean a smart feller and a well read social observer i'm guessing!

  20. #20
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    Quote Originally Posted by Dr Slump View Post
    Nice! Me wants one!
    The new SM helmet I bought (Arai X3) has tabs on the cheek pads that can be pulled down removing the cheek pads. supposedly for better access and easier (safer) removal of the helmet in the event of an unclean dismount.
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