Because medical fees are set according to the Health Insurance Law, people with medical insurance need not take financial matters into consideration when selecting a hospital.
But for the uninsured — like foreigners who have overstayed their visas — medical bills can differ greatly among hospitals. Since individual medical institutions are allowed to determine charges for such patients, costs at one institution may sometimes be twice as much as those at another.
“To get the best out of medical services here, foreigners should be fully informed about hospitals, such as their pricing policies,” said Yoneyuki Kobayashi, a medical doctor at Kobayashi International Clinic in the city of Yamato, Kanagawa Prefecture.
Kobayashi is president of AMDA International Medical Information Center, a Tokyo-based nonprofit organization that provides free medical referrals in seven foreign languages.
“More than anything, foreigners should be able to have access to doctors who understand foreign languages or are at least willing to examine foreigners,” he said.
According to a recent survey by the Tokyo Metropolitan Government, 22 percent of some 20,000 hospitals and clinics across the country said they can provide services in English. Only 5 percent said they are ready to accept foreigners who can speak neither Japanese nor English.
While working at a public hospital in Yamato, Kobayashi looked after the health of local refugees from Indochina. When he opened his own clinic in 1990, Kobayashi began a telephone information service.
His clinic was swamped with calls from foreigners across Japan, leaving him little time to treat his patients. Thus, he and five colleagues decided to establish the AMDA center to provide a full-time medical information service for foreigners.
“In order to get the most adequate service for the least money, foreigners should contact trained counselors before they go to a clinic,” he said. “This is especially true for those who do not have health insurance.”
Currently, the center’s Tokyo office in Shinjuku Ward has speakers of English, Spanish, Chinese, Korean and Thai on staff. They are on duty Monday to Friday from 9 a.m. and 8 p.m. In addition, Portuguese speakers work from 9 a.m. to 5 p.m. three days a week, and a Tagalog speaker is available Wednesday evenings.
At its Osaka office, English and Spanish speakers work Monday to Friday from 9 a.m. to 5 p.m., with Portuguese and Chinese speakers occasionally present.
These counselors have knowledge of basic medical terms and the Japanese medical system to provide information on health insurance, medical checks or preventive inoculation. If questions are beyond their knowledge, they call Kobayashi or other supporting doctors for advice.
They do not offer medical counseling directly, but introduce them to the most appropriate doctors from a list of 450 registered clinics and hospitals nationwide, after taking into account callers’ symptoms and language.
The center is financed by subsidies from the Tokyo Metropolitan Government and donations.
It has received an increasing number of calls from foreigners, recording 4,517 last year, an average of 30 calls per day, according to the center.
Recent years have also witnessed an increasing number of calls from medical institutions. Many ask the center to translate between foreign patients and Japanese doctors or social workers.
Between April 2001 and August this year, the center received 402 calls from hospitals and other medical institutions. In 215 cases, counselors were asked to translate a diagnosis, it said.
Given this trend, Kobayashi now envisions the center developing into a multilingual translation hub for medical institutions and foreign patients.
“We want all hospitals to be willing to use us when they accept patients with Japanese language difficulties,” he said. “It is our wish that no hospital has to reject foreign patients at the door due to language barriers.”