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The story
The Asahi Shimbun’s “How Much: Life in America” series turned its third installment to healthcare costs, reporting on how expensive treatment and medication are in the US, and how the lack of a public universal healthcare system like Japan’s has long been one of the reasons Americans go bankrupt. The 5ch thread sparked by the article saw a wave of comments praising Japan’s universal healthcare system as “wonderful,” but others pointed out that healthcare workers’ wages have stagnated and hospitals keep shutting down, and that American private insurers can refuse to pay out even after policyholders shell out roughly ¥3.84 million a year in premiums — leaving posters divided over which system is actually better.
How Much: Life in America (Part 3) — Healthcare
For years, medical costs have been cited as one of the main reasons Americans go bankrupt. Treatment and medication are expensive, and there’s no public insurance system that everyone can join, unlike in Japan. Even people who pay monthly premiums for health insurance sometimes end up struggling after receiving a massive bill when they actually go to the doctor.
Do you think healthcare in America is expensive?
Source: asahi.com / Original article here
What people said
Typical — once they're old themselves, they'll demand the young and middle-aged foot the bill to cover them.
Probably the type to pull "kasuhara" (customer-is-king harassment) on nurses and doctors too.
And even after charging that much, the US healthcare system is still on the verge of collapse.
Something's fundamentally broken and nobody can fix it.
Japan is too good. I had colon cancer surgery and the bill was so cheap it was almost anticlimactic — like "wait, that's it?"
Even the pre-insurance price is still cheaper than America. Honestly it could stand to be a bit higher.
And on top of that, you're free to choose whether to also get private insurance for extra coverage.
Thanks to that, healthcare workers are the ones left out of wage increases, and hospitals keep going under in the red.
New drugs and medical equipment keep getting more expensive, and even electronic health record maintenance costs a fortune — the current national health insurance system can't be sustained as-is regardless.
People need to drop the assumption that getting advanced medical care for cheaper than Southeast Asia or South America is just normal.
In the Nordic countries where healthcare and education are free, the tax rate is 50%.
Even so, I hear people over there report high happiness levels.
Wonder what's different from Japan.
That's old news.
During COVID, elderly and sick patients were left untreated —
because they triaged by priority.
In America, as long as you're a US citizen,
the elderly get welfare benefits unconditionally.
No matter what disease you have, the treatment's just strong painkillers and opioids lol
About the best you'd get is a chat with the pharmacist…
I haven't used my insurance card in years either, so my premiums are basically wasted money.
What exactly about this story is there to envy?
Japan just has "universal coverage" in name — and yet the premiums and out-of-pocket costs are insanely high too.
Sounds like American private insurance premiums are even higher.
The average household pays about $23,968 a year —
that's roughly ¥3,834,880.
What America has "robust" is employer-sponsored private insurance for big companies' employees.
It's a large bulk deal with lots of employees, so insurers give good rates — but if you quit, you lose coverage, so losing your job is hell.
Individual plans are basically worthless compared to those big corporate contracts, so insurers rip you off pretty badly on those.
America has health insurance plans anyone can freely sign up for too.
They exist, but there's no guarantee they'll actually pay out.
How much do you think that costs a month?
Isn't it the case that in America, people pay a lot, but the moment they actually try to use the insurance, the company nitpicks and refuses to pay?
Now that you mention it, Breaking Bad had a storyline like that —
DEA agent Hank got shot and couldn't walk, but his insurance wouldn't cover it,
so ironically, Walter ended up secretly helping Hank out using money from his drug business.
Isn't that just how private insurance works in general?
Doesn't add up, does it.
You'd think that if you only look at the surface-level wealthy,
but once you see the rundown slums and crime rates hundreds of times higher than Japan's,
you'd probably think Japan is better off — where getting even slightly injured can bankrupt you and end your life as you knew it.
Japan is on a straight path to poverty.
A few years ago it got overtaken by South Korea and Taiwan — called a historic reversal not seen since the Meiji Restoration — and now it's being left in the dust even faster.
GDP per capita, 2026 IMF October edition
Ireland: $140,186
Switzerland: $126,177
Singapore: $112,065
United States: $95,210
Hong Kong: $61,868
Taiwan: approx. $42,103
South Korea: approx. $43,511
Japan: approx. $35,703 — down 5 spots from last year (37th) due to the weak yen and low growth
Japan's system has way too many problems of its own too —
especially how lenient it is on lifestyle diseases and dialysis patients caused by people's own poor habits, while those who actually manage their health responsibly end up getting the short end of the stick.
Well, it's a country where "everyone's equal" arguments and people's feelings always come first.
Background and Key Points of This Topic
The original article is the healthcare installment of the Asahi Shimbun’s ongoing series “How Much: Life in America,” reporting that the US has no established public universal healthcare system, and that even people with private insurance can end up struggling with massive bills. What divided opinion in the thread was how to evaluate Japan’s universal healthcare system. Voices praising it as “wonderful” stood alongside concerns about worsening conditions for healthcare workers, deteriorating hospital finances, and the system’s sustainability amid Japan’s declining birthrate and aging population — making it hard to simply declare one system superior to the other. It’s also worth noting that even with American private insurance, payouts can be denied at the insurer’s discretion — a fact worth keeping in mind before assuming “having insurance means you’re covered.” The average household’s annual premium cited in the thread (roughly ¥3.84 million) and the point that Japan has been overtaken by South Korea and Taiwan in per-capita GDP read as supplementary information that backs up the original article’s point.
※This article is excerpted and summarized from the 5ch (News Flash+) thread “US Healthcare Costs That Even Cause Bankruptcies — One ER Visit at ¥190,000 “Limits Happiness”.”
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