Home > Focus on Japan 2010, Health Issues > The Health Check

The Health Check

December 4th, 2010

I had my first social-insurance health check in a long time yesterday. In Japan, you have two basic types of public health insurance: first, there’s shakai hoken, which you qualify for if you work more than 30 hours a week, and your employer pays into it along with a pension plan. Then there’s kokumin hoken, which you usually get if you don’t qualify for the first type, and which you have to pay for yourself and has no pension component. For years I’ve been on the latter type, but due to a local redefinition of work done outside the classroom and office, I’ve gotten onto the shakai hoken plan.

One of the fringe benefits of the plan is that the employer also spring for a yearly health check, where you go in and have a battery of tests carried out. I had this check-up years back–I don’t even remember when–but it was not quite as involved as it was this time, as they seem to have added a few new tests. Since it’s standard nationwide, large numbers of people are doing it all the time. So when you go in to have it done, it’s not like you’re doing it alone. When I went in for mine yesterday, I was with the afternoon group–about a hundred or more people. And that’s just the men’s floor.

When you come in, they take the forms you filled out, along with a sample you had to collect at home (ahem, you probably know what unpleasantness I’m talking about), and ask you to take a seat. Then they call you up to the desk and give you a number. You go in to the locker room, strip to your skivvies and change into two-piece jammies with the shirt being a tie-off. You then go back to the main room and sit in the seat with your number on it (I was #23), and wait for the tests to begin. They take urine and blood samples, measure your height and weight, take your blood pressure, give you a chest X-ray, an EKG, vision and hearing tests, and the thing where the doctor listens to your heart and breathing and asks to see your tongue. Between tests, you sit back in your chair, reading the usual waiting room magazine fare–unless you brought your own materials. I seemed to be the only one there who did that–I had my iPad, which was quite nice.

After all those standard tests, there’s one more they seem to throw in for fun: they put you on a motor-controlled X-ray platform starting at a 90-degree angle, so you begin standing up. They then give you a packet of seltzer which you you have to gulp down with what had to be a quarter-teaspoon of water, and then–without burping up any of the air that starts to build up in your stomach–you have to gulp down a large cup of gloopy white barium solution, which at least did not taste terrible, but nonetheless was hard to get down with your stomach bursting with gas. If you belch out any of the gas before the test is done, they make you drink more of the stuff.

But that’s just for starters. Once you have this explosive combination in your stomach, they then start rotating the platform, while demanding that you constantly roll over, again and again, in that small, restricted space, while they call for you to stop at various angles so they can take X-rays before telling you to roll over yet again. For giggles, they roll the platform at all angles, including one where you’re angling down head-first and it’s impossible to hang on without sliding [note to health center: friction pads on the handles would be nice], but they keep taking X-rays until you do. Then just to be thorough, a mechanical arm with a large pad on the end is extended to press down hard on your stomach–and you still better not belch out the gas.

One hopes this is some vital test, because if it’s not, then no way it’s worth it. At some point I gotta find out exactly what that was for. When I got off the stand, I asked the technician, “So am I ready for the Space Program?” He didn’t seem to get it. I then belched, long and loud.

Even that wasn’t the end of it. Despite giving no warning whatsoever in the pre-check materials, they then give you laxatives, so the radium doesn’t stay in your system. This being some time after they asked you to choose whether or not you would stick around an extra hour or two after the exams end to get a consultation with the doctor. I was glad I asked them to mail the results–though I found out that you can change your mind afterwards–because they gave no guarantees on when the laxatives would kick in.

As it happened, I chose correctly–they kicked in just as I arrived home. Had I stayed for the consultation, they easily could have kicked in while I was on the hour-long commute back. That would have been fun.

Further hilarity ensues when, after experiencing what Sachi branded as “the white craps,” you find that the barium solution is damned heavy, which results in your thanking the fact that you have a toilet brush.

Were it not for the barium thing, the check-up would be a breeze. With it, once a year seems a bit excessive.

Categories: Focus on Japan 2010, Health Issues Tags: by
  1. Tim Kane
    December 5th, 2010 at 01:02 | #1

    They do almost the identical thing in Korea. (I believe they have the same health care system as Japan). In four years there, I went to two check ups like that, including the weird x-ray or ultrasound machine thing. They always have some old retired doctor at the end give some briefing of your results to you. (loose some weight. get some exercise, etc…)

  2. Troy
    December 5th, 2010 at 03:56 | #2

    heh at NCB didn’t they have to give us annual check-ups because the union raised a stink about the company not following the law?

    I did go to that, they chose some sketchy place in Shinjuku where we had to go IIRC.

  3. Paul
    December 5th, 2010 at 12:48 | #3

    That sounds like one hell of a lot of radiation to soak up, in the X-rays.

  4. Troy
    December 5th, 2010 at 16:13 | #4

    nb, my Blue Shield PPO plan with the $4500/yr deductible is going up $44/mo (25%) thanks to the ACA.

    There were some major changes — no lifetime cap, no preexisting conditions for minors, and kids under 26 are now covered on parents plans, plus some other stuff.

    Apparently too they can’t discriminate premiums based on gender any more ? ? ?

    That sucks I think.

  5. Luis
    December 5th, 2010 at 21:57 | #5

    I found a page which describes the stomach thing:


    The page says that the technicians apply the lowest dose possible–it just seemed like they were taking lots of photos… I’m not worried though–I understand that current equipment has the doses down pretty low nowadays. Yes?

  6. Troy
    December 6th, 2010 at 05:28 | #6

    Equal to about 700 dental xrays apparently


    Think I’ll pass on that. Not sure what they’re expecting to find with all that jazz.

  7. December 6th, 2010 at 13:20 | #7

    I’ve been doing these annual checkups for 19 years, and they start adding more tests as you get older. The Barium Dance is usually started when you hit 40. I got flagged one year for a small indentation in the lining of my stomach and for 3 years after that had to go into the hospital for a special set of xrays, on a larger machine, with more complex rolling and pitching and yawing. The xrays in the consultation a month later were mind boggling. They had every nook and cranny all the way from the esophagus to the small intestine mapped out in great detail and from many angles. If I had had an ulcer, they would have found it (I just had an inflammation). The extra two years were just in case. Back in the day, the Barium used to taste like chalk. About 6 years ago they started flavoring it. The whole thing was a wonderful test of my Japanese grasp of space and movement, following the directions.

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