Hi Cherry,
Thank God you got the surgery you so desperately needed!

I'm wondering if surgery in Japan is an option for some of those here who are having so much trouble getting approval from their insurance companies or who have not insurance at all. Can you answer some questions for me?

Can you tell me what was the cost of your surgery in Osaka? Did your HMO medical insurance cover your treatment in Japan? If not, how were you able to afford the surgery there? How long was your hospital stay? Is it terribly expensive for a family member to pay for lodging there while waiting with the patient who is having surgery? What surgery was performed - was it the direct or in-direct by-pass or a combination of the two?  What folow-up treatment will you have and where?

I agree with you, our medical system is lousy. The medical care though, for those who can aford it, is exceptional. For a country where life, liberty and the pursuit of happiness are inalienable rights, there is certainly a huge number of people who are being alienated. You get what you pay for here. Many folks gamble that they won't contract a major illness so they pay the minimal amount for their health insurance, most often for an HMO policy. Sometimes that is the only coverage their employer offers and they can
't afford to supplement it. When a major illness strikes they usually get less than optimal care.  Others who are less willing to take the risk, pay more for the expensive individual insurance policy or for a supplemental policy. It costs more, but the coverage is "usually" pretty darn good. Then there are the two extremes, those who are too poor to afford any insurance at all and those who are huge risk takers and so pay for no insurance coverage at all, even though they could afford it, but choose instead to spend their money on a bigger mortgage or some other luxury. Some folks have a choice in the matter, but some don't.
Me, I'm the belt and suspenders kind of person. I'm self-employed, so pay for a catastrophic policy for my son (who is my business partner) and myself. We're out of pocekt $3000 every year for deductibles and $5,000 every year for stop-loss payments (when something catastrophic does occur) on top of paying $9,600 for the premiums - that's $17,600 a year - no wonder I don't own a home and still owe Stanford $4,000 for my 6-month followup this year. I sure don't know how to remedy the problem. I'm praying that someone does.  
Kim

Sorry I didn't response fast enough.  I had my account setted up as "notify me when I received a meg on my post", but I didn't receive any notfiication in my email.  Therefore I didn't look back yet until yesterday I received an email from Luca's father from South African.

Here're some of the most important things you might want to know:
1.      Cost: In my case, after reviewing my MRI and other testing results, Dr. Touho believes that I only need the surgery on one side. I stayed in his clinic from Aug 6th to Sep 2, almost one month.  The total cost including a private room (with private shower), food, all the lab tests and surgery cost was end up less than $20K US Dollars.  I consulted with Stanford Hospital before I went to Japan. I was told the cost in Stanford will be around $600K~$700K for surgery on both sides, which was not even includ the hotel cost.  Both my husband and I have Master’s degree and hold very well paid professional jobs.  However, we still cannot afford the cost in Stanford without insurance support.

The daily cost of a private room is around $145 USD a day.  Even though the room is not big, but if you are not picky, you can sleep on a cot in the room and stay close with Luca every moment.  Then you don’t need to spend any extra on hotel and transportation between your hotel and hospital.

They also have 2 patients and 4 patients room, which is a lot less cheaper than the private room.  I can check the price for you after work.  But I feel it’s better to have a private room when you have a one year old baby.  And if both you and your wife come along, stay together in the private room actually can save you a lot of money on hotels.

2.      Language:  This probably scared away lots of people from seeking treatment in Japan.  You’ve probably heard that Japanese speaks terrible English.  That’s true, but also that’s unfair to judge their English language skill since most of them don’t need to use English at all in their daily life.  But Japanese people are very gentle and patient, they will try their best to understand you and help you whenever they can.  

Dr. Touho speaks broken English, at least you will be able to understand.  He writes decent surgery report in English.  Dr. Touho’s right hand man- Dr. Yanakawa (actually she’s a woman) was a visit scholar in England, so she speaks English too.  There is one nurse who studied in Australia before.  Her English vocabulary level dropped after she came back to Japan, but during my one month stay, I talked to her in English every day and I noticed her English came back quickly.  At the end, we can talk about our life, love and hobbies without any problem.
All the nurses and lab assistants carries an electronic dictionary in their pockets.  You just need to speak to them slowly, or, in worst case you can just write down the word and they will understand you.
But I did hired a translator on the day before the surgery when Dr. Touho explains his surgery plan to me.  I didn’t want to guess or misunderstand anything of this important part.  The average translator cost is no more than $150 USD/Day.  And you really don’t need them every day.

3.      Food: If your whole family stays in the hospital the whole time, you will eat the hospital food.  It will cost you about $5~7 USD a day, but saved your time on food hunting in an unfamiliar neighborhood.  Breakfast is a small box of milk, bread or toast and a fruit cup.  Lunch and dinner are typical Japanese style “lunch box” kind food if you ever had it in South African.  It normally contains rice, fish, vegetable, soup etc.  The quantity is not big because Japanese doesn’t eat as much as American, ha-ha.  So you might feel hungry just like my husband did every day.  But you can always stock some instant noodle or things like that.
If you take Luca to Osaka for her surgery, I bet the food quality/quantity for you will be the least concern in your mind.  Is Luca still on breast milk or formula?  My son just turned 13 months old, he’s on regular table food already.

4.      The best part: Not like in Stanford, you only stay in hospital for 3 days during surgery, then you have to check the patient out and stay in a hotel for a week.  In Osaka, Luca will stay in hospital the whole time.  So if something doesn’t seem right, she can get any kind of emergency treatment immediately right there.  All the lab tests are in house so you don’t  need to worry about how to get to the hospital fast enough from a hotel.

Dr. Touho and Dr. Yanakawa take rotation on night-shift.  They are very dedicated to their work.  Dr. Touho basically lives in the hospital every day.  So you know that you can find either of them 24x7 if needed.

There was one time that I had a very bad headache after the surgery.  I told the nurse and within 10 minutes, Dr. came and send me to MRI room downstairs.  It turned out everything was fine but I can’t imagine if I was in a hotel somewhere, how quickly I can be diagnosed.

5.      The worst part: Japanese hospital normally doesn’t give you much freedom as American hospital does.  If you are checked in as a patient, you are not allowed to go out unless you get a doctor permission.  They don’t want the patients go out freely and catch cold or get infection from the outside world to ruin the whole thing.  But you are not patient, you can go out whenever you want to buy something.

6.      I met  lots of children patients there.  Most of them are between age 3~9.  I don’t know if Luca is old enough to have the surgery.  You can email Dr. Touho to ask.  You can also mail Luca’s MRI/MRA disk to Dr. Touho for a free consultation.  Sometimes Japanese computer can’t read your disk due to some region code or whatever reason.  So what I did was do a “screen print” of all my MRI images and save them as JPG files, zip it and email to Dr. Touho, and he can view the JPG file without any problem.  I know it’s time consuming.  It took me about 4 hours to save each screen but I’m sure you don’t mind doing it for Luca.

7.      Dr. Touho can also give you an estimate cost after reviewing Luca’s MRI.  (Normally they will give you a discount at checkout since they understand how hard it is to pay everything out of your own pocket.)


If you want to email Dr. Touho, you can mention my name.  I’m a “celebrity” in this hospital.  I’m 100% sure that they will be very proud that someone from South African heard about them.  For this reason, if you finally decided to go there, you will definitely get the best treatment ever.  Oh, if you write to them, keep in mind to use plain English.  Don’t confuse them with fancy word or very long combined sentences.  Just keep every sentence simple to help him fully understand you.

By the way, I will be in Japan from November 28th to December 1st  for follow up check.  I did a price comparison, including the airline tickets, it’s still cheaper than going to Stanford even though Dr. Steinberg is willing to do it for me.  

Good luck, I’ll pray for little Luca.