Saturday, January 24, 2009

Isn't that overkill?

Yarisugi janai?

The Pumpkin Princess has the chicken pox. I regret that I didn't get her vaccinated. It's not required here, but it's safe and effective, and I really should have, but I procrastinated, and now it's too late. I took her to the pediatrician's a couple days ago. The clinic has a separate waiting room with a separate entrance for the kids with infections like chicken pox, measles, mumps, influenza, etc. We had the room all to ourselves, and there was a generous supply of toys and picture books. We kept each other entertained until the pediatrician (a woman about 10 years my senior and about my size and shape, when I'm not preggers anyway) came into the room with the nurse, examined her, pronounced my diagnosis of chicken pox correct, prescribed her some drugs, and left. The nurse came back with the drugs, explained them to me (this one is taken four times a day, at least four hours apart, this one you dab on the splotches with a Q tip, this one is in case she gets a fever, you can save them for later if she doesn't need them). I looked at the drug names, and found the oral med was acyclovir, an antiviral drug. I didn't know they give you antiviral drugs for chicken pox. I compared notes with my co-workers later that day, and they said that they got acyclovir for their kids when they got chicken pox, too. Seems to be standard procedure in Japan. It doesn't change the (already low) complication rate, but it shortens the course of the disease. They don't give it in the US, which I can understand. It strikes me as kind of being overkill. Still, I gave it to her, since it's a pretty safe drug and it's standard procedure here. 3 days later, most of the splotches have crusted and she is no longer getting new ones. We've had minimal tears about itching and lesions in the mouth. She's not had any fevers. Plus, the drugs and the exam were free. Who am I to complain?

Health care for children is free in Japan. How long depends on where you pay taxes. In Pumpkin City, you get free health care up until you start 1st grade. (If you want to get technical, the health insurance from my work pays for 70%, and Pumpkin City pays for the remaining 30%). I flash this card and I'm good. For Thursday's exam and the drugs, I paid 50 yen (60 cents or so?) for the container the topical Q-tip drug came in.

The system is not perfect. The premise is that you have regular health insurance. Most people do, but a small minority of low income households do not, and they won't pay the 30% if no one will pay the 70%. Also, the length of the coverage depends on the city. Pumpkin City is about 6 years, but the neighboring city will only pay for kids up to the age of 3. In Pumpkin City, they were kicking around the idea of paying until age 12, but with the economic downturn (and decreased tax revenue) of recent months, that one might go down the drain. We'll see.

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