Could I afford to NOT retire in Japan?

[Tokyo]

Our plan in The Before Times was to have a base here in Sendai then take a couple of extended trips abroad (6-10 weeks or so) each year, either to spend time with family (we have kids in Canada and Sweden, my family in Spain, and friends in the UK and the US) or to visit places on the bucket list (I still want to make it to Mexico).

We'll see how this plays out in the future, and whethr Covid and other factors actually allow us to travel (and whether we want to).

I guess the key in this (like everything) is to experiment, be flexible, and see how things go.

That sounds like a plan! There are a few practical issues you might want to consider for longer trips. Obviously, insurance costs a lot more. Secondly, my doctor isn’t willing to issue prescriptions for much more than the standard month’s worth although I have received up to 6 weeks. Finally, I am really into one bag travel: I fly with only carryon baggage (consisting of a small messenger bag & a largish 30liter duffel/backpack) which complies with domestic & international carryon limits. No lost or stolen luggage & no waiting forever at the carousel for me! But I only travel a few weeks, by choice. Not sure if I can fit 10 week’s stuff in. But you gotta do what makes you happy… whatever that is. Good luck!

[RetireJapan]

That sounds like a plan!

Well, we'll see how things go. Seems like it is going to become a lot easier to return to Japan next month.

Now I just need to stop working -I'm still helping my wife with her school on a full-time basis.

[captainspoke]

...issue prescriptions for much more than the standard month’s worth ...

Hmm, I'm on a 3-month renewal cycle--was just there yesterday. I wonder if it depends on prescription specifics or what.

Regardless, my scripts are nothing unusual (or abusable), and I think the same drugs would be available in SE asia over the counter. I might check to make sure on some local forums there before going, but that would be looking to confirm that it is, rather than really asking whether it is. Of course, I would not expect that in the developed world.

[TokyoWart]

...issue prescriptions for much more than the standard month’s worth ...

Hmm, I'm on a 3-month renewal cycle--was just there yesterday. I wonder if it depends on prescription specifics or what.

Regardless, my scripts are nothing unusual (or abusable), and I think the same drugs would be available in SE asia over the counter. I might check to make sure on some local forums there before going, but that would be looking to confirm that it is, rather than really asking whether it is. Of course, I would not expect that in the developed world.

I work in the pharmaceutical industry in Japan. There is a special rule for new drugs here (drugs that have had their price set within the last 1 year) that you can't issue more than a 2 week supply of the drug at any one time. The idea is that this forces closer supervision of the patient. Many physicians seem to continue the spirit of that rule by leaning for relatively shorter prescriptions than would be typical in the US. Also unlike the US, Japan doesn't have a prescription refill system where the patient can get a 1 month prescription along with a note for refills for the next several months (although they can give more than 1 month of pills at one time when the drug has passed the new approval 14 day restricted supply period).

https://www.jstage.jst.go.jp/article/rsmp/9/2/9_69/_pdf
https://pj.jiho.jp/lexicon/l-1226563932169

[RetireJapan]

My ENT doctor is very reluctant to give me more than four weeks of allergy meds

I have managed to get 5-6 weeks for special occasions (when I went into hospital, or if the fourth week falls on the Golden Week holiday or something).

[Beaglehound]

The reluctance to give repeat prescriptions without a doctor visit is pretty annoying. Makes sense with some conditions but, for example, I have eczema which I can manage better than any doctor, knowing my body and having years of experience. It serves no purpose for me to trot along every few months to tell the doctor nothing has changed and pick up the medication I need.

[tokyojoe]

Mulling over a blog post at the moment, but recently I have been thinking about how reasonable the cost of living can be in Japan (at least for our situation here in Sendai, owning or mostly owning our home).

Right now I am pretty confident about our ability to retire here and live off pensions and investments.

Looking at prices in other countries (UK, US, Australia, etc.), mostly housing but also food, eating out, utilities, etc. I'm not sure we would be able to do so in another country.

Even Thailand has seen prices explode since I first went there in 1997.

What do you think? Are you confident of being able to move out of Japan and life the same kind of lifestyle?

Housing is super cheap in Japan, which I would expect means that the cost of living is lower in Japan overall.
Certainly moving back to the UK to spend your retirement in rented accommodation
would be a tough proposition financially for most people.
However, if you have got to the point where you have bought and paid for a house in the UK, the costs of living
then reduce dramatically. If you can cover your rates, utility bills and food costs then that's pretty much it in terms
of essential spending, although we should probably add in dental costs (since NHS dentists no longer exist in much of the country)
and maybe house maintenance costs. However there are no charges for the NHS, and you should eventually get free
bus travel! (I do appreciate that the NHS has a lot of problems coming its way at the moment though.)
In Japan you would have to pay something for any medical treatments, and food costs (as in groceries) are generally higher
(depends on the exchange rate of course, but maybe as a consequence of the fact that almost no supermarket food in the UK has VAT applied,
UK food costs have tended to be significantly lower than in Japan).
Inflation may be having an effect, but with a weakening yen and a low self-sufficiency in food
https://www.nippon.com/en/japan-data/h01101/
Japan can't hope to escape those inflationary winds in food at least.


If you are lucky enough to buy a house with a large garden in the UK those food costs can be further offset
by growing your own fruit and vegetables of course - I guess this may also be possible in Japan in rural areas.
However there are a couple of other factors re: the UK - for those people who qualify for a state pension
then that pension will rise at the very least in line with inflation (so long as a triple lock is maintained)
whereas this UK pension will be frozen if you receive it in Japan (whereas the Japanese one will
be the same whether you receive it in the UK or Japan or elsewhere). For me the pension is likely
to be a reasonably significant component of my retirement income, so this is one consideration.

There are also a few general points concerning the long term - Japan is perhaps more likely to be adversely affected by
climate change than the UK, while Japan also has a strong population decline ongoing, while the UK's population is
rising ... although there are of course lots of other uncertainties.

I guess the decision also depends a lot on non-financial factors though - where are more of your friends / family,
what do you want to do in retirement etc. ?

[TJKansai]

My ENT doctor is very reluctant to give me more than four weeks of allergy meds

I have managed to get 5-6 weeks for special occasions (when I went into hospital, or if the fourth week falls on the Golden Week holiday or something).

My ENT guy will give me as much as I ask for, generally a season's worth. Same with my skin doc, who will load me up with enough creams to last 6-12 months. In both cases, I am a long-time patient with minor, chronic problems that never really get bad.

One other alternative is overseas pharmacies/supermarkets. A trip to a US Costco supplied me with enough Loratadine for 4 years ($9 for 365 pills). They reached expiration by still worked fine.

One caveat: 25 years ago I came back from the States with $2 box of supermarket allergy pills and they took them away due to one of the ingredients.

[Tkydon]

The doctor makes more money if he gets to charge you (and your insurance company) for a consultation every month for the repeat prescription...

[TokyoWart]

The doctor makes more money if he gets to charge you (and your insurance company) for a consultation every month for the repeat prescription...

I don't think this is the reason that prescriptions are deliberately limited in time in Japan because that multitude of very short visits is not necessarily very profitable for the physicians and a large number of physicians work in settings (eg universities or as hospital system employees) where they don't get any increase in income based on numbers of patients seen. Japan has a history of trouble with "polypharmacy" with a relatively large number of prescriptions per patient, especially among the elderly, and the government pays the majority of the cost of medicines in Japan because of the way the national health insurance system operates. Besides the safety oversight, there is a strong incentive for the government to limit the number of pills issued at any one time. I work in the pharma industry and of course we see this very differently (those short prescriptions are limiting access to drugs and result in gaps in treatment), but this is maybe best considered one part of the many cost controls the Japanese government has put on the growth in prescription costs.