Could I afford to NOT retire in Japan?

[TJKansai]

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 thought the same thing until I read the below. In my experience, Japanese doctors handle many more patients than American docs but are paid less per patient, so they make up for it with volume. That said, many docs seem more than willing to chat when not too busy (especially if their English is decent and they can practice a bit).

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.

I know they now have the booklets, but no one in my family remembers to take them.

I imagine the logical thing is for the medical system to be unified someday using My Number and a doc/pharmacist in one city will be able to see your records in another. That doesn't exists now, does it?

[RetireJapan]

I imagine the logical thing is for the medical system to be unified someday using My Number and a doc/pharmacist in one city will be able to see your records in another. That doesn't exists now, does it?

This started this year, but is being implemented slowly. Hospitals have to opt in, and have to pay for the necessary infrastructure. Patients are also charged more if the hospital has opted into the My Number health card system (+9 yen if they use the old health card, +21 yen if they choose to use their My Number card).

Seems a pretty stupid way to try to promote a new way of doing things

[TJKansai]

I imagine the logical thing is for the medical system to be unified someday using My Number and a doc/pharmacist in one city will be able to see your records in another. That doesn't exists now, does it?

This started this year, but is being implemented slowly. Hospitals have to opt in, and have to pay for the necessary infrastructure. Patients are also charged more if the hospital has opted into the My Number health card system (+9 yen if they use the old health card, +21 yen if they choose to use their My Number card).

Seems a pretty stupid way to try to promote a new way of doing things

Yeah. Offering a ¥ discount for My Number would make a lot more sense. Kind of like the cash incentive to get it in the first place.

[captainspoke]

One thing I take, warfarin, requires blood monitoring, so every renewal cycle (90days) I get blood-tested for what that's doing, along with some other things on the side. I just counted, and there are 48 items on the results sheet, they took five vials. I think I could discontinue the warfarin--I asked to keep taking it when the normal course was done. The other two may just be along for the ride, a statin and one for BP, so they're renewed on the same 90day cycle as the path of least resistance. Also, the 90day cycle (4x/yr) overlaps with another followup (CT every ~6 months), so 2 out of 4 yearly visits coincide with another reason to be at the hospital.

I haven't looked, but these are probably available online, or as above, OTC in SE asia during an extended stay there.

[Cracaphat]

Here is my ride till I die.Nice to go see the family but love coming back even more Being in the 50+ club,go home and do what to earn a crust?
I'm staying here.Though if I came into a lotta money,I could think about living in Australia again.As is,the cost of living is too steep for my shallow pockets.

[IloveJapan]

Hello, retirejapan, hope are doing well, and I am sorry you lost your teaching job. I would imagine that is part of the reason you are thinking about the future…

Regarding inflation, I believe Japan has every bit as much inflation as the United States! I’m not joking! Consider this: Up until now, Japan has been a country with a lot of shrinkflation for many products. Shrinkflation means that companies facing cost pressures from materials, salaries and the like will reduce the number or amount of items they offer in a pack while keeping the price the same! So a company might for example reduce the number of biscuits in a packet from 10 to 9 rather than raising the price. But in fact that means the price of that packet of biscuits has effectively increased by 10%, without the consumer noticing! One prime reason this phenomenon is so huge in Japan, is that women controlling the family purse strings are highly sensitive to price increases!

I do believe people’s standard of living is being affected, but they are just not noticing it yet…

The other thing I should point out is that pensions may not keep up with inflation, because governments can’t afford to increase them in line with high inflation. I believe the Japanese authorities will find a way to look after the retired, helped by Japan’s giant public pension fund. As for the frozen UK pension, that will end up being inflated away more quickly than people anticipate! Even a British person retiring in a non-frozen country may suffer, because a country with double-digit inflation (the UK) won’t be able to keep its pension promises even if it wanted to.

Tell me, what do you consider to be inflation-friendly jobs or investments?

[RetireJapan]

Hello, retirejapan, hope are doing well, and I am sorry you lost your teaching job. I would imagine that is part of the reason you are thinking about the future…

Thanks! Although it was pretty much mutual by the end there. Haven't thought about the place once since April

As well as inflation friendly jobs (anything that gives you real raises I guess) and investments (the stock market?), I would also think about an inflation friendly lifestyle.

The less you spend, and the fewer things you buy, the less inflation affects you.

For my family, our baseline spending is so low compared to our income/investments that prices would have to double or triple before it bothered us much. That comes from very low housing and transport expenses, and little discretionary spending.

It's not that we are depriving ourselves either, but honestly I don't feel like spending more.

My two biggest spending categories are probably coffee and books -and I spend lavishly on those

[goran]

My two biggest spending categories are probably coffee and books -and I spend lavishly on those

This will be my answer for when I need to reply to what I want to do when I grow up.

Be able to spend lavishly on coffee and books!

[Gulliver]

I work in the pharmaceutical industry in Japan.

Not sure in what capacity you work for the pharmaceutical industry, but do you have any kind of inside track on approval of existing or new pain medications in the pipeline for non-cancer patients (opioids, THC etc.)?

This might be a situation where I would not be able to afford living in pain for the rest of my life in Japan.

[TokyoWart]

I work in the pharmaceutical industry in Japan.

Not sure in what capacity you work for the pharmaceutical industry, but do you have any kind of inside track on approval of existing or new pain medications in the pipeline for non-cancer patients (opioids, THC etc.)?

This might be a situation where I would not be able to afford living in pain for the rest of my life in Japan.

I’m sorry you are in this difficult situation. My employer has never worked in pain medicine development. Within the industry this was always a difficult area for companies because opioids are both very inexpensive (essentially no profit margin for the generics) and there’s a lot of social stigma to the therapeutic area. I attended an FDA advisory meeting once where a company was presenting a new opioid formulation that would be more difficult to abuse and almost every public comment in the meeting was from a family who had lost someone to overdose and argued tearfully AGAINST approval of a drug that was designed to reduce the risk. That company subsequently went bankrupt from the US opioid litigation which is so expensive it has further decreased drug development in this area. I don’t personally know of anyone working in this development space because of the risk of litigation tied to abuse.