The food is different. Social norms are different. Fashions are different. Body language is different. It feels like just about everything, one way or another, is at least a little different when you move to another country. It doesn’t take much time to adapt to most differences, but some things are harder learned than others.

One unexpectedly difficult thing to get used to in Japan, at least for many Americans, is actually having access to affordable healthcare.

Got a bad cold and want to see the doctor? Easy and cheap here. But back in the USA? Often too expensive, even with insurance, so people commonly put up with what ails them without proper care and just hope for the best. This is true whether it’s a minor illness or injury or even something fairly serious. Because of the costs, many Americans become conditioned to avoiding treatment for all things short of an abject emergency.

So when Americans move somewhere like Japan, there is often a sense of relief that, if they need it, they can get medical care and not go broke in the process. But that doesn’t necessarily mean they go when they should.

The medical system in Japan is far from perfect, but, as exorbitant costs tend not to be one of the primary complaints¹, why do American immigrants still commonly resist going to the doctor? Relevant phobias and language difficulties aside, the long-term conditioned response of associating medical care with potentially losing all of your money is a hard thing to shake.

I fall prey to this as well, avoiding going to the doctor when I really should, putting it off until the problem gets bad enough that I force myself to go. And without fail, I feel relieved and foolish when it comes time to pay.

Recently, I’ve had some severe knee problems. I’ve missed work, been in a great deal of pain, and still put off going to the clinic. I figured I’d give it a little time to see if it went away on its own. It didn’t, and I only went when I did because my partner basically forced me to.

No referral needed, I went directly to an orthopedic clinic near my apartment. Overall, I went three times over a couple of weeks, but in short I got treatment, a diagnosis, and medication, all at extremely reasonable cost. When I went yesterday, they drained fluid from my knee, gave me a Cortisone injection, and sent me on my way with the medicines I needed. Total out-of-pocket cost? ¥1,880, or about US $17.00.

Similarly, back in 2019, I went to the dentist to fix a lost filling after two years of careful brushing and avoiding thinking about it. They replaced the lost filling, replaced another filling that wasn’t looking good, and gave me a full cleaning. In all, it took 45 minutes and cost ¥5,500 (US $50). I damn near danced in the street.

I sincerely hope I can eventually unlearn my automatic aversion to seeking the help that I need, and I hope that other Americans in Japan, many of whom have admitted to having the same tendency, can do the same. But, like I said, that conditioning is hard to shake.