Ventilator-Assisted Living©

Spring 1992, Vol. 6, No. 1

ISSN 1066-534X

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Read selected articles from this issue ...

Ventilator Use in Japan
Yasuoka Kikunoshin, Japan

Spring Has Come
Kimiyo Sato, Japan

More on Ventilator Considerations: Lease vs. Purchase
Jerry Daniel, Vancouver, Washington

Saludos from Spain
Daniel C. Vilaseca Dreischer

Travel & Ventilators: Travel by Air "With Air" Is Possible
Lori Hinderer

Potpourri

Camps for Ventilator-Assisted Children


Ventilator Use in Japan

Yasouka Kikunoshin, Japan (from Another Voice, October 1991)

The most urgently needed system now, and at the same time the biggest obstacle for ventilator users, is the problem involved in the purchasing of the ventilator. Ventilators should be provided to users like other everyday equipment, e.g., electric wheelchairs.

Last year, home ventilation treatment became a category under health insurance as "home ventilation instruction and managing fee," counting 1500 points. This means that, if used, the hospital will get 15,000 yen a month. This is slight progress, but no one has used this system and started to live at home. The points are so low that the hospitals wouldn't get any advantage. Some say that hospitals will purchase ventilators by the money they can get from the insurance, but I think that is very unlikely and unrealistic. No hospital would use such low insurance money to provide new ventilators to each individual with a disability who needed one.

Ventilators and expenses can amount to approximately 3 million yen (about $22,000 USD), and are paid by the individual. Even if you have the money, the medical equipment vendor will not sell it to an individual. Currently, the purchase is performed in a round-about manner. The individual donates the money equivalent to the price of the ventilator to the hospital and then the hospital lends the equipment to the individual for an indefinite period. This is the only way to get a ventilator and live at home in the community.

Some local self-governing bodies, like the Niigata prefecture (since 1990) and Tokyo (from this year), have developed systems of subsidies to the purchase of ventilators. These are systems in which hospitals who practice home mechanical ventilation can ask the local government for subsidies when purchasing a ventilator.

Unfortunately, in Sapporo or in Hokkaido, there are no subsidies. There is only one ventilator user equipped in Union of Patients with Obstinate Diseases in Hokkaido. There are only two ventilator users in Sapporo, and I suspect that there are not so many even in Niigata or Tokyo where there are subsidies. There are no statistics for people using ventilators in the community.

The important thing is to make the national government legally admit the ventilator as everyday equipment or subsidiary equipment and include it in the medical benefit of the welfare project for those who are disabled. The government should also make the ventilator available to individuals, not just medical institutions. The medical institution should support the ventilator user living at home.

Editor's Note: The consensus among American ventilator manufacturers who market ventilators in Japan is that the Japanese Ministry of Health is moving slowly toward making ventilator rentals more accessible to those individuals who need them and toward encouraging the use of home mechanical ventilation. The situation is more promising for individuals in the larger cities.

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