My experience as an American with a Japanese wife has led me to do as much of my health care “purchasing” as possible in Japan.
I pay over $17,000 per year for my Blue Shield Silver plan for my wife and myself while here in the US. But I still did a colonoscopy in Japan last year. Cost: $200. As a foreigner. With no valid insurance in country. It would cost me at least $1500 here in the US…after high deductibles were met.
On another occasion, I became seriously ill in Japan. Wife called ambulance. To hospital. X-rays. Blood test. Sonogram. Super polite doctors. Hella cute nurses. About $180 cash.
I still do annual exams, IV hydration, blood panels, eye exams, chest X-rays, any procedure I can “schedule” – it’s still cheaper to pay cash and do it in Japan. (This excludes cost of airfare, which I have to cover for my business anyway. As pure medical tourism, the numbers wouldn’t work. But since I am there anyways, everything medical seems much much cheaper.)
And I greatly prefer the way the doctors and nurses and clerks treat me. In the US, I feel like a two-legged insurance number with a credit card.