A few years ago, Chinese tourists engaged in bakugai (explosive shopping spree) in Tokyo’s Ginza district made headlines.

But that seems to be a thing of the past, as more Chinese tourists now seek services and experiences unique to Japan. And one of the most prominent fields is medical services.

“In recent years, a larger number of patients come to Japan for therapy and health checkups,” said Li Xin, vice president of Hibikojyo, a medical service agency based in Tokyo that has offices in several cities in China, including Beijing and Shanghai. This is “because more hospitals in Japan are ready to receive foreign patients and have loosened the admission criteria,” such as accepting more intermediate and advanced cancer patients, he said.

According to the Foreign Ministry, 70 medical visas were issued in 2011, when the government first introduced the special visa category. By 2018, the number had increased to 1,650, 84 percent of which were for visiting Chinese patients.

Foreign visitors entering Japan on tourist visas can also receive medical services, except for long-term therapies or surgeries requiring three months or more treatment, which is permitted under the medical visa. As the Tokyo 2020 Olympic and Paralympic Games draw near, the government is eyeing a goal of attracting 40 million foreign visitors next year.

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If Japan achieves that goal and 4 percent of them needed medical attention during their visit, that would amount to about 1.6 million patients, of which about 70 percent would be from China, according to Japan Medical Support System for Visitors from Abroad, a private institution providing health care-related support for foreign patients.

Jiyugaoka Clinic, a large cosmetics hospital in Tokyo, started to cultivate its international reputation seven years ago, given the gloomy prospects for growth in domestic patients.

“In 2010, we barely had foreign patients,” said Yoshiaki Furuyama, the clinic’s CEO. “Last year we received more than 1,200 clients from mainland China.”

In a boost to Japan’s medical establishment, experts say the country’s international recognition as a health care provider is on the rise.

According to the Health Care Index for Country 2019 released by the crowd-sourced global database Numbeo, Japan ranked third among 84 countries in terms of overall quality of its health care system, the standard of personnel and costs. China, however, came 46th in the same rankings.

Due to uneven regional economic development, Chinese people in inland or rural areas don’t have easy access to functional health care services. Instead of queuing in front of the overcrowded top hospitals in big cities, affluent patients would rather travel overseas to seek better medical care.

And for many Chinese patients, the greatest allure of Japan’s health care and medical service is its quality.

Japan was ranked the highest in five-year survival rates of lung cancer and esophagus cancer patients from 2010 to 2014 based on the data of 37.5 million patients from 71 countries and regions, according to a report published by the U.K.-based medical journal The Lancet in early 2018, as cited in the Mainichi Shimbun.

With the prospect of better treatment and recovery, Chinese are willing to travel the extra mile — to Japan.

“We’ve learned that the proton beam therapy technique here is more developed than in China,” said Sun Jing, 36, from the northeastern city of Harbin, who has been escorting her 61-year-old father for bile duct cancer treatment at Southern Tohoku General Hospital in Fukushima Prefecture since January. “The doctors walk the patient through by providing explanations in each treatment process, and it has gone smoothly for us so far.”

Li of Hibikojyo said that systematization and the precision of cancer screening tests in Japan are the main attractions to Chinese patients. In some fortunate cases, he added, patients have detected early-stage cancer during the tests and have received timely treatment.

The polite attitude of medical personnel is also a plus.

“When the nurses meet my clients, sometimes they kneel down, because it’s easier to serve sitting patients,” Li said. “Those patients felt overwhelmingly spoiled. They said they couldn’t even imagine it in China.”

Zhang Qingqing, a 22-year-old female Chinese student, underwent both an eight-hour general anesthesia surgery and a stitching double-eyelid operation in Kyoto in 2018.

“I chose to receive operations in Japan because I trust the doctors here,” Zhang said. “I knew everything was according to plan, and they were very responsible.”

Undergoing cosmetic treatment overseas, especially in Japan and South Korea, has become something of a status symbol for well-heeled Chinese of late.

While South Korea has become the leading overseas destination for Chinese cosmetic-surgery tourists, botched procedures and treatment accidents have been highlighted in the media in recent years, prompting more Chinese patients to come to Japan.

“Doctors in Japan care more about the treatment quality than the volume of customers,” Naohiko Sakai, a surgeon at Ginza S Aesthetic and Plastic Surgery Clinic in Tokyo, said about the growing Chinese clients bound for Japan for plastic surgery. “The techniques and treatment efficacy here are more reassuring to those patients.”

Qu Tuo, president of the Chinese cosmetic surgery agent Amazing Bird, started to become an agent for Chinese beauty patients in Tokyo in 2014. At the time, a large proportion of his clients had experienced failed procedures in South Korea and came to Japan for remedial treatments.

“Those desperate patients found me at that time, coming to me as their last chance,” said Qu. “Last fiscal year ending in July, we received nearly 1,600 customers, 40 percent of whom were for repair surgeries.”

Good things don’t come cheap. In Japan, patients who are covered by the national health care system are only responsible for basically 30 percent of the actual medical costs. Foreign medical tourists, on the other hand, are required to pay the full amount.

According to the guidelines by the Ministry of Economy, Trade and Industry, hospitals may charge foreign patients for additional expenses such as for services and documentation fees.

“The medical charges for international patients are often double or triple the Japanese patients’ full expenses,” Li said.

This is partly because hospitals don’t want their limited resources stretched by foreigners, said Toshiki Mano, a professor at Chuo University who is an expert on medical tourism.

“It’s also the case that they require extra work” administratively, compared to Japanese patients, he said.

Owing to the language barrier, many overseas patients visiting Japan tend to receive an intermediary company’s “one-package services,” which usually include transportation, interpretation and escorting fees that further add to the bill.

According to a recent article in the National News Daily, a financial newspaper in China, average spending on cancer treatment in Japan is estimated to be between $50,000 (¥5.47 million) to $100,000, triple the cost in China.

Nevertheless, higher medical bills are not stopping the avalanche of Chinese medical tourists flowing into Japan.

“Chinese patients care less about money. What they want are reassuring treatment and services,” Sakai said.

Yi Xiaojun is a graduate student at Akita International University, Japan. This article is part of his course work in journalism at the Graduate School of Global Communication Practices. Former AIU student Wei Yaning contributed to the report.