The Harver Group: Son watched father die, writes book on health care system


David Goldhill’s father died from an infection he contracted in a well-regarded New York hospital.

That began a quest to investigate America’s health care system. In his book “Catastrophic Care: How American Health Care Killed My Father and How We can Fix It,” Goldhill reports that nearly 100,000 Americans die every year from hospital-borne infections.

That’s more than double the number of Americans killed in car crashes and five times the number of those murdered.

How did American hospitals miss the quality control revolution that affected the rest of the American economy?

Goldhill contends that our current system drives “excess treatment, cost inflation and medical errors.” And he says the Affordable Care Act only worsens the perverse incentives and would raise the cost of care.

He worries that the exchanges will reduce competition among insurers, the subsidies will make consumers less price-conscious and mandates will cause healthy people to drop insurance.

The result may be less coverage at higher costs than the authors of the Affordable Care Act intended. He describes the health care system as “the Beast” that tolerates excess and careless medicine.

“Bad health care is crowding out needed care,” he writes.

His solution is to combine the liberal desire for universal health care with a conservative desire for market-oriented approaches.

He calls for a national insurance safety net that covers health crises that are “major, rare and unpredictable.”

“Insuring everyone isn’t the same as insuring everything,” he writes.

That means using insurance as it was meant to be used, for rare catastrophic events.

What the health care system does disastrously is provide quality care at affordable prices. In 2009, Medicare had $54 billion in proper payments.

Goldhill’s plan involves health savings accounts, health loans and catastrophic insurance.

- Increase money we put into health care and save the difference.

- Reduce the use of unnecessary health care to some people so others may build savings.

- Cut spending in ways that don’t hurt quality and transfer that into savings.

Money currently put into the health system would accumulate in a tax-free account. That money would be used to pay premiums for cradle-to-grave health insurance.

If you run out of money, you can borrow against your future contributions. While it doesn’t sound practical in today’s political system, the ideas are based on an interesting set of principles. His plan is basically along the same lines as Singapore’s national system.

“We’re stuck in a vicious cycle in health care. The more we try to protect ourselves from the realities of care, the more complex and unconnected from us the system becomes,” he wrote. It’s far too complicated for the average person.

The Harver Group - Most state health insurers seek rate boost: Proposals compared


Proposed rate changes for 2015 individual health plans are all over the map, but most companies are keeping up with tradition by requesting increases in premiums.

If approved, rate increases for 2015 individual health plans proposed by 12 insurance companies may affect most policyholders, whether they bought their plans through Washington Healthplanfinder’s online marketplace or in the outside market.

Washington is one of the first states to see proposed rate changes for 2015 individual health-insurance plans.

The proposed rate changes range from a decrease of 6.8 percent — from Molina Healthcare of Washington — to an increase of 26 percent from Time Insurance, a national company with relatively few Washington policyholders.

Most rate-change requests, particularly from larger insurers, were in the middle ground, with most asking for increases from about 2 to about 11 percent.

To anyone who has had individual insurance, premium increases are not surprising: Records show that, on average, insurers have proposed rate increases for individual plans from about 9 percent to more than 18 percent every year from 2007 to 2013. After review by the Office of the Insurance Commissioner, the average rate increases imposed were lower — in most cases, only slightly lower. But in one year, rate-increase requests were cut by more than 3.5 percentage points.

With the exception of relatively few grandfathered plans, all individual plans were new in 2014 to comply with provisions of the Affordable Care Act (ACA), which set certain standards for coverage and barred insurers from excluding people with pre-existing conditions.

Some insurers offer plans only inside the Healthplanfinder exchange; some offer plans only in the outside market. Five are proposing plans both inside and outside the exchange. Any rate- change proposals for those insurers would affect both inside and outside plans.

The rates do not become final until they pass review.

Spokeswoman Stephanie Marquis said it likely would be a tough review this year because insurers have only a few months’ worth of actual claims data, so they must use other data sources to justify rate increases.

There didn’t appear to be differences between proposed rates for plans sold only inside the Healthplanfinder exchange market and those sold only outside.

BridgeSpan Health, whose exchange plans picked up a relatively small portion of the market this year, asked for a 1.7 percent increase; its affiliate, Regence BlueShield, which offers only outside-the-exchange plans, asked for 5.1 percent.

Coordinated Care Corp., with exchange-only plans, asked for 11.2 percent, as did Group Health Cooperative, which has plans both inside and outside the exchange. Group Health Options, with plans offered only outside the exchange, asked for 14.2 percent.

Premera Blue Cross, offered both inside and outside the exchange, and Community Health Plan of Washington, with only exchange plans, asked for 8.1 and 8.4 percent, respectively.

In the small group market, insurers on average proposed smaller rate increases, with at least four insurers asking to decrease rates. That may be because insurers expect to pick up younger members now insured by association plans that have been discontinued because they did not meet the requirements of the ACA, Marquis said.

Four new companies have submitted proposals for individual plans to be sold inside Washington’s Healthplanfinder exchange. Because the plans are new, there are no rate changes proposed. Those companies are Columbia United Providers, Health Alliance Northwest Health Plan, UnitedHealthcare of Washington, and Moda Health Plan. Moda currently has individual plans in the outside market but plans to replace all existing plans.

For more related topic, visit Harver Health Insurance Counter Fraud Group

The Harver Group: How Will 2015 Health Insurance Premiums Compare to 2014?


The Affordable Care Act’s (ACA) 2014 open enrollment period for the individual health insurance market has only just ended, and actuaries for health insurers already are developing premium rates for the 2015 plan year. Much of the uncertainty regarding the health spending by plan enrollees that existed when insurers submitted their 2014 rates remains for 2015.  Although insurers have information on enrollee demographics, only limited information will be available on enrollee health status and health spending when premium submissions are due this spring.

Key drivers of 2015 premium changes include how the composition of the risk pools in 2014 compares to what was expected, the reduction of funds available through the temporary reinsurance program, and the underlying growth in health costs. How enrollment differs from projected will vary by insurer and by state, with larger premium increases possible in states that adopted the transition policy allowing non-ACA-compliant plans to be renewed.

The composition of the risk pool and how it compares to what was projected

When calculating 2014 premiums, insurers had to make assumptions regarding which individuals would purchase coverage and what their medical spending would be. There was much uncertainty regarding these assumptions because insurers had only limited experience data on individuals who would be newly insured.

Insurers face a similar uncertainty for 2015. Although they have information regarding the age and gender of their 2014 enrollees, they have only limited information on enrollee health status, due to the reporting lag between when health care services are provided and when claims are processed. Practitioners are observing that while some insurers are seeing 2014 enrollee demographics fairly similar to what they projected, others are seeing an older-than-expected enrollee population. Any available medical claims data will need to be adjusted to reflect any expectations that individuals enrolling later during the open enrollment period are healthier.

The composition of the risk pool and the impact on premiums will vary by state. Many states opted for the transitional policy that allowed non-ACA-compliant plans to be renewed. In these states, the risk profile of 2014 ACA-compliant plans might be worse than insurers projected if lower-cost individuals retained their prior coverage and higher-cost people moved to new coverage. The transitional policy was instituted after 2014 premiums were finalized, meaning insurers weren’t able to incorporate this policy into their premiums. For most states, the transitional policy for 2015 is known in advance and can be incorporated into assumptions regarding the composition of the 2015 risk pool. The impact on premiums could be greatest in states that had large, heavily-underwritten individual markets in place prior to 2014.

Differences by state in enrollment outreach efforts or technical problems with the marketplaces could also have affected the composition of the 2014 risk pool. Insurers will incorporate that experience into their 2015 premium assumptions to the extent they expect such trends to continue.

Importantly, if actual experience regarding the risk profile of 2014 enrollees differs from assumptions and losses occur in 2014, insurers cannot recoup past losses through higher future premiums. Instead, assumptions for 2015 will be reset incorporating available 2014 experience.

Reduction of reinsurance program funds

The ACA transitional reinsurance program compensates plans in the individual market when they have enrollees with especially high claims. Reinsurance payments reduce net claims, allowing insurers to offer premiums lower than they otherwise would be.

For the 2014 plan year, $10 billion will be used to reimburse plans for a portion of the spending for high-cost individuals. These payments generally have reduced projected 2014 net claims by about 10 to 14 percent. For the 2015 plan year, the amount collected for the reinsurance program will decline to $6 billion, and will likely reduce net claims by about 6 to 8 percent. This lower reduction in claims translates to about a 4 to 7 percent increase in projected claims for 2015 relative to 2014, due solely to the reduction in the reinsurance program and not factoring in any other factors such as medical trend. This increase could be offset to the extent that insurers expect a healthier risk pool profile in 2015, arising for instance from lower-cost individuals delaying enrollment until 2015 rather than enrolling in 2014.

Underlying growth in health care costs

The increase in costs of medical services, referred to as medical trend, reflects not only the increase in per-unit costs of services, but also increases in health care utilization and intensity. In recent years, health spending growth has been low relative to historical levels. Premiums for 2015 will reflect assumptions regarding the extent to which the recent slowdown will persist.

Other drivers of 2015 premium changes

Other factors potentially contributing to rate changes include any modifications to provider networks; provider reimbursement structures; benefit packages; risk margins; administrative costs; or geographic region definitions. The increase in the health insurance fee imposed by the ACA could put upward pressure on premiums if it is not offset by a commensurate increase in enrollment. Insurers will also incorporate market considerations when determining 2015 premiums.

The Harver Group - Your Health Insurance Counter Fraud Services Tokyo

More Insured, but the Choices Are Narrowing

In the midst of all the turmoil in health care these days, one thing is becoming clear: No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.

These so-called narrow networks, featuring limited groups of providers, have made a big entrance on the newly created state insurance exchanges, where they are a common feature in many of the plans. While the sizes of the networks vary considerably, many plans now exclude at least some large hospitals or doctors’ groups. Smaller networks are also becoming more common in health care coverage offered by employers and in private Medicare Advantage plans.

Insurers, ranging from national behemoths like WellPoint, UnitedHealth and Aetna to much smaller local carriers, are fully embracing the idea, saying narrower networks are essential to controlling costs and managing care. Major players contend they can avoid the uproar that crippled a similar push in the 1990s.

The Times would like to hear from Americans who have signed up for health care under the Affordable Care Act.

“We have to break people away from the choice habit that everyone has,” said Marcus Merz, the chief executive of PreferredOne, an insurer in Golden Valley, Minn., that is owned by two health systems and a physician group. “We’re all trying to break away from this fixation on open access and broad networks.”

But while there is evidence that consumers are willing to sacrifice some choice in favor of lower prices, many critics, including political opponents of the new health care law, remain wary about narrowing networks. A concern is that insurers will limit access to specialists or certain hospitals. “Too often, Obamacare cancels the policy you wanted to keep and tells you what policy to buy,” Senator Lamar Alexander, a Tennessee Republican, said in a speech in April.

Dr. Monica Wehby, a pediatric neurosurgeon, is using the potential reaction to narrower networks as momentum for her campaign for Senate in Oregon. A Republican promising to repeal the Affordable Care Act, her slogan is “Keep your doctor. Change your senator.”

Other complaints involve confusion over which providers are participating in which plans.

“The thing you’re buying is access to the provider network,” said Lynn Quincy, a policy expert at Consumers Union. “Right now it feels like you’re forced to guess.”

In response, state and federal regulators say they are more closely monitoring the plans being offered in the coming year to be sure they are clear and that consumers have sufficient access to hospitals and doctors. In some cases, they are already insisting on changes.

Nonetheless, for people who are directly picking plans in the open markets, insurers say price is turning out to be critical. People “are weighing affordability and breadth of network,” said Karen Ignagni, the chief executive of America’s Health Insurance Plans, an industry trade group. “What we’re finding is individuals are experiencing a preference for affordability,” she said.

Minnesota would seem to be a case in point.

On the state exchange, PreferredOne offered an inexpensive plan with a network of 13 hospitals, but those low premiums helped the insurer grab 60 percent of the individual insurance market.

While many insurers are including only those hospitals and doctors willing to charge lower prices, experts say the makeup of the networks is likely to evolve over time, focusing less directly on price and more on the ability of providers to deliver coordinated and high-quality care.

Although a similar attempt to restrict choice failed in the early ‘90s, after opposition to H.M.O.s and managed care, insurers insist these efforts will not run into the same resistance because they are now working more closely with providers, and customers are more concerned about costs. “It’s a new era,” said Dr. Sam Ho, the chief medical officer for United Healthcare.

Others agree. “You’re going to see this as a dominant strategy,” said Jeff Hoffman, who works closely with hospitals for Kurt Salmon, a consulting firm.

The Harver Group - Your Health Insurance Counter Fraud Services Tokyo

Even if you were smart (or lucky) enough to have a comfortable retirement nest egg, you may still worry that it may not last you through what may be 30 years of retirement. As many retirees and pre-retirees saw in 2008, one unexpected financial disaster can devastate your life savings.
And many others have discovered that even the best-laid plans for retirement can be ripped apart by an unanticipated medical crisis.
Not to worry. We talked to financial planning firms, big and small, across the United States, and asked for their best tips to help retirees protect, preserve and grow their retirement savings.

There are the easy ones, like once you turn 50 you can take advantage of the catch-up contributions to your 401(k) ($5,500) and IRA ($1,000). You can delay taking Social Security until you're 70 because each year you wait, your benefit will increase by 8%. Or you can increase your savings rate.

"I see people putting away 1% or 3% of their salary," says John Sweeney, executive vice president of retirement and investing strategies at Fidelity Investments. "People have to realize that is probably not enough to maintain their lifestyle in retirement. We're talking about 10% to 15% of your current income."
Besides increasing your savings, here are a few other tips:

1. Have an emergency or "rainy day" fund outside of your retirement account. Some retirement planners say retirees should have six months to a year of living expenses outside of your retirement accounts.
"Rainy funds are absolutely important," says Srinivas Reddy, senior vice president and head of full-service investments at Prudential Retirement. "You need to have a rainy-day fund that covers 90 to 180 days of living expenses, not only so you have a safety net, but so you don't draw from longer-term investment savings for retirement."
Jeremy Kisner, president of Surevest Wealth Management in Phoenix, says his company recommends four to five years of living expenses insulated from the stock market — and they put the money in a laddered bond portfolio. That account is where your annual living expenses are drawn from.
"As you spend your money for this year, you have to replenish it (from the growth accounts)," he says. "In a typical year you are harvesting gains and dividends from growth side, and replenishing your safe money in the income segment."
That offers his clients five years of "reliable" income. They did not have to worry about withdrawing funds after the crash in 2008. And by the time they had to transfer money from those retirement accounts, the market had recovered, he says.
But that rainy day money should not be in cash, says Nicholas Yrizarry, president and CEO of Nicholas Yrizarry Wealth Management Group in Laguna Beach, Calif. "Money in cash is a negative investment. There is no return after taxes and inflation. Be careful not to put too much money in cash."
2. Plan for health care, even if you are relatively healthy. "You have to plan for catastrophic illness," says Curt Knotick, CEO of Accurate Solutions Group in Butler, Pa. "You have to plan for some kind of critical illness, whether it's long-term care or mid-term disability." There's a good chance that two out of five retirees will need some level of long-term care, and that can destroy your nest egg, Knotick says.
Sweeney says health issues are difficult to predict. "You never know what problems may develop later, how severe it might be or how long it might last," he says. "We include it in the budgeting. Couples will probably need $225,000 for medical expenses over the span of their lifetimes. "And they usually don't anticipate changes in expenses because they are expenses they don't have today," Sweeney says.
If a health savings account is offered, people should take it. "It's triple tax-free," he says. It goes in before tax, grows tax-free, and it's tax-free upon withdrawal. The key condition is you have to have enough income while working to not draw that down."
3. Consider downsizing. Not only will a home sale add to your savings, but you may also reduce your living expenses.
"A lot of people need to start thinking about using the equity in their homes," Kisner says. Think about downsizing and think about it well in advance. There are people who live in Southern California. They can't afford to retire in Southern California. Relocating and downsizing is an important topic."
4. Consider taxes in everything you do. Curt Whipple, chief managing partner at C. Curtis Financial Group in Plymouth, Mich., and author of Retiree Lifeline! How to Get Government Out of Your Pocket, says most couples want to live on the interest from their investments, but that's not always the most tax-efficient way to draw income.
"I had a couple come in," he says. "They were making $45,000 a year. Of that, $25,000 represented Social Security and $20,000 was interest income off their investments.
"The problem with interest income is it's all taxable," he says. "As a result, they ended up being taxed on 85% of their Social Security. I called the company they had their investments with and rearranged how the money was invested. Their taxes went to zero. Now they are getting the whole $45,000 with no taxes.They stopped paying taxes on Social Security. That's a major key to make sure your money lasts longer in the most tax-efficient manner possible."
5. Don't wait until 70½ to begin withdrawals from your retirement account. Whipple says many people wait, even though they are eligible to make withdrawals starting at 59½, but avoid doing so to avoid the taxes. But that only makes the problems worse.
His recommendation: At 60 years old, start withdrawals, pay the taxes and put it in a Roth IRA account. The result: The money growth is in the tax-free Roth. And when the retiree reaches 70, there is far less in required minimum distributions.
6. Consider life insurance. Knotick says life insurance may help protect a nest egg in some situations.
"For some individuals it may not be an appropriate tool, because they may not have the funds necessary," he says. "But what we've found is if someone has marginal assets or needs to use a lot of assets in retirement, one way to free up in their mind is to incorporate life insurance into their lives, so when the first spouse passes, the surviving spouse receives a tax-free benefit."
His example: "If a couple has $600,000 and intends to draw $2,000 a month, they may instead draw down $2,500 or $2,600 and pay insurance premiums. The surviving spouse is left with a $100,000 to $150,000 lump sum that could be reinvested tax efficiently to provide that surviving spouse with any lost income."
"Life insurance is unique to each individual situation," he says. "There may be insurability issues. But when appropriate and when possible, it is a great planning tool to provide for the surviving spouses and frees up the assets."
7. Consider an annuity. An immediate annuity will turn part of your savings into a lifetime stream of income for you and your spouse. For some people, having a regular monthly payment means peace of mind. And annuities have another benefit: "You've sheltered yourself from longevity risk," Yrizarry says. "People are living longer. I suggest people insure that risk."
You have to protect against longevity," says Sweeney. "For couples, there is a 25% chance that one of the two will live into their 90s. People underestimate how long they will live in retirement. You must have an income stream that anticipates that."

Matrix Absence Management introduces ADA Advantage™

Service platform integrates with full-service Absence management offering

The Harver Group — Matrix Absence Management, Inc., (Matrix), a market leading integrator of insurance and absence management services, has introduced ADA Advantage™, a service platform to help employers administer American with Disability Act (ADA) programs.

The Americans with Disabilities Act (ADA) was signed into law on July 26, 1990 by President George H.W. Bush. Modeled after the Civil Rights Act of 1964, ADA is an “equal opportunity” law for people with disabilities. The ADA Amendments Act (ADAAA), which went into effect in 2009, expanded upon the definitions and applicability of ADA in the workforce.

ADA requires employers to consider accommodations for employees with disabilities so that their jobs can be maintained, with or without reasonable accommodations. These accommodations often involve extensions of employee leave that is otherwise governed by federal (FMLA) or state leave laws. Your Health Insurance Counter Fraud Services Tokyo

“In our market space, as an extension of our clients’ HR and benefits organizations dedicated to managing employee absence and productivity, we most often see an intersection with ADA at the time Federal and or State leave entitlements and/or disability benefit periods end,” according to Kenneth Cope, president of Matrix. “In that regard, we have developed an offering to help our clients address the escalating demands of ADA in synch with other, often conflicting, employee entitlements.”

Headquartered in Phoenix, AZ, Matrix has service locations nationwide, including claims hubs in San Jose, Phoenix, AZ, Hawthorne, NY and Portland, OR. Matrix clients employ nearly 2 million employees nationwide with total payrolls exceeding $60 billion.

Together, Matrix and sister company Reliance Standard Life Insurance Company market a range of integrated employee benefits called Absence Solutions®.

Focusing on medical investigation and support, Matrix will provide ADA support services for all employee leaves, empowering the employer to make the best determinations based on available information. This service delivery model leverages a secure software platform accessed jointly by both Matrix and client administrators for streamlined data collection, communication, tracking and reporting. Tasks required for effective administration and to drive compliance will be documented in the system allowing for full audit capabilities.

ADA allowances for requests other than extended absence – such as the need for a modified workstation, ergonomic keyboard or change in work shift – are a large part of managing compliance with the law. The new Matrix product is inclusive of both leave and “non-leave” requests.

Highlights of the top-tier service model include management of all activities including obtaining medical information; conducting interactive employee assessments; obtaining referrals such as ergonomic evaluations; tracking and managing employee accommodations; and providing follow up and reporting. The service delivery model leverages a secure software platform accessed jointly by both Matrix and client administrators for streamlined data collection, communication and reporting.

The Matrix offering was successfully piloted beginning in the 4th quarter of 2013 and is now available as an add-on service for all leave customers. For more information, see your local Reliance Standard sales representative or account manager, or visit

Reliance Standard Life Insurance Company (Reliance Standard) is a leading insurance carrier specializing in innovative and flexible employee benefits solutions including disability income and group term life insurance, a suite of voluntary (employee paid) coverage options and fully integrated absence management. Reliance Standard markets these solutions nationwide through independent brokers and agents to employers of all sizes.

Both Matrix and Reliance Standard are members of the Tokio Marine Group. Tokio Marine Holdings, Inc., the ultimate holding company of the Tokio Marine Group, is incorporated in Japan and is listed on both the Tokyo and Osaka Stock Exchanges. The Tokio Marine Group operates in the property and casualty insurance, reinsurance and life insurance sectors globally. The Group’s main operating subsidiary, Tokio Marine & Nichido Fire (TMNF), was founded in 1879 and is the oldest and leading property and casualty insurer in Japan.

Foreign travel advice - Japan

Safety and security

Crime levels are low. It is generally safe to walk about at night and to travel on public transport, but you should maintain the same level of vigilance as you would at home and take sensible precautions.

Reports of inappropriate touching or ‘chikan’ of female passengers on commuter trains are fairly common. The police advise that you shout at the perpetrator to attract attention and ask a fellow passenger to call the train staff.

The Roppongi entertainment district of Tokyo is considered a higher risk area for crime. British nationals have been arrested following disputes with bar staff and doormen. There have also been reports of drink spiking with drugs like Rohypnol. Victims have described loss of consciousness for several hours, during which time large amounts have been fraudulently billed to their credit card.
If your passport is lost or stolen, you should report this at a police station and get a police report.

Emergency services
In cases of emergency, dial 110 for the police and 119 for the fire or ambulance services.  Calls are free of charge from any phone, including pay phones.

Based on guidance from UK Government scientists, the FCO advise against all travel to the exclusion zones around the Fukushima Dai-ichi Nuclear Power Plant identified by the Japanese authorities. These exclusion zones are kept under review. Even areas where evacuation orders are ready to be lifted (marked green on the map) are still subject to some restrictions - for instance visitors are not allowed to stay overnight.

The exclusion zone around the Fukushima Daiichi Nuclear Power Plant has been designated a restricted area. Anyone entering this area illegally is liable to a fine of up to 100,000 yen (£589) or detention.

The Japanese authorities are carrying out comprehensive checks to monitor radiation in the area surrounding Fukushima and to monitor possible contamination of water, and food and produce. They impose strict controls where necessary. There continue to be reports about leaks of contaminated water. These reports are being monitored by UK government scientists. Any significant change in the current situation will be reported on this page.

Although the situation at Fukushima will remain of concern for some time, the risks are gradually declining.

Road travel
To drive in Japan, you must hold an International Driving Permit (IDP), a current UK licence and insurance. An IDP is only valid for use in Japan for one year regardless of its date of expiry. Check the Tokyo Metropolitan Police Department website for further details. You must carry your driving license with you at all times. Penalties for driving in Japan without the correct documents are severe.

If you intend to stay in Japan for longer than one year, you should apply for a Japanese driving licence. For more information and details of offices where you can apply for a Japanese licence, visit the Japanese Automobile Federation website.      

There are two types of driving insurance available in Japan:

Compulsory insurance (jibaisekihoken) and voluntary insurance (nin’i no jidoshahoken). The compulsory insurance on its own may be insufficient in cases of personal liability.

Roads are well maintained. Driving is on the left, as in the UK. Road rules are mostly the same as in the UK, but drivers should pay particular attention to: pedestrians crossing roads at green lights, especially at junctions; cyclists travelling on the pavements or on the wrong side of the road and without lights at night; and taxi drivers stopping suddenly.

There are severe penalties to deter drink driving, including allowing someone else to drink and drive (for example if you are a passenger in a vehicle being driven by a drunk driver). Offences can attract a heavy fine or imprisonment.

In 2012 there were 5,237 road deaths in Japan (source Dft). This equates to 4.1 road deaths per 100,000 of population and compares to the UK average of 3.0 road deaths per 100,000 of population in 2012.

Political situation
Japan is a stable democracy. Civil disturbances and violent demonstrations are rare. Occasionally, demonstrations of a pro-nationalist kind can involve hostility to foreign countries. Keep yourself informed of developments and if you become aware of any protests, leave the area immediately.

Mobile phone networks
Only 3G and 4G capable UK handsets will work in Japan. GSM-only UK phones don’t work, as there’s no GSM network. If you plan to make lots of calls or use mobile data in Japan, SIM cards are available to hire online or in-store. WiFi zones are also increasingly available in coffee shops, hotels and other public spaces.

Foreign Travel Advice by The Harver Group - Your Health Insurance Counter Fraud Services Tokyo