This is absolutely not true. I pay the equivalent of about $40 for X-rays and blood tests. A simple consultation is about $15, if that. I recently got diagnosed with asthma, and the whole set of tests plus a month of medicine came out to about 6000 yen, which I suppose is $40.
The only reason you would pay that much is if you're visiting a private no-insurance clinic and not using insurance. And private clinics pretty much only exist to prey on people who identify as expats and make zero attempt at learning non-English languages, aside from a few exceptions (certain speciality dentists, plastic surgery, anonymous STD treatment, some cancers).
The whole debate is about what insurance companies are paying for those services, right? It's when one walks in without insurance that you see the true cost of the service.
> The only reason you would pay that much is if you're visiting a private no-insurance clinic and not using insurance
What alternatives does a tourist have? If Japan truly had cheaper procedures, it would see a huge uptick in medical tourism. There's no doubt that Japan has state-of-the-art facilities and treatment options, comparable to the US. It's no surprise that costs are comparable too.
A country has no obligation to make its medical system cheap and affordable for tourists. Your mention of "foreigner" was wrong because foreigners have access to all the same health care as a local.
No matter what country on earth you go to, a tourist will pay more than a resident for doctor's visit. That's why travel insurance exists. And health tourism is a disaster for any country since it results in high paying foreigners lining up for treatment and locals being neglected. There's a reason primarily poor and corrupt countries offer it for regular treatments, putting aside vanity treatments (balding, rhinoplasty, etc)
I think the salient point is that in all jurisdictions, there are subsidies for locals, either through government or private industry, to make health care affordable. That those subsidies create perverse incentives is unsurprising. Since perverse incentives distort the market, they are not useful. Hence we cannot measure the true cost of health care by looking at what locals pay, because there isn't one single rate for a local (this includes free/fully subsidized). The true cost of the service is most clearly evident to those who do not qualify for any subsidies, it makes the most sense to measure that.
I mention medical tourism because it's a real thing. People do shop around globally to take advantage of medical systems where the cost-to-service ratio is beneficial to them, and in many cases, not all but many, those people are paying the true cost of delivering that service (this includes the flight cost).
The only reason you would pay that much is if you're visiting a private no-insurance clinic and not using insurance. And private clinics pretty much only exist to prey on people who identify as expats and make zero attempt at learning non-English languages, aside from a few exceptions (certain speciality dentists, plastic surgery, anonymous STD treatment, some cancers).