A 75-year-old man in Japan died earlier this year after 25 hospitals rejected him 36 times while he was driven around in an ambulance for two hours, according to reports.
The man—who lived alone in a city north of Tokyo—called for an ambulance one night in January with "breathing problems." Although paramedics arrived quickly, the man was refused admission to more than two dozen different hospitals for reasons such as "a shortage of beds" and a "lack of available doctors," according to Agence France Press (AFP).
Eventually, the ambulance made a 20-minute drive to a hospital in a neighboring city, but the man was pronounced dead shortly after arrival. One of the paramedics told a local news organization that he had never experienced "a patient being rejected so many times."
Japanese health experts say that the man was not the first patient to die after being rejected from many hospitals. In 2007, a government report cited as many as 14,000 emergency patients who had been rejected at least three times before being admitted for treatment, according to the Associated Press.
"Ironically, experts say, part of the problem lies in Japan's low-cost healthcare system," TIME reports.
A hospital visit in Japan costs half as much as a comparable visit in the United States thanks to government subsidies, but that means that EDs are often overcrowded with patients looking for routine care, according to a 2009 Washington Post article. Moreover, patients do not suffer penalties for overusing the system and there is no law against providers turning away sick patients.
Overcrowding may only skyrocket over the next 25 years as Japan's demand for medical care triples with its aging population, according to a McKinsey & Company report (Agence France Press/Google, 3/5; Wang, TIME, 3/6).