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September 25, 2009



Yeah consider that Japan and most of the Western European countries with national health are losing population. What up with that?


He's right.
I especially concur with this point:
". Japan lacks a large population of illegal immigrants and welfare recipients obtaining health care through visits to the emergency room. This doesn't just keep costs down. It also prevents the resentment that is endemic in American health care, where the middle class rightfully believes they are picking up the tab for non-citizens and deadbeats."

Add that to the conformist, healthy life style Japanese culture and you have tagged two of the most significant differences.


I agree with much of that, except that Japanese men do drink a lot.

There is also very little violent crime (did he mention that?).
Even with all of that, Japanese doctors told me the down side of their system is they have very little time with each patient.
My friends who had babies there were very pleased, my friends who got sick there were less so. One friend's diagnosis was terribly wrong, and she had to fly out to the US in the midst of a painful health crisis.
At the time we left, the majority of doctors didn't tell patients they had cancer or were dying. So I'm not sure how much end-of-life care goes on.

But yeah, we aren't Japan.


"Turning Japanese" What a great eighties song! Those were the days -- my initial reaction was it was a hit Cheap Trick, but I googled it, and it was the Vapors.
Can that song really be almost thirty years old? Sheesh.


I was referred to a top Japanese hospital in early 80s because they had cardiac diagnostics not available at US military hospitals in-country.

All went well for me except the moment when the primary doc/tech called in his associates and a round of that "Ttsssss..." sucking-in sound filled the room as they viewed my pictures. Never did find out what it was about but my AF doc assured me, 'no worries'.

That's the good news. The bad news (according to Japanese friends and expats) is that diagnosis and treatment almost always follow the conventional wisdom script. All science - no art. Those whose problems don't yield to the conventional wisdom go abroad if they have the means.

It is my understanding that it is extremely uncool for any med professional to suggest alternatives to diagnosis by conventional wisdom. An old friend (a former nurse in Japan) told me that a likely result of a nurse asking an inconvenient question of a doctor was a slap in the face. Not a woman given to histrionics.

I was also caused to believe by Japanese employees that cancer rates in Japan were meaningless as there was a stigma associated with those diseases and they were often listed as other ailments.

All that said, I love Japan greatly and would welcome another few years there - hell, I'm getting to the age where I'd welcome a few more years, anywhere :-)


There's also that great tradition of the Samurai cure. Gives the term "whack job" a whole new spin.

Meanwhile, we're calling lawyers and burying our courtrooms in human chaos generated in mass quantities by bureaucratic delusions of socially responsible work product.





Blie--ditto on both counts

Gregory Koster

If conformity is what Japan is offering, small wonder The Once urges us to look westward. His brand of conformity enforced by his gang of crackpots and zanies will do wonders for mental health.

In the days when I worked in California, that terrific reference book the PARKER DIRECTORY TO CALIFORNIA ATTORNEYS had a section of attorneys by specialty. The "Medical Malpractice" section was about six pages long. The "Attorney Malpractice" section was about half a page long. When those ratios are reversed, we'll be making progress.


In addition, everybody in the country, simply for reasons of decency and common courtesy, wear face masks when they feel a cold is coming on, so as to avoid spreading germs everywhere by coughing. There are also folks paid to stand out front of the train stations and shopping malls in order to hand out free packages of small Kleenex type tissues to everyone who walks by.

And from my experience, for about the last decade, every person entering Japan through airport customs has been temperature scanned upon arrival. During times of High Contagion Alerts; (SARS, H1N1) the temperature scanning takes on a very serious aspect and you are denied entry into the country and become immediately quarantined from the general public if exhibiting symptoms of hi-fever, coughing, etc. That fits in well with this reports mentioning of almost no illegal immigrants exist in the Nation, as foreigners are very regularly required to renew their Visa's, plus, since about 15 years ago, one's fingerprints were required by the state of all non-Japanese citizens.

None of that do we regularly do in this Nation, yet all of that has to be considered as advantages in preventing medical problems in Japan.

Jack is Back!

He forgot to mention that the Japanese are true racists. Try assimilating into their culture as a white ex-pat and you'll understand.

Maybe that is why they have such a wonder of a health system. If we were more racists here in America then we could match up better.


As a fifteen year resident of Kyoto, a white guy immigrant, and before a brief comment on the Japanese health care system, let me respond to Jack is Back: learn to read, write and speak Japanese fluently, not much to demand of an immigrant to any country, in my opinion, and not only does one easily assimilate easily into Japanese culture, but one is able to thrive and all and all is at a major advantage in many ways (including access).

Racist is certainly the wrong word. There is a strong and vital culture here, a shared learning, mostly based on the word, written and spoken, and for ex-pats who after some time in Japan return to their native countries crying "racism, racism" I always ask one question: how's your Japanese? Inevitable those who say "great" can't even read at a fourth grade level and speak even less well. Which is not to say the Japanese won't treat you well if you are a culturally illiterate "white" person , but you certainly won't find yourself being assimilated. Thankfully. Rightfully.

As for the health care system. What the national health care system allows by way of procedure and treatment is fairly restricted and cost is directly controlled. However, additional insurance, in the marketplace, to cover procedures outside the box, is easily attainable and competitively priced and many doctors and hospitals thrive in this subtext. Costs here too are fairly low. Access to MRIs and other high end diagnostic tools are very inexpensive and available without delay.

The biggest difference, as an American brought up in U.S. healthcare, is time. Very wham, bam. Five to ten minutes with the doctor. Likely in a room where your conversation is overheard by other patients in queue. A doctor may see 50 to a 100 patients a day. Ten beds to a room are normal for stays in a hospital, with a few feet and a thin curtain you can draw, between beds. If you have money or additional insurance, though, you can get your own room, still very Spartan though. In a word, there is no luxury to the medical experience. I for one have few complaints, but there is cultural subtext that is wholly inappropriate for U.S. healthcare, as the linked piece correctly outlines, and for a hypochondriac like myself, one the one hand I don't get much touchy-feely time with the doctors, but, on the other hand, I can get MRI's for three hundred dollars a pop anytime I want.


one to many "easily"s and for other typos and mistakes--apologies

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