I'm sitting in my Tokyo hotel room, studying the conflict over US health care reform from a comfortable distance. Here in Japan, they don't understand our problem. Here in Japan, there is no health care crisis - even with a rapidly aging population. No one goes bankrupt over medical bills. No one is denied medical services. If someone wants a special medical treatment, they can buy it here or in Switzerland or wherever. Yet they have a private system with no public option. What they do have is a strictly regulated medical insurance industry. While some shortages of specialized care exist and some rural hospitals are understaffed, they have a more robust primary care system than we have in the States, which means people see the doctor more often. More visits mean early detection and lower long-term treatment costs. The poor - and there are lots of unemployed people here - receive health care via government insurance subsidies - something like Medicaid. So while health care professionals earn a fraction of their what their counterparts earn in the US, they are a respected group and earn a good middle-class living.
Here in this egalitarian middle-class society, they have one of the healthiest populations among industrialized nations, despite the fact that they smoke like chimneys. According to a recent post in The New York Times,
Japan has about the lowest per capita health care costs among the advanced nations of the world, and its population is the healthiest. That is largely due to lifestyle factors, such as low rates of obesity and violence, but the widespread availability of high-quality health care is also important.
In Japan, adequate health care is a right that comes with being a member of this hardworking society. Their government does not allow health care to become a major profit center for big businesses at the expense of public welfare.
With this in mind, I mentioned my particular situation to a Japanese colleague. I explained that I had a very mild heart attack about nine years ago. It was a wake-up call. I had gained a bit of weight, and my cholesterol was up slightly. Since then, I've been taking my meds and watching my diet. Today, the doctors can find no sign of artery disease, but no insurance company will give me coverage. Their adjusters simply right me off because of my 'pre-existing condition'. My friend wonders if that is legal. Sadly, it is completely legal, and then I quoted from an article by T.R. Reid for the Washington Post:
American health insurance companies routinely reject applicants with a "preexisting condition" - precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital.
So, what is the solution to our national health care crisis? In my opinion, it begins with insurance and pharmaceutical industry regulation - like they do in Japan and in other countries. Of course, these industries are large and powerful. They exert a lot of influence in Washington, DC and through their mouthpieces at News Corporation and the Wall Street Journal. Nevertheless, we need to ask ourselves, "Is this a nation 'of the people and for the people' or is this a nation that serves the interests of business at the expense of the people's business?" I don't believe the Founding Fathers ever imagined that business would grow so powerful that its voice would drown out that of the people. Maybe it's time to pass that Constitutional amendment to kick business and other special interests out of government?