Life In Japan: A Morning at the Clinic

The clinics here vary in size. Some are like a doctor’s office. Some are facilities attached to hospitals. When you need medical attention, unless it’s an emergency, you go to a clinic.

I rarely have problems with my health. But I’ve been a permanent resident here now for over eight years, and I have used medical services in Japan a few times. One time a very bad fall from my bike required some very extensive care. I broke my collar bone — I don’t recommend it as it’s very painful — which involved several sessions with an orthopedic doctor and physical therapist. Other occasions were more typical: one time I had an extremely sore throat, another time a kidney infection. Common types of things.

People back in the U.S. are always asking me what it’s like to have universal “socialized” medical care. They’ve been fed all the propaganda by the inefficient but certainly very profitable health care industry there: expect long waits, impersonal care, low standards, lousy doctors, etc. These stories, of course, are generated by the insurance companies, the for-profit clinics and hospitals, the mega-wealthy specialists, rock-star surgeons, all the vested interests who are beneficiaries of the windfall of hard cash that the current system in the U.S. generates for them, and who selfishly but predictably want to keep things the way they are.

I have one story that accurately represents how it works here, straight from my perspective as a patient. Let me say up front, I’m completely blown away by health care in Japan, but I’ll let you judge for yourself the merits of centrally organized and controlled health care.

My wife, Masumi, and I were planning on spending three weeks in the U.S. starting the last week in July. We’d be visiting some of my friends back there, staying at a couple B&Bs, camping at the national parks, even couchsurfing with a retired music teacher in Seattle.

About two months before we were to leave, I started noticing tightness in my chest, and a feeling like my lungs were being compressed. Not a good sign. Red flags immediately went up! What if I have a serious problem while we’re on vacation? I have no health insurance in the United States. And I had serious doubts about the availability of emergency services, based on the stories I regularly hear about the inadequacies and outright failures of health care back in America. Scary!

As the symptoms persisted for a few days, I became certain my discomfort had something to do with my heart. Back in 2010 when I had my back surgery in Seoul, South Korea, they discovered one of my ventricular valves was only functioning at 68% efficiency. Maybe it had fallen apart and was now flapping like bedsheets in a summer breeze!

I decided to take action. The best place for this was a ten-minute bike ride from my house.

Are you ready for my harrowing tale? Because here’s exactly what happens when you have to depend on “socialized” universal health care.

I showed up at 8:45 am with no appointment, bearing a note in Japanese describing my symptoms and suspicions. Twenty minutes later I was interviewed and examined by a heart specialist. He scheduled testing.

Another fifteen to twenty minutes later, I was taken to a special room and wired up for an electrocardiogram. My heart was monitored both as I rested, and as I did “stress testing”. That meant going up and down a small set of steps, which made my heart work harder. The entire procedure took maybe twenty minutes.

I went back to the waiting area for maybe ten or fifteen minutes. Then I was taken into another special room where using ultrasound echocardiography, they observed my heart function in real time, its rhythm, contraction, the operation and efficiency of the valves. This was put on video. After being edited by Stephen Spielberg, scored by Hanz Zimmer, it is now available on Netflix. Okay okay . . . I made up that last part. But the ultrasound of my beating heart was recorded and entered into the system as part of my medical record.

Back to the waiting area. Within no more than thirty minutes, I was escorted back to the office of the heart specialist. He had a printout of my electrocardiogram spread out on the desk before him and was watching my ultrasound as it played on his computer monitor.

Would I need an artificial heart? A transplant? Or maybe it was simply too late!

Actually, my heart was in great shape. The doctor explained there was absolutely nothing that I should be worried about. This, in fact, turned out to be accurate. Whatever the weird symptoms were that I had been experiencing went away after a few days — maybe I’d been eating too many marshmallows or my t-shirts had shrunk — and since then I’ve never had any problems with my heart. Knock on wood, as they say.

Now . . . the part that can often truly give a person a heart attack.

[ Cue dark tremulous scary cello and trombone music. ]

THE BILL FOR MEDICAL SERVICES RENDERED!

Summarizing . . .

At least twenty minutes consultation with a heart specialist. A complete electrocardiogram including a stress test with a nurse. A recorded ultrasonic echocardiography session with a nurse and a technician. I’d been in their clinic for over two hours.

OMG! Will I have to get a job? Get a second mortgage on the cat?

I heard my name called and walked with great trepidation to the payment window and was handed my invoice . . . 3600 yen . . . 3600! THREE THOUSAND SIX HUNDRED YEN!

Why that’s . . . that’s . . . $33.

Unbelievable, eh?

$33 for the entire thing.

No appointment. No waiting. Qualified heart specialist. Comprehensive testing.

$33. No tipping.

Any folks out there who want to offer an estimate of what this would cost in the U.S.?

One last side note on the horrors of socialized medicine. When I tell Japanese people that an ambulance trip in the U.S. can cost $2,000-5,000 . . . they look at me in total shock. Ambulances here are completely free.

[ This originated at the author's personal website . . . https://jdrachel.com ]



Life In Japan: A Morning at the Clinic

Life In Japan: Highway Service Areas

There are highway service areas in Japan so elaborate and well-outfitted that families pay the pricey highway toll just to visit them and spend the day. For these folks, going there is the same as going to a park or a shopping mall to hang out and have fun.

Highway service areas in Japan are what we in the U.S. call ‘rest areas’.

Years ago, I used to spend a lot of time traveling the entire Eastern half of America by car. This was roadwork for my music business activities, initially as a musician, then later as a band manager and music producer. Trust me, I’m very familiar with rest areas. While I hear that these days there are some very fancy ones — with restaurants, shops, showers, and the like — this is how I remember them. Since this is a current, there are obviously still many which conform to this basic design.

There are simple, basic highway service areas in Japan. However, they tend to be atypical. Even these rudimentary iterations provide more than just a restroom and a picnic table. Want to take a break from driving to do some fishing? Or feed some ducks?

Most of Japan’s service areas offer abundant opportunities to shop, eat, relax and play. They are more stop and play than gas and go.

We have a highway service area about 15 minutes from our house, which we visit with my step-daughter, Azusa, and her dog Ji Ji — because it has a dog run! We access it from a small road behind the service area grounds, which runs parallel to the tollway. So actually we visit this highway service area without even going on the highway.

So I won’t be accused of cherry picking a few exemplary but unrepresentative examples, here are just some of the highway service areas within 100 kilometers of my home town.

How do I explain how things work here? I guess it suffices to say that Japanese excel at taking everything to a logical and elegant extreme. They have extremely high standards and are perfectionists. This even shows in something as routine as setting up a place to pull off the road to take a break from driving.

[ This originated at the author's personal website . . . https://jdrachel.com ]


Life In Japan: Highway Service Areas

Life In Japan: Public Restrooms

Japanese folks will wonder why in the world am I writing about public restrooms. They take it for granted that when you gotta go, you just go. Restrooms are plentiful, clean, safe, well-maintained and open to the public everywhere here.

I can explain why this is a big deal. I’ll answer with a question: Have you ever tried to pee in New York City?

Without checking into a hotel?

Without sitting down to a meal at a restaurant?

Without buying an ensemble you didn’t need at a department store?

Or let’s say you do happen to stumble on one of the extremely scarce public toilets.

If you don’t encounter a homeless family who have set up housekeeping . . .

. . . if you don’t see a junkie shooting up over in the corner . . .

. . . if you don’t have to step over dead body or two . . .

. . . if you don’t find perverts having sex through a glory hole between adjoining stalls . . .

. . . then the stench will drive you out, because the place hasn’t been cleaned since they laid off some janitorial city worker six months ago to give tax breaks to Wall Street execs.

Let me be clear.

I consider peeing-on-demand a basic human right. Like breathing, going to the bathroom is not a lifestyle choice.

Japan completely respects the inevitability and the all-too-often urgency of nature’s call.

Here in my hometown of Tambasasayama, in the eight or ten block area which comprises the center of our town, I counted no less than four public toilet facilities. As restrooms go, they’re fine. Nothing fancy. But clean, properly kept up to the high standards and hygienic expectations of the citizens here.

Additionally, there are restaurants, temples, public buildings, stores which have toilets. I’ve never seen a ‘Restrooms For Customers Only’ sign anywhere in Japan.

Along with the four public toilets downtown is an outdoor one at a supermarket . . .

. . . another at a 7-11 convenience store . . .

. . . and yet another at a curios shop/restaurant.

Could relief be any more accessible? Adult diapers? (Ugh!)

Granted, there are those who might accuse me of focusing too much here on the mundane. Come on! Toilets?

Just remember. Sometimes it’s taking care of the little, simple things in life, which makes the much bigger, more complex things possible. Try to enjoy that stroll through Greenwich Village or taking in the sites at Times Square when you’ve had to hold it in for four hours.

[ This originated at the author's personal website . . . https://jdrachel.com ]





Life In Japan: Public Restrooms

Life In Japan: JA

JA stands for Japan Agriculture.

JA is a huge, sprawling organization, with hundreds of stores, facilities, and offices across the entire country. But . . .

It’s not a corporation.

It’s not a government facility, branch, or department.

It’s a cooperative — or more accurately, this from an article on Wikipedia, a “national group of 694 regional co-ops in Japan that supply members with input for production, undertake packaging, transportation, and marketing of agricultural products, and provide financial services.”

They of course have commercial outlets which make available local farm products. Here is our main store in town.

But because JA provides so many services within the hundreds of communities it serves, it also has numerous offices, some large and imposing complexes. The ‘JA’ logo adorns quite a few buildings right here in Tambasasayama.

Did I mention that JA is a cooperative? Of course I did!

Why is this important?

Because it’s set up as a cooperative, it’s not subject to government bureaucracy, political influences, or the whims and wishes of whoever is politically in power at any given time. Even more importantly, it doesn’t have to answer to a corporate board of directors, it isn’t beholden to shareholders, and doesn’t measure its success in terms of “profitability”.

JA is there exclusively to serve its members and the needs of the community.

What a concept!

[ This originated at the author's personal website . . . https://jdrachel.com ]





Life In Japan: JA