The nights are falling sooner. The air is growing chillier. Autumn is here. And here to stay for a bit it seems, though Japanese will call it ‘winter’ here before long. I’ve already been warned by several of my co-workers that the temperatures can even get down to freezing occasionally, usually in the early mornings. Their eyes grow wide when I tell them that on good winter day in Kansas, the temperatures might get up to freezing by midday. Of course, it won’t be a day at the beach for me entirely. Like air conditioning, heat seems to be a rationed commodity in Japan. I might have it in the teacher’s room at my schools, but the classrooms will be without, and I never quite figured out the air conditioning / heating unit at my apartment. My little space heaters will have to bear the burden.
At my schools, the students are getting in as much quality time on the playground as they can before the weather becomes unbearable, I suppose. And I am often their honored guest during recess. Kids on both hands pulling me in every direction to the swings, jungle gyms, and teeter-totter (which they always crack up when I say the name of). I’ve gotten quite a bit of respect from the younger kids for scaling the jungle gym with them and sliding down the slides.
With the older kids, we usually head for the all-purpose sports field where there are always a number of matches going on: soccer, kickball, dodge ball, and a big favorite – dodge frisbee. There is occasionally a teacher or two playing along with the students, but for the most part, the kids are on their own during this 45 minutes after lunch. They usually stay divided by grade and class and can spend 15 – 20 minutes working out the rules – though once the game begins, I’ve never seen any fights erupt and all disagreements seem to be worked out very quickly and without hurt feelings – so, I suppose that time is spent well.
Choosing teams is a fun thing for me now. When I was a kid in elementary school, I was always in the bottom half of kids chosen. The first mark against me, of course, was that I was a girl, we’re always chosen last. The second mark was that I was pretty middle of the road when it came to athleticism and popularity, the two factors that can help a girl get chosen before others. I never realized how affected by that I was, or honestly, the fact that I was affected at all – I never remember a time when I was the absolute last kid picked. But, I have to admit that I get a good deal of satisfaction at always being the first one chosen for teams here in Japan. Finally, the popularity factor works in my favor. But being chosen first isn’t the only benefit I’m accorded. I’m rarely targeted during games of dodge ball and frisbee and ties always seem to go to Jenny-sensei. It would get old after too long, but at the moment, I’m quietly enjoying this small sense of playground revenge.
Starting last week, I began teaching lessons about Halloween to some of my older students. The existence of Halloween is certainly well-known here in Japan. I’ve seen images of jack o’lanterns everywhere from department stores to car dealerships to school classrooms. I walked past a high-end patisserie in the basement of a local department store with a large Halloween display consisting almost entirely of pumpkins and a large portion of their treats were pumpkin based – though nothing Americans would be familiar with.
I have little idea what Japanese actually know about the holiday other than faces carved on pumpkins, though. In fact, when I introduced ‘jack o’lanterns’ to my first and second graders, they called them ‘halloweens.’
I tried to compare Halloween to the Japanese holiday, Obon. But, it’s not a very good comparison. Obon is more like the Mexican holiday, Dia de los Muertos - a day where souls of the dead, particularly ancestors, return for a visit. But Obon doesn’t really have any of the fear element that Halloween does and I didn’t want to frighten my students, so I chose more cartoon-like pictures of ghosts, skeletons, and various monsters. From their laughter, I suppose I succeeded in not frightening them at least, if not really impress upon them the meaning of ‘scary’ in relation to Halloween. Oh well, at least, they all had a good time with balloon races and making paper jack o’lanterns.
Current reading material – Dorothy Parker’s Complete Stories. Her wit is legendary, of course, but it is her style that I admire so much. As an aspiring writer myself, I am in awe of how effortlessly Parker makes it look. I have to admit though, she’s best read when one isn’t in a relationship. Outlook on romance - not very sunny.
Album currently playing on my IPOD – Gram Parsons’ GP / Grievous Angel. I was introduced to Gram Parsons by my Dad when I was in high school and was immediately reminded that the phrase ‘good country music’ need not be an oxymoron, despite all contemporary evidence to the contrary.
- Jenny
Thursday, October 30, 2008
Saturday, October 18, 2008
Yes, But What Does Britney Think?
There are a great many things that I miss about America. Many, of course, I expected: my family and friends, favorite shops, and restaurants. It’s what I didn’t expect to miss that is really throwing me for a loop, however.
I miss Twinkies. I don’t really even like Twinkies that much and I rarely eat them, but somehow their absence is keenly felt.
I miss American television; particularly the guilty pleasure shows, the shows that I would never think to watch unless I was bored and had come upon them while channel surfing - the VH1 marathon of last season’s ‘America’s Next Top Model’ or the second-rate action movie on TNT.
Mostly, I find that I miss magazines. I miss reading the witty and thought provoking editorials and essays in The New Yorker and Time Magazine. Now, I know that I can read them online. Even the cartoons, which I admit constitute about half of my reading pleasure in The New Yorker, are included on it’s online pages. But, it’s not quite the same as sitting down in a comfortable chair and flipping through the pages.
And as much as I miss the respectable magazines, I must confess what I really miss are the gossip rags. I miss People and US Magazine. It’s all fine and good to read about the Pakistani President’s unsettlingly friendly relationship with the Chinese leadership in Time, but what about Jennifer Aniston’s love life? Where can I find photos of Nicole Richie at the supermarket or a picture gallery of recent celebrity ‘baby bumps’? And yes, I can find much of this online as well. But, there is something about actually setting out to find gossip that takes so much of the joy out it. And viewing the pictures online just isn’t the same. There is something about the glossy pages and splashy, exaggerated headlines that transforms them from tacky gossip into perfectly acceptable entertainment.
And where People and US Magazine are like Pizza Hut pizza– not my usual preference for dinner, but the subject of an occasional craving – OK! and Star Magazine seem to fill the role of Twinkies in this admittedly odd allegory. I never actually buy them, but there is something very comforting about their presence in the grocery check-out line; something reassuring about the competing headlines of a Jolie / Pitt break-up versus their plans to marry on Christmas Eve at the Taj Mahal.
More evidence, I suppose, that even metaphorical superficial cuts cause more irritation than deeper wounds. I wonder if I’ll spend one of my first days back in the States sitting in front of the television eating Twinkies and flipping through US Magazine while ‘America’s Next Top Model’ is on. And no doubt, remembering very quickly why I never thought I would miss them in the first place.
Recent DVD viewing– The 1987 BBC series of Dorothy L. Sayers Lord Peter Wimsey films starring Edward Petherbridge and Harriet Walter. I’m enjoying them tremendously and am now very interested in reading the original novels.
Album currently playing on my IPOD – Gomez’s 2004 album, Split the Difference. Great band, check them out.
- Jenny
I miss Twinkies. I don’t really even like Twinkies that much and I rarely eat them, but somehow their absence is keenly felt.
I miss American television; particularly the guilty pleasure shows, the shows that I would never think to watch unless I was bored and had come upon them while channel surfing - the VH1 marathon of last season’s ‘America’s Next Top Model’ or the second-rate action movie on TNT.
Mostly, I find that I miss magazines. I miss reading the witty and thought provoking editorials and essays in The New Yorker and Time Magazine. Now, I know that I can read them online. Even the cartoons, which I admit constitute about half of my reading pleasure in The New Yorker, are included on it’s online pages. But, it’s not quite the same as sitting down in a comfortable chair and flipping through the pages.
And as much as I miss the respectable magazines, I must confess what I really miss are the gossip rags. I miss People and US Magazine. It’s all fine and good to read about the Pakistani President’s unsettlingly friendly relationship with the Chinese leadership in Time, but what about Jennifer Aniston’s love life? Where can I find photos of Nicole Richie at the supermarket or a picture gallery of recent celebrity ‘baby bumps’? And yes, I can find much of this online as well. But, there is something about actually setting out to find gossip that takes so much of the joy out it. And viewing the pictures online just isn’t the same. There is something about the glossy pages and splashy, exaggerated headlines that transforms them from tacky gossip into perfectly acceptable entertainment.
And where People and US Magazine are like Pizza Hut pizza– not my usual preference for dinner, but the subject of an occasional craving – OK! and Star Magazine seem to fill the role of Twinkies in this admittedly odd allegory. I never actually buy them, but there is something very comforting about their presence in the grocery check-out line; something reassuring about the competing headlines of a Jolie / Pitt break-up versus their plans to marry on Christmas Eve at the Taj Mahal.
More evidence, I suppose, that even metaphorical superficial cuts cause more irritation than deeper wounds. I wonder if I’ll spend one of my first days back in the States sitting in front of the television eating Twinkies and flipping through US Magazine while ‘America’s Next Top Model’ is on. And no doubt, remembering very quickly why I never thought I would miss them in the first place.
Recent DVD viewing– The 1987 BBC series of Dorothy L. Sayers Lord Peter Wimsey films starring Edward Petherbridge and Harriet Walter. I’m enjoying them tremendously and am now very interested in reading the original novels.
Album currently playing on my IPOD – Gomez’s 2004 album, Split the Difference. Great band, check them out.
- Jenny
Thursday, October 9, 2008
E Cannibus Unum?
Recently, the sumo world has been rocked by scandal. Two wrestlers have been permanently banned from professional sumo for having failed drug tests. They were found to have used… wait for it…. Marijuana. Yes, that dangerous drug that gives a professional athlete such an unfair advantage.
The Chairman of the Japan Sumo Association has lunged to accept the full blame of such a disastrous scandal and responded by tendering his resignation, though he insists that he had no prior knowledge of it and in actuality, completely believes the wrestlers when they deny having used marijuana. The Japanese, as a culture, have such an amazing ability to accept full blame for a situation, while at the same time, completely denying any of the responsibility. As usual, it seems to be the opposite of America, where everyone wants the responsibility, yet accepts none of the blame.
And after recounting all of the dirty details of lifetime bans and resignations, the media then focuses on two, in my estimation, minor details in the scandal. One, the fact that the wrestlers are Russian borne, though they have been living and working in Japan for a good portion of their young lives. And two, they allegedly attained the pot while in America. The implications are unspoken, yet certainly not subtle; no true Japanese sumo would have succumbed to this terrible western drug. It’s as though the Japanese believe that they couldn’t possibly be corrupted by such things.
And yet, the more I see, the more I kind of believe it. Not that Japanese can’t be corrupted by things, but they seem to be completely unaware of marijuana’s existence, and at the same time, naively aware of it.
A slight digression, but stick with me. All Japanese schoolchildren have pencil cases in which they carry pencils (of course), erasers, crayons, rulers, and - somewhat oddly in my mind – needles and thread. The younger kids usually leave them in their desks and the older grades bring them to my class despite the fact that they never, ever use them. In fact, it was when I was directing them to set them down on the floor by the wall to keep them out of the way, when I noticed the large number of cases in very distinct colors of green, black, and orange-red. It was the unmistakable image of a cannabis leaf on the lid of one of the cases that really caught my eye, however. I won’t insult you by pretending that I didn’t immediately recognize it. Despite what social conservatives proclaim, to be raised in a small town in Kansas and not recognize the shape of a cannabis leaf or the distinctive smell when it’s being smoked, requires such a passionate commitment to ignorance that I am grateful to have never had.
I had a class to teach, though, and no time to investigate this interesting development. Thankfully, I was scheduled to eat lunch with the one of the other 6th grade classes and would have the opportunity to check it out.
And we circle closer and closer. I think I’ve described in general terms lunch-time in Japanese elementary schools before, but to give you a little better picture of what happens – lunch period officially begins at 12:30. It’s at this time that about six students put on their aprons and caps and head down to the ‘kitchen’ area and collect lunch and all of the dishware for the entire class. This usually consists of a basket full of bowls, plates, and chopsticks, a metal bucket full of rice, another containing soup and a smaller covered pan with the fish and / or pickled foods. Another pair of students head to the school refrigerators to collect the milk for the class. When they return to the classroom, these students set up an assembly line and serve their classmates. Nobody begins eating until everyone is served and the students on lunch duty for the day have removed their aprons and caps and settled down to eat.
This entire process often takes a good twenty to twenty-five minutes. I’ve seen it take up to thirty minutes a few times. It’s odd to me how these students react at lunch-time - it’s beyond patient and bordering on the apathetic. We can have our food sitting in front of us for ten minutes and the kids never act annoyed or even curious as to why we haven’t started eating yet. I have to admit, I become both curious and annoyed, though I try to hide it.
My point – and yes, I do have one – is that I often have ten or fifteen minutes to interact and observe the kids as we wait for our lunch to begin. The kids are often reading, drawing, playing cards, etc. Most importantly, they are often opening their desks, revealing their pencil cases. During this particular lunch, I didn’t immediately sit down and start talking with the kids at my particular lunch group. Instead, I wandered around the room on the lookout for that distinctive leaf. Almost immediately, I spied a very sweet and somewhat shy girl named Naoko open her desk, and sure enough, sitting on top of her Winnie the Pooh folder, was her metal pencil case in that distinctive green color and covered with outlines of cannabis leaves. On the corner of the case, however, were the words ‘The Hemp Society.’ Now, Japan actually has a decently large hemp market, so I withheld judgment.
In the desk next to her, however, I hit jackpot. The boy threw open his desk to get his comic book to show his friends and next to it was his pencil case. It was black, green, and red striped and in big, black letters completely covering the top of the case, said ‘CANNABIS.’ I kind of caught his and Naoko’s eye, and tried to subtly look at the cases questioningly. Their faces as they looked back at me were the definition of childlike innocence. There was no hint of a smirk which I would have suspected.
I’ve had my eyes on the lookout since, and these particular pencil cases are everywhere and they seem as though they’re all from the same company or brand. And despite their wide dispersion throughout all of my schools, nobody seems to indicate that know what they represent.
But seeing young girls walk around with pencil cases advertising marijuana along with their Winnie the Pooh binders and their Hello Kitty pencils isn't the only incongruity to been found in Japan. A common sight in downtown Kumamoto are thin, young men with Clay Aiken hairdos and delicate features wearing oversized FUBU clothes, and small boutiques filled with lacy, frilly clothes and playing Bob Marley’s ‘Africa Unite’ on the speakers.
It’s like an entire country is in on the joke and nobody is blinking.
My Current Reading Material – Stanley Lombardo’s brilliant translation of Virgil’s Aeneid. Dr. Lombardo was a professor of mine at the University of Kansas and I’ve had the extraordinary pleasure of listening to him read from several of his translations, including Homer’s Iliad and Odyssey. He brings such a modern voice to these classics, while still remaining faithful to the spirit of the author and work. I cannot recommend these translations more highly.
Album currently playing on my IPOD – Robert Johnson: The Complete Recordings. And next up – Eric Clapton’s 2004 album, Me and Mr. Johnson.
- Jenny
The Chairman of the Japan Sumo Association has lunged to accept the full blame of such a disastrous scandal and responded by tendering his resignation, though he insists that he had no prior knowledge of it and in actuality, completely believes the wrestlers when they deny having used marijuana. The Japanese, as a culture, have such an amazing ability to accept full blame for a situation, while at the same time, completely denying any of the responsibility. As usual, it seems to be the opposite of America, where everyone wants the responsibility, yet accepts none of the blame.
And after recounting all of the dirty details of lifetime bans and resignations, the media then focuses on two, in my estimation, minor details in the scandal. One, the fact that the wrestlers are Russian borne, though they have been living and working in Japan for a good portion of their young lives. And two, they allegedly attained the pot while in America. The implications are unspoken, yet certainly not subtle; no true Japanese sumo would have succumbed to this terrible western drug. It’s as though the Japanese believe that they couldn’t possibly be corrupted by such things.
And yet, the more I see, the more I kind of believe it. Not that Japanese can’t be corrupted by things, but they seem to be completely unaware of marijuana’s existence, and at the same time, naively aware of it.
A slight digression, but stick with me. All Japanese schoolchildren have pencil cases in which they carry pencils (of course), erasers, crayons, rulers, and - somewhat oddly in my mind – needles and thread. The younger kids usually leave them in their desks and the older grades bring them to my class despite the fact that they never, ever use them. In fact, it was when I was directing them to set them down on the floor by the wall to keep them out of the way, when I noticed the large number of cases in very distinct colors of green, black, and orange-red. It was the unmistakable image of a cannabis leaf on the lid of one of the cases that really caught my eye, however. I won’t insult you by pretending that I didn’t immediately recognize it. Despite what social conservatives proclaim, to be raised in a small town in Kansas and not recognize the shape of a cannabis leaf or the distinctive smell when it’s being smoked, requires such a passionate commitment to ignorance that I am grateful to have never had.
I had a class to teach, though, and no time to investigate this interesting development. Thankfully, I was scheduled to eat lunch with the one of the other 6th grade classes and would have the opportunity to check it out.
And we circle closer and closer. I think I’ve described in general terms lunch-time in Japanese elementary schools before, but to give you a little better picture of what happens – lunch period officially begins at 12:30. It’s at this time that about six students put on their aprons and caps and head down to the ‘kitchen’ area and collect lunch and all of the dishware for the entire class. This usually consists of a basket full of bowls, plates, and chopsticks, a metal bucket full of rice, another containing soup and a smaller covered pan with the fish and / or pickled foods. Another pair of students head to the school refrigerators to collect the milk for the class. When they return to the classroom, these students set up an assembly line and serve their classmates. Nobody begins eating until everyone is served and the students on lunch duty for the day have removed their aprons and caps and settled down to eat.
This entire process often takes a good twenty to twenty-five minutes. I’ve seen it take up to thirty minutes a few times. It’s odd to me how these students react at lunch-time - it’s beyond patient and bordering on the apathetic. We can have our food sitting in front of us for ten minutes and the kids never act annoyed or even curious as to why we haven’t started eating yet. I have to admit, I become both curious and annoyed, though I try to hide it.
My point – and yes, I do have one – is that I often have ten or fifteen minutes to interact and observe the kids as we wait for our lunch to begin. The kids are often reading, drawing, playing cards, etc. Most importantly, they are often opening their desks, revealing their pencil cases. During this particular lunch, I didn’t immediately sit down and start talking with the kids at my particular lunch group. Instead, I wandered around the room on the lookout for that distinctive leaf. Almost immediately, I spied a very sweet and somewhat shy girl named Naoko open her desk, and sure enough, sitting on top of her Winnie the Pooh folder, was her metal pencil case in that distinctive green color and covered with outlines of cannabis leaves. On the corner of the case, however, were the words ‘The Hemp Society.’ Now, Japan actually has a decently large hemp market, so I withheld judgment.
In the desk next to her, however, I hit jackpot. The boy threw open his desk to get his comic book to show his friends and next to it was his pencil case. It was black, green, and red striped and in big, black letters completely covering the top of the case, said ‘CANNABIS.’ I kind of caught his and Naoko’s eye, and tried to subtly look at the cases questioningly. Their faces as they looked back at me were the definition of childlike innocence. There was no hint of a smirk which I would have suspected.
I’ve had my eyes on the lookout since, and these particular pencil cases are everywhere and they seem as though they’re all from the same company or brand. And despite their wide dispersion throughout all of my schools, nobody seems to indicate that know what they represent.
But seeing young girls walk around with pencil cases advertising marijuana along with their Winnie the Pooh binders and their Hello Kitty pencils isn't the only incongruity to been found in Japan. A common sight in downtown Kumamoto are thin, young men with Clay Aiken hairdos and delicate features wearing oversized FUBU clothes, and small boutiques filled with lacy, frilly clothes and playing Bob Marley’s ‘Africa Unite’ on the speakers.
It’s like an entire country is in on the joke and nobody is blinking.
My Current Reading Material – Stanley Lombardo’s brilliant translation of Virgil’s Aeneid. Dr. Lombardo was a professor of mine at the University of Kansas and I’ve had the extraordinary pleasure of listening to him read from several of his translations, including Homer’s Iliad and Odyssey. He brings such a modern voice to these classics, while still remaining faithful to the spirit of the author and work. I cannot recommend these translations more highly.
Album currently playing on my IPOD – Robert Johnson: The Complete Recordings. And next up – Eric Clapton’s 2004 album, Me and Mr. Johnson.
- Jenny
Sunday, September 28, 2008
Newman's Top Ten
In honor of my favorite actor, an extraordinary man, here are my Top Ten Paul Newman Films:
1. Butch Cassidy & The Sundance Kid - 1969
2. Cat on a Hot Tin Roof - 1958
3. Cool Hand Luke - 1967
4. The Sting - 1973
5. The Long, Hot Summer - 1958
6. Slap Shot - 1977
7. Hud - 1963
8. The Hustler - 1961
9. The Color of Money - 1986
10. The Verdict - 1982
1. Butch Cassidy & The Sundance Kid - 1969
2. Cat on a Hot Tin Roof - 1958
3. Cool Hand Luke - 1967
4. The Sting - 1973
5. The Long, Hot Summer - 1958
6. Slap Shot - 1977
7. Hud - 1963
8. The Hustler - 1961
9. The Color of Money - 1986
10. The Verdict - 1982
Sunday, September 21, 2008
This is Covered, Right?
“To everybody out there who pays taxes, we just bought an insurance company! And it only cost us… $85 billion. Well, if it keeps our government from socializing health care, I’m all for it.” – Jon Stewart on the federal government’s recent bail-out of AIG.
Whenever election time rolls around (and let’s face it, with campaigns starting earlier and earlier, it’s always election time) we are bombarded with dire warnings that some people want to socialize our health care system. Even the name is enough to strike fear into the heart of any patriotic American. Socialized Health Care. It’s socialized. That sounds like Socialism, which we all know is just a another word for Communism. They’re communists! And they want to turn us into communists, too!
And now for a few caveats from our author. I am no expert on health care systems: free-market, publicly-funded, or otherwise. The statistics presented in this blog come from a 1994 monograph titled, ‘Japan’s Universal and Affordable Health Care, Lessons for the United States?’ by Victor Rodwin, Ph.D., Professor of Health Policy and Management at New York University. Observations and real world situations come from my own experiences in the American health care system and from what my friends and acquaintances here in Japan have related to me.
Back to our regularly scheduled program. The dangers and threats of socialized health care; or as the rest of the world calls it, publicly funded health care; have been fully catalogued by it’s opponents: no choices for the consumer, a labyrinthine bureaucracy impossible to navigate, a steep decline in the quality of health care received – ridiculously long waits to get a doctor’s appointment, shorter hospital visits, rationed high tech medical care, and medical decisions being taken out of the hands of doctors and patients and in the hands of the bureaucrats, and most threatening of all – the outrageously high cost in form of taxes.
When talking about the dangers of publicly funded health care, most opponents refer (often misleadingly) to the health care systems of Canada, Cuba, or European countries. Rarely, do they mention the Japanese universal health care system. So, I thought I’d share a few of my observations of how it works and it’s results with you.
First, the set-up. Yes, Japan’s health care system is compulsory for all Japanese citizens. For permanent residents, it is possible to not participate: however, once in the system, it is extraordinarily difficult to leave – kind of like what I’ve heard about Bally’s Fitness Club. (With my 1-year work visa, I am considered a visitor in Japan and consequently purchase my health care through my employer as I would if I were in the States.) So yes, there is little to no choice for the consumer. Though, as an American citizen who has purchased her own health insurance for almost 10 years now, I can’t say I’ve ever felt overwhelmed with choice as health insurance companies vie for my patronage.
But back to Japan, virtually all residents are covered without regard to any medical conditions they may have or to their actuarial risk of succumbing to illness. And they do not lose their insurance when they change jobs or move to a different region. Again, as an American who has had 6 different health insurance plans in the last 10 years, because of changes in my employment and situation, Japan’s system appears very attractive in this regard.
But what about the labyrinthine bureaucracy they warn about? Well, if you’ve never had to battle bureaucracy in the American health care system, then my hat’s off to you. Whenever I’ve gotten a new health insurance plan, I spent way too much time worrying and checking to see if my doctors accept that insurance and if not, which doctors will. I arrive at any new doctor at least twenty minutes early to fill out all of the insurance forms and expect to spend an extra fifteen minutes for the receptionist to ask her fellow co-workers if they deal with this particular company before calling the company to iron out paperwork discrepancies.
Here in Japan, there is never any question if the doctor accepts the insurance and no bureaucracy telling you which doctors or specialists you can or cannot see. There’s little to no paperwork, either. At the first visit, they make a copy of the patient’s insurance card and they ask to see it at all following visits – much like in the States. And since there are only dealing with one insurance provider, the workers in the doctors’ offices are experts at the paperwork and technical details.
Probably the biggest concern for most Americans is the quality of health care received. I’ll rely on Dr. Rodwin and his well-researched monograph for my data here. Japan has the lowest infant mortality rate and highest life expectancy at birth. Japan has 15.8 inpatient hospital beds per 1,000 persons, more than three times the American ratio. And at 50.5 days, Japan has the longest average length of stay for inpatient hospital services, focusing on bed rest and complete recovery while the patient is in the hospital- a rate more than five times that of the United States. Japanese doctors have the highest number of physician contacts per capita, almost three times the American rate, and 45% of appointments are same or next-day.
My friends and acquaintances confirm that last fact. I’ve never seen anyone wait longer than two days for a doctor’s appointment, even for a routine physical. I, on the other hand, once had to wait close to four weeks to get an appointment for a physical. A friend of mine also visited the emergency room recently for a severe cold - a national holiday had the doctors’ offices closed - and was in and out within two hours having received an I.V. of vitamins and fluid and a filled prescription of antibiotics in hand.
Regarding high-tech medical care, Japan has the highest number of computerized axial tomography (CT) scanners per capita and the highest number of extra-corporal shock wave lithotriptors per capita. Japanese have nearly twice as many magnetic resonance scans per capita as Americans do.
And as for bureaucrats, I’ve seen and heard of no evidence of bureaucratic interference in medical care. A friend was recently informed by his doctor of a possible reoccurrence of cancerous cells on his stomach. He was given the choice of an invasive surgery to confirm, and if necessary, remove cancerous cells, or he could visit the doctor once every three months for non-invasive tests which would alert them immediately if there was a need for the surgery. Either decision would have been similarly covered by his insurance. Choosing the quarterly non-invasive tests, the total bill for his appointment with the specialist to have the tests done and again for the results comes to the equivalent of $1.46. I suppose the insurance doesn’t cover the Winnie the Pooh band-aid or watermelon flavored lollipop.
As always, everything comes down to the money. Looking at the big picture, spending on health care accounted for a mere 6.6 percent of Japan's total gross domestic product versus 13.4 percent of America's. On the more individual scale: yes, Japan’s health care system is based primarily on payroll taxes. Once a year, citizens pay a tax which roughly equals or is slightly less than what American’s pay a year for their health insurance. And when comparing co-pay for doctor’s visits, prescription costs, etc., Japanese pay significantly less.
And once over the age of 70, Japanese pay nothing in premiums, yet receive a significant percentage of health care services. An friend’s 80 something-year-old mother was recently in the hospital for a little over two weeks. Her total bill including the hospital, doctors, tests, prescriptions, etc., came to about $1,000. That’s less than a hotel stay.
There are, of course, significant cultural differences between the two countries and systems that would be dangerous to ignore. The overall good health of Japanese citizens in comparison to Americans can also be attributed in good part to their traditional balanced diet of fish, rice, fruits, and non-processed sugars. Japanese also put a high value on exercise. Most companies begin the work day with a mandatory stretching session with the employees and often have another in the afternoon after lunch. As I drove to work one day with the radio on, the radio station even stopped it’s programming for ten minutes to broadcast the traditional stretching routine. However, though I don't have the statistics, I would assume that the rates of lung cancer and emphysema here in Japan are much higher than America. They really are chain-smokers here. And to their great concern, studies show that the effects of globalization and Westernization are being felt as obesity, diabetic, and heart condition rates are on the rise in Japan.
And while Japanese blame rising obesity rates on McDonalds, I will admit that I find the following Japanese medical detail terribly disturbing. Though Japanese visit the doctor almost three times as often as Americans, the length of appointment is less than half the time. Japanese doctors rarely explain their diagnoses to the patients and to my horror to discover, often withhold their diagnoses from the patients if it is terminal, informing the family instead and often encouraging them to lie to the patient rather than ‘depress’ them with the truth. I've even heard of doctors not labeling the medicine they prescribe their patients to prevent them from discovering what is really wrong. That is a cultural issue, however, and not an effect of the state run health care.
It would be impossible to wholly compare the health care systems of Japan and America and decide definitively which is better. At least, it would take a much more intelligent and dedicated mind than mine. The Japanese publicly funded health care system is more complicated behind the scenes than I have described it here. Even the average Japanese citizen would be hard pressed to fully describe how it works. I do not claim America should import the Japanese system wholly and without pause, but I do hope that as Americans, we can open up our minds to the possibilities offered around the world without dismissing them categorically as un-American and therefore evil. There is much we can teach the world, but only if we keep our minds open to what the world has to teach us.
And there’s my $0.02 on fixing America’s problems :)
My current reading material – The Norse Myths by Kevin Crossley-Holland. Though I haven’t felt the transcendent impression of ‘these are my people,’ as Stewart described he did when reading these myths, I do admit that the fatalistic attitudes expressed does ring some bells in this mid-western girl. My favorite line so far: “Every morning the two ravens, Thought and Memory, are loosed and fly over Midgard; I always fear that Thought may fail to wing his way home, but my fear for Memory is greater.”
Album currently playing on my IPOD – Steely Dan’s 1972 ‘Can’t Buy a Thrill’. The first album released by Steely Dan and number 238 on Rolling Stones’ list of the 500 greatest albums of all time.
- Jenny
Whenever election time rolls around (and let’s face it, with campaigns starting earlier and earlier, it’s always election time) we are bombarded with dire warnings that some people want to socialize our health care system. Even the name is enough to strike fear into the heart of any patriotic American. Socialized Health Care. It’s socialized. That sounds like Socialism, which we all know is just a another word for Communism. They’re communists! And they want to turn us into communists, too!
And now for a few caveats from our author. I am no expert on health care systems: free-market, publicly-funded, or otherwise. The statistics presented in this blog come from a 1994 monograph titled, ‘Japan’s Universal and Affordable Health Care, Lessons for the United States?’ by Victor Rodwin, Ph.D., Professor of Health Policy and Management at New York University. Observations and real world situations come from my own experiences in the American health care system and from what my friends and acquaintances here in Japan have related to me.
Back to our regularly scheduled program. The dangers and threats of socialized health care; or as the rest of the world calls it, publicly funded health care; have been fully catalogued by it’s opponents: no choices for the consumer, a labyrinthine bureaucracy impossible to navigate, a steep decline in the quality of health care received – ridiculously long waits to get a doctor’s appointment, shorter hospital visits, rationed high tech medical care, and medical decisions being taken out of the hands of doctors and patients and in the hands of the bureaucrats, and most threatening of all – the outrageously high cost in form of taxes.
When talking about the dangers of publicly funded health care, most opponents refer (often misleadingly) to the health care systems of Canada, Cuba, or European countries. Rarely, do they mention the Japanese universal health care system. So, I thought I’d share a few of my observations of how it works and it’s results with you.
First, the set-up. Yes, Japan’s health care system is compulsory for all Japanese citizens. For permanent residents, it is possible to not participate: however, once in the system, it is extraordinarily difficult to leave – kind of like what I’ve heard about Bally’s Fitness Club. (With my 1-year work visa, I am considered a visitor in Japan and consequently purchase my health care through my employer as I would if I were in the States.) So yes, there is little to no choice for the consumer. Though, as an American citizen who has purchased her own health insurance for almost 10 years now, I can’t say I’ve ever felt overwhelmed with choice as health insurance companies vie for my patronage.
But back to Japan, virtually all residents are covered without regard to any medical conditions they may have or to their actuarial risk of succumbing to illness. And they do not lose their insurance when they change jobs or move to a different region. Again, as an American who has had 6 different health insurance plans in the last 10 years, because of changes in my employment and situation, Japan’s system appears very attractive in this regard.
But what about the labyrinthine bureaucracy they warn about? Well, if you’ve never had to battle bureaucracy in the American health care system, then my hat’s off to you. Whenever I’ve gotten a new health insurance plan, I spent way too much time worrying and checking to see if my doctors accept that insurance and if not, which doctors will. I arrive at any new doctor at least twenty minutes early to fill out all of the insurance forms and expect to spend an extra fifteen minutes for the receptionist to ask her fellow co-workers if they deal with this particular company before calling the company to iron out paperwork discrepancies.
Here in Japan, there is never any question if the doctor accepts the insurance and no bureaucracy telling you which doctors or specialists you can or cannot see. There’s little to no paperwork, either. At the first visit, they make a copy of the patient’s insurance card and they ask to see it at all following visits – much like in the States. And since there are only dealing with one insurance provider, the workers in the doctors’ offices are experts at the paperwork and technical details.
Probably the biggest concern for most Americans is the quality of health care received. I’ll rely on Dr. Rodwin and his well-researched monograph for my data here. Japan has the lowest infant mortality rate and highest life expectancy at birth. Japan has 15.8 inpatient hospital beds per 1,000 persons, more than three times the American ratio. And at 50.5 days, Japan has the longest average length of stay for inpatient hospital services, focusing on bed rest and complete recovery while the patient is in the hospital- a rate more than five times that of the United States. Japanese doctors have the highest number of physician contacts per capita, almost three times the American rate, and 45% of appointments are same or next-day.
My friends and acquaintances confirm that last fact. I’ve never seen anyone wait longer than two days for a doctor’s appointment, even for a routine physical. I, on the other hand, once had to wait close to four weeks to get an appointment for a physical. A friend of mine also visited the emergency room recently for a severe cold - a national holiday had the doctors’ offices closed - and was in and out within two hours having received an I.V. of vitamins and fluid and a filled prescription of antibiotics in hand.
Regarding high-tech medical care, Japan has the highest number of computerized axial tomography (CT) scanners per capita and the highest number of extra-corporal shock wave lithotriptors per capita. Japanese have nearly twice as many magnetic resonance scans per capita as Americans do.
And as for bureaucrats, I’ve seen and heard of no evidence of bureaucratic interference in medical care. A friend was recently informed by his doctor of a possible reoccurrence of cancerous cells on his stomach. He was given the choice of an invasive surgery to confirm, and if necessary, remove cancerous cells, or he could visit the doctor once every three months for non-invasive tests which would alert them immediately if there was a need for the surgery. Either decision would have been similarly covered by his insurance. Choosing the quarterly non-invasive tests, the total bill for his appointment with the specialist to have the tests done and again for the results comes to the equivalent of $1.46. I suppose the insurance doesn’t cover the Winnie the Pooh band-aid or watermelon flavored lollipop.
As always, everything comes down to the money. Looking at the big picture, spending on health care accounted for a mere 6.6 percent of Japan's total gross domestic product versus 13.4 percent of America's. On the more individual scale: yes, Japan’s health care system is based primarily on payroll taxes. Once a year, citizens pay a tax which roughly equals or is slightly less than what American’s pay a year for their health insurance. And when comparing co-pay for doctor’s visits, prescription costs, etc., Japanese pay significantly less.
And once over the age of 70, Japanese pay nothing in premiums, yet receive a significant percentage of health care services. An friend’s 80 something-year-old mother was recently in the hospital for a little over two weeks. Her total bill including the hospital, doctors, tests, prescriptions, etc., came to about $1,000. That’s less than a hotel stay.
There are, of course, significant cultural differences between the two countries and systems that would be dangerous to ignore. The overall good health of Japanese citizens in comparison to Americans can also be attributed in good part to their traditional balanced diet of fish, rice, fruits, and non-processed sugars. Japanese also put a high value on exercise. Most companies begin the work day with a mandatory stretching session with the employees and often have another in the afternoon after lunch. As I drove to work one day with the radio on, the radio station even stopped it’s programming for ten minutes to broadcast the traditional stretching routine. However, though I don't have the statistics, I would assume that the rates of lung cancer and emphysema here in Japan are much higher than America. They really are chain-smokers here. And to their great concern, studies show that the effects of globalization and Westernization are being felt as obesity, diabetic, and heart condition rates are on the rise in Japan.
And while Japanese blame rising obesity rates on McDonalds, I will admit that I find the following Japanese medical detail terribly disturbing. Though Japanese visit the doctor almost three times as often as Americans, the length of appointment is less than half the time. Japanese doctors rarely explain their diagnoses to the patients and to my horror to discover, often withhold their diagnoses from the patients if it is terminal, informing the family instead and often encouraging them to lie to the patient rather than ‘depress’ them with the truth. I've even heard of doctors not labeling the medicine they prescribe their patients to prevent them from discovering what is really wrong. That is a cultural issue, however, and not an effect of the state run health care.
It would be impossible to wholly compare the health care systems of Japan and America and decide definitively which is better. At least, it would take a much more intelligent and dedicated mind than mine. The Japanese publicly funded health care system is more complicated behind the scenes than I have described it here. Even the average Japanese citizen would be hard pressed to fully describe how it works. I do not claim America should import the Japanese system wholly and without pause, but I do hope that as Americans, we can open up our minds to the possibilities offered around the world without dismissing them categorically as un-American and therefore evil. There is much we can teach the world, but only if we keep our minds open to what the world has to teach us.
And there’s my $0.02 on fixing America’s problems :)
My current reading material – The Norse Myths by Kevin Crossley-Holland. Though I haven’t felt the transcendent impression of ‘these are my people,’ as Stewart described he did when reading these myths, I do admit that the fatalistic attitudes expressed does ring some bells in this mid-western girl. My favorite line so far: “Every morning the two ravens, Thought and Memory, are loosed and fly over Midgard; I always fear that Thought may fail to wing his way home, but my fear for Memory is greater.”
Album currently playing on my IPOD – Steely Dan’s 1972 ‘Can’t Buy a Thrill’. The first album released by Steely Dan and number 238 on Rolling Stones’ list of the 500 greatest albums of all time.
- Jenny
Thursday, September 11, 2008
Politics as Unusual
This is perhaps the most interesting time to be an American living in Japan.
The above sentence is hopeless vague and unwieldy. It can be interpreted, construed, rebutted, denied, bolstered and defended innumerable ways. In my opinion therefore, it is the perfect lede in a blog about politics and politicians.
As many of you know, I love politics… the Platonic ideal of Politics, that is. It can be beautifully demanding and challenging: intellectually, philosophically, and ethically. Consequently, watching current politicians and their campaigns for office, I feel akin to a trainspotter watching a head-on train collision. My amateur enthusiasm and knowledge make it all the more horrifying and compelling to witness.
With the internet, my view of the American political stage is no less clear from halfway across the world than it would be from America’s Heartland. I can find just about any clip of a speech, interview, or off-hand remark made by well… anyone. I can find press releases, news articles, and editorial columns from basically anywhere. And I do. I am perhaps more up-to-date regarding this Presidential Election than I would be if I were living in the States. Living in Japan, however, has reinforced and magnified my belief in the importance of being aware of the bias not only of one’s news sources, but of oneself when gathering information this way. It’s something I’ve always believed, but feel even more strongly about it as I experience living outside of the United States.
In the States, I would without any effort on my behalf, encounter news stories and opinions from sources much more right-leaning than I am. Now, I have to go out of my way to find them. And finding them is important. We naturally tend to gravitate towards sources that we feel share our perspective and opinions, and there is no end to such sources on the internet. But, this wouldn’t give me a very well-rounded view of the American political reality. So, I watch (with gritted teeth) Bill O’Reilly on YouTube as well as full Daily Show with Jon Stewart episodes (thank you Nate, for pointing these out to me.) I’ve bookmarked and track the conservative news site, TownHall.com as well as the more liberal HuffingtonPost.com. The most vital site recently added to my bookmarks is FactCheck.org to help me sort out all of the various truths, half-truths, misleading statements, and outright lies I read and hear. This is a full time job.
However, no matter how hard I work to keep up with it all, I find a vital element of politic-watching missing– the watercooler talk. It’s something I used to roll my eyes at, but I find that I miss it desperately. I know what the liberal and conservative bloggers and analysts are thinking, but I have no idea as to what they ordinary men and women who don’t post their opinions to the web think. I have a fairly good idea as to what campaign claims are true and which are false, but I don’t know what Joe and Jane America accept as the truth, what they believe are the important issues of this campaign.
I recently saw a poll on CNN International that showed the percentage of people claiming to be highly interested in the American Presidential Election by country. According to this poll, 83% of Japanese are highly interested in this year’s election and only 80% of Americans. Whenever I mention the election to some of my acquaintances, though, it is the historic element that draws their attention. The individual candidates’ positions on the issues is given little notice. Most seemed to favor Obama because they liked the fact that he would be the first African-American as President. But now Sarah Palin has been named McCain’s running mate, they seem genuinely excited over either possibility as it would be either the first African-American in office or the first woman as V.P. It’s an interesting observation considering the ambivalence many Japanese felt regarding the suggestion that royal succession rules be amended to allow the Crown Prince’s eldest daughter to succeed him to the throne and their relief when a son was born to the younger brother of the Crown Prince whose birth allowed the debate to fade into the background.
It’s also interesting to compare the American President Election to the current campaign and upcoming election of the Japanese Prime Minister since the current P.M., Yasuo Fukuda, announced his resignation a little over a week ago. He was in office not quite one year and whose approval ratings mirror President Bush’s current approval ratings. There has been very little talk on the subject among my co-workers as fair as I can tell. Of course, this election is one in which only members of the Diet (parliament) can vote, not the Japanese citizens.
Candidates for the post were just announced a few days ago and the election will be held in two weeks. But even in normal elections, the campaigns only run for 6 weeks before they vote. My acquaintances laugh when I express my wish that American campaigns were similarly short, especially considering Obama and McCain have been on the campaign trail nigh on 19 months by now.
Even more enviable is the post-election clean up of campaign signs. In my first week in Kumamoto, they held the mayoral election I believe, and the day after the election ended, city workers were out in full force taking down all of the signs decorating the city. The next day none remained.
All of that said, I do hold the American political process in even higher regard today than ever before. I am so happy that such a wide range of thought and opinions are available for consumption. And I am proud to have to opportunity to have my own voice heard in such an important decision.
- Jenny
The above sentence is hopeless vague and unwieldy. It can be interpreted, construed, rebutted, denied, bolstered and defended innumerable ways. In my opinion therefore, it is the perfect lede in a blog about politics and politicians.
As many of you know, I love politics… the Platonic ideal of Politics, that is. It can be beautifully demanding and challenging: intellectually, philosophically, and ethically. Consequently, watching current politicians and their campaigns for office, I feel akin to a trainspotter watching a head-on train collision. My amateur enthusiasm and knowledge make it all the more horrifying and compelling to witness.
With the internet, my view of the American political stage is no less clear from halfway across the world than it would be from America’s Heartland. I can find just about any clip of a speech, interview, or off-hand remark made by well… anyone. I can find press releases, news articles, and editorial columns from basically anywhere. And I do. I am perhaps more up-to-date regarding this Presidential Election than I would be if I were living in the States. Living in Japan, however, has reinforced and magnified my belief in the importance of being aware of the bias not only of one’s news sources, but of oneself when gathering information this way. It’s something I’ve always believed, but feel even more strongly about it as I experience living outside of the United States.
In the States, I would without any effort on my behalf, encounter news stories and opinions from sources much more right-leaning than I am. Now, I have to go out of my way to find them. And finding them is important. We naturally tend to gravitate towards sources that we feel share our perspective and opinions, and there is no end to such sources on the internet. But, this wouldn’t give me a very well-rounded view of the American political reality. So, I watch (with gritted teeth) Bill O’Reilly on YouTube as well as full Daily Show with Jon Stewart episodes (thank you Nate, for pointing these out to me.) I’ve bookmarked and track the conservative news site, TownHall.com as well as the more liberal HuffingtonPost.com. The most vital site recently added to my bookmarks is FactCheck.org to help me sort out all of the various truths, half-truths, misleading statements, and outright lies I read and hear. This is a full time job.
However, no matter how hard I work to keep up with it all, I find a vital element of politic-watching missing– the watercooler talk. It’s something I used to roll my eyes at, but I find that I miss it desperately. I know what the liberal and conservative bloggers and analysts are thinking, but I have no idea as to what they ordinary men and women who don’t post their opinions to the web think. I have a fairly good idea as to what campaign claims are true and which are false, but I don’t know what Joe and Jane America accept as the truth, what they believe are the important issues of this campaign.
I recently saw a poll on CNN International that showed the percentage of people claiming to be highly interested in the American Presidential Election by country. According to this poll, 83% of Japanese are highly interested in this year’s election and only 80% of Americans. Whenever I mention the election to some of my acquaintances, though, it is the historic element that draws their attention. The individual candidates’ positions on the issues is given little notice. Most seemed to favor Obama because they liked the fact that he would be the first African-American as President. But now Sarah Palin has been named McCain’s running mate, they seem genuinely excited over either possibility as it would be either the first African-American in office or the first woman as V.P. It’s an interesting observation considering the ambivalence many Japanese felt regarding the suggestion that royal succession rules be amended to allow the Crown Prince’s eldest daughter to succeed him to the throne and their relief when a son was born to the younger brother of the Crown Prince whose birth allowed the debate to fade into the background.
It’s also interesting to compare the American President Election to the current campaign and upcoming election of the Japanese Prime Minister since the current P.M., Yasuo Fukuda, announced his resignation a little over a week ago. He was in office not quite one year and whose approval ratings mirror President Bush’s current approval ratings. There has been very little talk on the subject among my co-workers as fair as I can tell. Of course, this election is one in which only members of the Diet (parliament) can vote, not the Japanese citizens.
Candidates for the post were just announced a few days ago and the election will be held in two weeks. But even in normal elections, the campaigns only run for 6 weeks before they vote. My acquaintances laugh when I express my wish that American campaigns were similarly short, especially considering Obama and McCain have been on the campaign trail nigh on 19 months by now.
Even more enviable is the post-election clean up of campaign signs. In my first week in Kumamoto, they held the mayoral election I believe, and the day after the election ended, city workers were out in full force taking down all of the signs decorating the city. The next day none remained.
All of that said, I do hold the American political process in even higher regard today than ever before. I am so happy that such a wide range of thought and opinions are available for consumption. And I am proud to have to opportunity to have my own voice heard in such an important decision.
- Jenny
Thursday, September 4, 2008
Lessons at Lunch
As I was trying to ward off a sneak tickle attack by a rambunctious 4th grade girl while we were settling down for lunch, I noticed an interesting poster on the wall behind her.
If you’ve ever been instructed on the correct way to hold chopsticks, you’ve probably been told to hold one like you would hold a pencil, keeping the other one stationary while using the one to move and pinch the food. Well, it turns out Japanese children receive the same lesson in reverse. This poster gave directions on how to hold a pencil, by showing pictures of a hand holding chopsticks that gradually morph into it holding a pencil. It makes sense, of course. Japanese children have been using chopsticks since they were old enough to sit upright. It still struck me as funny to use something fairly complex, using chopsticks, to describe how to do something so simple, hold a pencil.
Speaking of chopsticks, a few days ago, one of my co-workers again showed concern / surprise at my using chopsticks to eat. About once every couple weeks, one of my fellow teachers will ask if I’m comfortable with chopsticks or one of my students will giggle that I do eat with chopsticks. After assuring the teacher that I was fine without a spoon, fork, and knife: I turned back to the group of 6th graders I was sitting with and tried to tell them that Americans often eat with chopsticks, too. It’s a slight exaggeration, but I do get the feeling that they believe no American has ever seen chopsticks unless they have traveled to Japan themselves. I made the mistake however, of listing some of the foods I’ve eaten with chopsticks, among them being sushi, when one of the girls quickly set me straight, informing me that I shouldn’t be eating sushi with chopsticks but with my hands. And in Japan, that’s true. If you are at a sushi restaurant, it is traditional and expected that you eat the sushi with your hands. Sushi from the grocery store, on the other hand, would be okay to eat with chopsticks, I think.
As usual, I tried to show these Japanese children that Americans can be cosmopolitan and worldly, only for them to decide that I was quite the opposite.
- Jenny
If you’ve ever been instructed on the correct way to hold chopsticks, you’ve probably been told to hold one like you would hold a pencil, keeping the other one stationary while using the one to move and pinch the food. Well, it turns out Japanese children receive the same lesson in reverse. This poster gave directions on how to hold a pencil, by showing pictures of a hand holding chopsticks that gradually morph into it holding a pencil. It makes sense, of course. Japanese children have been using chopsticks since they were old enough to sit upright. It still struck me as funny to use something fairly complex, using chopsticks, to describe how to do something so simple, hold a pencil.
Speaking of chopsticks, a few days ago, one of my co-workers again showed concern / surprise at my using chopsticks to eat. About once every couple weeks, one of my fellow teachers will ask if I’m comfortable with chopsticks or one of my students will giggle that I do eat with chopsticks. After assuring the teacher that I was fine without a spoon, fork, and knife: I turned back to the group of 6th graders I was sitting with and tried to tell them that Americans often eat with chopsticks, too. It’s a slight exaggeration, but I do get the feeling that they believe no American has ever seen chopsticks unless they have traveled to Japan themselves. I made the mistake however, of listing some of the foods I’ve eaten with chopsticks, among them being sushi, when one of the girls quickly set me straight, informing me that I shouldn’t be eating sushi with chopsticks but with my hands. And in Japan, that’s true. If you are at a sushi restaurant, it is traditional and expected that you eat the sushi with your hands. Sushi from the grocery store, on the other hand, would be okay to eat with chopsticks, I think.
As usual, I tried to show these Japanese children that Americans can be cosmopolitan and worldly, only for them to decide that I was quite the opposite.
- Jenny
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