Podium

In 24 hours, I will officially join what is thought by many to be "socialized health care." I will walk into a Hamamatsu ward office and leave with an insurance card. This card means doctors would only charge me 30% for any health care I need outside of the meager insurance provided by my company (which I was told at the ward office is traveler's insurance). So when I go to the dentist, a much needed trip, I will be responsible for paying 30% of the procedure and any prescriptions. It's the first time since I've been a working American male that I've had my own health insurance, and it is a shame that I could not get a similar option in America.

The landmark study "Care Without Coverage: Too Little, Too Late," has been widely quoted in the midst of the health care debate in America. This 193-page report has been so important because it points out that 30 million (that's one in seven) working-age Americans cannot get insurance from their employer or are too young for Medicare; approximately 10 million children lack insurance altogether. The fact that 18,314 people die in the USA each year should be a sobering one for the country that outspends the rest of the world in health care but provides only a fraction of the population with adequate health care.

For many Americans, the idea of not having health insurance is unfathomable. Some people have been fortunate to not know what it is like to lack coverage. However, this American has never had his own health insurance plan and is now officially too old to be covered under his mother's health insurance. In America, I would be between a rock and a hard place should something happen to me. Even when I was partially covered under my mother's plan, I had to pay a considerable amount for health care. It was generally enough that I usually avoided hospitals and dentists. That avoidance could have prevented my health, particularly my teeth, from declining. I know several people who refuse to call an ambulance because the cost of having one come to pick you up, even in an emergency, is not covered in their insurance, if they are in fact covered at the time of illness. Personally, I had to open a credit card to pay for previous dental work that I am still trying to pay for two years later, because the interest rate is sky high. If I were in America working the exact same job, I would not currently have any options to consider about my health care.

I do not say this lightly: thankfully, I am not in America.

I am in Japan, a country with socialized health care insurance and the world's highest life-expectancy rate. To be clear, about 80% of Japanese hospitals are privately owned, so it is not "socialized medicine," as NPR clarifies in an April article on the health care situation of Japan. Japan has what many Americans are fighting for now, universal health care. Specifically, a Public Option. Simply put, I can opt for National Health Insurance. Japan requires health care for everyone, but I can choose from three different programs:

1) Shakai Kenkou Hoken (Company-Provided Insurance)- Your company will provide you with this insurance if you are currently working full-time. Your deductible will come directly out of your paycheck and is a certain percentage of your earnings and will cover up to 70% of your medical bills. (Now the kicker is that full-time means 30 hours a week, I am reportedly working 29.5 and not full-time which makes me ineligible for this option.)

2) Kokumin Kenkou Hoken (National Health Insurance)- Opting into this plan means the government pays 70% of your treatment, while you pay the other 30%. This is the plan most students, unemployed and self-employed people have. The government sends you a bill every month like an insurance company but the amount you pay is based on residence tax, dependents and property owned.(This is the option I will have to choose)

3) Private Health Care- like America, you can choose your own personal health care option which gives you the coverage that you prefer at the costs you prefer. This option, for those who can afford it, usually means full-coverage, or at least more than 70% (which honestly isn't bad to begin with!)

In fact, the only people really complaining about Japanese health care are physicians. Japanese health care has limits on how much doctors can charge for operations and procedures. This is standardized across the country. While in America one doctor can charge an arm and a leg for an X-ray, the cost of imaging is the same all over Japan, and relatively cheaper.

Japanese people live longer than Americans because of diet as well as preventive care. They see a doctor three times as much as Americans according to T.R. Reid with NPR. And they see any doctor they want. Of course no health care plan is perfect, but the fact that I have choices, "options open to the public" if you will.

See, the thing people seem to be confused about is that the Public Option that the President is seeking is no different at all from the one already in place here in Japan and other intelligent developed countries. England's universal health care program began in 1911, but really expanded into the modern form in 1946 after the blitz of World War II. And England has learned that it's program isn't perfect and is currently seeking ways to reform it to improve hospitals and wait times. But at least it has a system in place to insure everyone has access to care. And no one in Japan has to declare bankruptcy because of unexpected hospital bills. It is a kick in the face that once a doctor saves your life you don't have much to life for when the bills pile up. Having a Public Option means I can choose to have private insurance or choose the government to assist me when I need health care. Knowing the government has a safety net for me makes me feel like an actual human being.

Which makes me afraid to figure out what will I be if I have to go back to the states and lose any coverage.

I'll continue to post about my journey through the scary path that is socialized health care.

Ikuzo.