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    Don’t send me no doctor

    Posted by Sean at 13:17, May 29th, 2004

    Here we go. This is hardly the beginning–there’s been news like it at regular intervals for years–but the Ministry of Health, Labour, and Welfare (note the British u in that fourth word–this is a class-act, civilized country, you know) bean crunchers and number counters have estimated that total health expenditures in 2025 will be more than double what they are now: 69 trillion yen (about US $630 billion). That includes out-of-pocket payments by users but, naturally, mostly consists of Social Insurance premiums and taxes. The most quickly increasing sector is geriatric care, of course; it’s projected to be half the total by then.

    When people ask me what the health care system is really like over here, I never quite know what to say. Care for minor stuff is great; so is care for catastrophic illness. I’ve had friends who had heart bypasses and treatments for cancer that were, to judge from the results, first-rate. No, it isn’t the Nirvana a lot of collectivists in America think it is: care for things that are significant but not life-threatening is seriously hit-or-miss. You have to work hard to find a good dentist. It’s common to tell a GP that you’ve already tried aspirin for your fever and still walk out of his office with powdered acetaminophen. Treatments are often drawn out into short segments given over weeks or months. Part of this is because the traditional Asian view of how to restore health involves slowly and naturally prodding the life processes back into normal alignment.

    But part of it is also that more visits help maximize revenue from patients who don’t have many other options. Despite the long average life span here, the lack of transparency in operations (and deemphasis on personal responsibility and initiative) that create drag on the Japanese domestic economy are bad for the health care system, too. This article is out-of-date, but it compiles several of the cases that got the most publicity in the first few years I lived here. Since then, you get similar stories regularly: a sociopathic nurse in Sendai killed his patients by giving them heavy doses of muscle relaxant. Even though the frequency with which his patients worsened was such that his colleagues called him “Nosedive Mori,” and he was using unprescribed doses of muscle relaxant that were missing from inventory, he seems to have kept this up for years. And then there’s the “thank-you money” that people routinely give their surgeons in addition to the set fee.

    None of this is to be interpreted as meaning that people are lying or incorrect when they say that Japan has good health care. It’s just that you can’t point to Japan and say that having a national health care system improves things over private insurance by ensuring better control and an orientation toward service rather than profit. Everyone knows that as the population ages, caps on care will change; it will be unpleasantly interesting to see how the revised MHLW rules play out as they move through the medical system in real time and on real terms.

    Never one to roam / I took the first bus home / and I haven’t changed

    Posted by Sean at 20:46, May 28th, 2004

    It’s this sort of story that makes me glad I live in a country in which people will just say straight out that they believe Koreans are congenitally lazy and stupid and Chinese people are treacherous. You can then disagree, with reason and example, and actually get somewhere.

    But where…how do you…is it even…WTF can you possibly say to this?

    The city of Chicago will continue to set aside a portion of its construction contracts for firms owned by blacks, Hispanics and women — but not Asian-Americans.

    The revised ordinance, approved Wednesday night by the City Council, lists the groups that statistical evidence shows are socially disadvantaged.

    Under the law, Asian-Americans can still apply for city work if they do so as individuals and document that they have been discriminated against.

    The changes upset Asian-American leaders as well as some aldermen who said the city was opening itself up to a return to discriminatory practices.

    The City of Chicago is “opening itself up to a return to discriminatory practices,” by airily judging who’s downtrodden enough to compete for clubby set-aside municipal contracts? Good Lord. Imagine what might happen if they pull out all the stops and start discriminating for real.

    It gets better. There seem to have been warning signs from a few months ago on that Asian-Americans would be excluded. At least one affected party is clearly not one to let anything so trivial as self-respect get in the way of a good gravy train:

    Nakachi is concerned that Asian business owners are being defined too narrowly. He noted one line in Moran’s decision about the disparity of people eligible under the program: “A third-generation Japanese-American from a wealthy family, and with a graduate degree from MIT, qualifies.”

    “We have polled our membership and we can’t find any MIT graduates,” Nakachi said. “It’s kind of a stereotype that all Asians are highly educated and highly successful.”

    I know that’s what I look for in people in charge of public works projects: the conviction that they and their kind are as capable of being mediocre as anyone else is.

    Okay, fine–he didn’t say they were stupid or incompetent, only that their degrees might not have brand value and they might not have achieved prominent reputations. And I realize that I’m falling into the Gotcha! routine that Camille Paglia complained about in discussing blogs with Salon. (Well, she didn’t elaborate, but I assume she was referring to the practice of linking to an article, quoting its dumbest paragraph, appending some snarky put-down, and signing off.) But I find few things more infuriating than encountering people who are frankly anti-aspirational.

    Goring the Good Book

    Posted by Sean at 01:16, May 27th, 2004

    I know that at least one of you has guns in the house. Do me a favor, please? If I ever, ever, ever put a time-honored metaphor through the wringer like this, shoot me dead?

    “He planted the seeds of war. He harvested a whirlwind,” Gore added. “And now the corrupt tree of a war waged on false premises has brought us the evil fruit of Americans torturing and sexually humiliating prisoners who are helpless in their care.”

    A guarantee

    Posted by Sean at 10:31, May 26th, 2004

    More about the very brief Japan-DPRK meeting last weekend (this may have been available from other news outlets earlier this week, but I tend to read the Nikkei thoroughly and half-pay attention to NHK on television while cooking, so this is the first I’ve seen it): Koizumi actually met with Charles Jenkins. Were the whole situation (“Hi! Your wife was kidnapped from her free, prosperous home country to teach its culture to spies in a bankrupt and eventually starving hell-hole of a dystopia, and now that she’s finally home after two decades, she’d kind of like to have her children with her, so we’ll do our damnedest to keep your country from prosecuting you as an Army deserter!”) not so appalling, it would be like a spy thriller. And even as it is, it can be darkly amusing. The report is that, to underscore the message that Japan would “make its utmost efforts” to assure that the US doesn’t push for extradition–meaning that Jenkins can live with his wife and daughters in Japan–a Foreign Ministry official with Koizumi wrote, “I guarantee it [私が保証する is the way the story renders it; paradoxically enough, that means I can’t be sure what the English wording was]” on a slip of paper and passed it across the table. Make a great movie scene.

    Jenkins has, of course, ultimately agreed to meet in Beijing. Beijing is friendly to the DPRK, so Japan initially indicated that it wouldn’t accept a reunion between Jenkins and Soga there, but it’s changed its mind and is now pushing in that direction. Soga expressed anxiety about meeting in Beijing and averred that there’s no way in hell she’s going back to North Korea (I should say not!). So we’ll see who moves. I imagine the first meeting probably will, ultimately, be in China. This is an Asian mother with two unmarried daughters in their late teens and early 20’s, so odds are she’ll decide it’s worth putting aside her concerns about traveling to a DPRK ally and do what needs to be done to get her family back together. My pruriently-curious side (is there any other?) wonders what the first night of pillow talk is going to be like in that reformed household.


    Posted by Sean at 22:07, May 24th, 2004

    Which of you wiseasses hid the receipt/claim check-thing I need to pick up my passport at the Embassy this Friday? This is not funny….

    Let me into your temple

    Posted by Sean at 12:54, May 24th, 2004

    Paul Varnell’s newest article at IGF notes something I was kind of wondering about, too: People are taking longer than I expected to freak the hell out over gay marriage in Massachusetts. Not that I’m relishing the prospect, or anything. I trust it’s not surprising that, while I’m troubled by the methods that are being used to bring these changes about and not at all confident in the motives of some of their loudest proponents…well, seeing the pictures and reading the accounts from Massachusetts makes my heart leap. How could it not? My deepest hope (read: it’s the Lagavulin talking) is that obsessive activists on our team will see this as a sign that, while we still face a lot of opposition, there’s a real fund of goodwill out there that we don’t have to get hysterical to tap into, and that anti-gay types will at least recognize something familiar and human in seeing people want to make the relationships that sustain them official. Then maybe (wait–there’s a little Scotch left…not anymore!) we could start talking in terms of how we’re going to treat behaviors as a society and not screeching past each other about what constitutes “approval” of this or that.

    I was vaguely bemused, though, by this paragraph in Varnell’s article:

    And not just legally wed, but welcomed with religious marriage ceremonies by the venerable and influential Unitarian church, whose ministers almost to a man � and woman � have made themselves available to same-sex couples wishing a blessing in the religious tradition.

    Oh, my. In the sense that today’s Unitarianism evolved from challenges to the concept that God is a trinity, sure, it’s…um…old. But I have to say, my first boyfriend took me to a service in Lower Manhattan ten years ago, and I just didn’t get it. My idea of a religion is the church I was brought up in: two-hour services every week, during which you looked up every cited scripture and took notes, no work allowed on the Sabbath, and a kind, accessible Christ balanced by a God the Father whose attitude ran more toward, ARE YOU PEOPLE GOING TO LISTEN TO ME ALREADY OR DO I HAVE TO SMITE YOU WITH A BLEEDING CURSE?!

    The idea at the Unitarian place–and I understand that it may have been somewhat extreme in this regard, but from what I’ve read of Unitarian beliefs it wasn’t way, way on the fringes–seemed to be that you do whatever you felt like doing anyway, and God loves you for it. In fact, the atmosphere of strident, you’re-special! good cheer was so irritating that by the time I left the building, I just wanted to go kick puppies. This is America, and people are, of course, fundamentally free to worship whatever God they choose. I also understand why gays who don’t believe our lives are sinful don’t have a whole lot of choices of denomination. I just can’t help thinking that it doesn’t profit us much to be leaning on a sect with (what appears to me to be–I’d love to be proven wrong) quite that degree of an I’m-okay-you’re-okay approach to life.


    Posted by Sean at 13:15, May 22nd, 2004

    Everyone seems to be bitching about the return of the cicadas this year; of course, in Japan, the cicada is a major topic of summer-themed traditional poetry, mostly using its voice to evoke solitude or its short life to evoke the 無常 (evanescence, contingency) of This World. Basho Matsuo, the greatest of the haiku poets, wrote several such verses, and one frequently sees them in translation. One of my favorites, though, is this affecting, if less-profound, example, which doesn’t seem to make it into translation often:


    Ide ya / Ware yoki nuno kitari / Semi koromo

    Behold me! I wear
    the finest garments–the robe
    of the cicada

    A sucky translation, but hey, it’s the spur of the moment. I’m as drawn to the serious insights of traditional poetry as anyone, but I like the way the great writers such as Basho and Saigyo were able to find something enlightening about a relaxed, playful moment, too. The summer lightness of his simple, rough clothing makes Basho feel like a cicada with translucent wings. An image to savor now. Soon, most of Japan will be like the inside of a dumpling steamer; not even with the aid of air conditioning will the finest linen and cotton feel like anything but a soaked dishrag.

    Added at some ungodly hour Monday morning: It occurs to me that, since two people who might be reading this are into sewing, the poem above might have more impact if I make it clear that I think the main way Basho is drawing an analogy between his clothing and the wings/shell of the cicada is through their common texture. The summer robe of a priest would have been made of unfaced, loosely-woven raw cotton or silk. The uneven slubs would have created a texture very much like the veined wings of the cicada, and the folds created by the way it draped might have suggested folded wings, too.

    A sort of homecoming

    Posted by Sean at 13:16, May 21st, 2004

    So Prime Minister Koizumi went to Pyongyang, where Kim Jong-il has said he was welcome, most welcome. The meeting apparently ended in less than two hours–perhaps there was a spontaneous city-wide banquet in Kim’s honor that he had to rush off to–but there was plenty to talk about. There’s that little matter of nuclear disarmament, for one thing (the DPRK has been known to file missiles over our heads in Japan–just testing, you know).

    But the focal point was clearly the Japanese abductees. Five have returned to Japan; that leaves eight that the DPRK says are dead (I can’t remember all the cover stories, they’re so lame; one involved graves being washed away in a mudslide and therefore unrecoverable–things like that) and two that it claims never entered North Korea. So from the Japanese viewpoint, there are five abductees repatriated and ten missing, of whom the DPRK acknowledges eight. That’s a total of fifteen, which I’m pretty sure is lower than the number of cabinet ministers and party officials currently implicated in the non-payment-of-pension-premiums scandal, but I could be wrong.

    The Japanese are trying to get abductees’ family members (mostly children) in North Korea to Japan, which is why there’s such a fuss over US Army deserter Charles Jenkins, who defected to North Korea in the ’60’s and is married to abductee Hitomi Soga. The US has indicated that it may, in fact, expect him to be handed over for court martial if he accompanies his daughters to Japan to see their mother. All of this making nice with the DPRK makes me sick, but I guess diplomacy wouldn’t be a delicate business if it always involved dealing with good people.

    Added at 1 a.m.: Predictably, the families of abductees are stomping mad that Koizumi didn’t push more for information about those unaccounted for. One’s heart goes out to them–most of these people were snatched off Japanese soil in their teens or early twenties, remember. But I have a hard time imagining what good a hard-line stance would do in this kind of case. The DPRK is run by whim-driven nut cases, unfortunately. In the meantime, children from two families came from North Korea and were reunited with their repatriated parents near Haneda Airport. It’s been a year and seven months since they’ve seen each other. One of the parents, Kaoru Hasuike (beautiful name, that: Kaoru means “fragrance,” and Hasuike means “lotus pond”), said, “My daughter has become so lovely….and my son has grown tall.” The last sentence in this article reports, “With that, he broke into the smile of a proud father.” Good for them. Let’s hope the rest of the endings are as happy as they can be.

    Live from Europe

    Posted by Sean at 12:40, May 19th, 2004

    I didn’t know whether there’d be more to report about this: アルカイダ幹部が新潟に1年以上潜伏 (Key al Qaeda Member Hid Undetected in Niigata for Over a Year), but it looks as if for now, that’s about what they know. He’s Algerian-French and named Lionel du Mont; he was in Niigata from the end of 2002 through 2003 with his German wife. He went in and out three times (at least once on a false passport); he had a tourist visa, so he probably wanted to avoid crossing paths with the law by overstaying. His business was used cars, but it looks as if they suspect him of moving equipment and funding for al Qaeda.

    I can’t imagine how the government is all that surprised. Yes, the man was wanted, apparently, in connection with an attempted bombing at the G7 Summit in Lyons in 1996 (that’s background in the article, not my encyclopedic knowledge of current events talking). InterPol was looking for him. But still, his passport was French, and people pass through Japan’s international airports from Europe and Malaysia in droves every day. It looks as if they think he was helping to establish part of the network here. Lovely. He was apparently arrested in Germany at the end of last year, so I hope they’re getting some information out of him.

    Lucky takes you out for a ride

    Posted by Sean at 15:51, May 18th, 2004

    I forgot to say anything about this a week ago, but this month is the 25th anniversary of the release of one of my all-time favorite albums:

    Bad Girls by Donna Summer

    Yeah, I know–I’m just a regular old annihilator of stereotypes, huh? Well, before you get too smirky and derisive, just remember that the last few weeks have seen a movie in which Brad Pitt stars as Achilles in an adaptation from Homer become a giant box-office hit in America, so how about having the Standards discussion with a neighbor on your own side of the Pacific, huh? Anyway, I’m not going to get all soi-disant rock critic here, but I will say I adore Bad Girls from beginning to end (yes, including Side 3) and hope that Summer, despite being a born-again Christian, recognizes it as a real accomplishment herself.