The Great Debate

Public vs. Private Health Care

Throughout my half a century in this life the debate over or between which is the better form of health care; public or private, has cast a huge shadow over public discourse. My first memory of this topic was overhearing as a child my parents talking with relatives who recently met with the Canadian branch of the family. Those who had met them had asked how they liked their national healthcare and reported that they said that it was great for OTC medicine but that they crossed the border in to the US for anything requiring more and paid out of pocket for it. This would have had to have been in the 70s.

Living overseas, this topic has heated up for me personally. I do not care what system they have in the UK or Canada. I really couldn’t have cared less except those I meet from the two countries have an evangelical like desire to convert me to their religion of nationalized health care. They are obsessed with the National Health Services and while they gleefully cite what they believe to be the truth of the “system” we have in the States they simply can not stand even one bad word being spoken about theirs. One Brit I knew said he was shocked to learn that the leading cause of personal bankruptcy in the States was health care costs after serious injury or illness and attempted to use this as a way of saying that his NHS was far superior. So I asked him about wait times for needed health care interventions and told him that apart from the normal scheduling like we have for our drink ups, we have none in the US. Then I asked which is better, the family of the injured and sick going bankrupt or the whole nation going bankrupt as each try to pay for healthcare. A blank stare slowly contorts to an expression of anger followed momentarily with an angry shove back from the bar table and storming off to friendlier waters.

A Canadian I used to work with and got along with very well cited Michael Moore with the less than accurate statement that hospitals turn away patients who can not pay for health care. My dad retired as a paramedic, simply not true, but everyone seems to think it is. We have a national health care scheme in Japan the requires all employed persons to pay in to. This statement alone is loaded but I will not unpack it at present. However, if one should find themselves in need of emergency care in Japan and they or another calls them an ambulance, then they have “taraimawashi” to deal with. This translates roughly into “the run around”. Actually, I think that that is precisely the dictionary definition, however, unlike then English phrase, in this case it is much more literal as the ambulance will most likely have to run/drive from hospital to hospital to hospital around and around and around until they find one willing and able to accept their patient. Here are some articles I have collected on this phenomenon over the years. This I wrote for another publication. I have decide to keep some things that are not directly on target with the rest of this piece to give the inquisitive nuggets to go after. I being in Japan, most cover that country’s often touted public health care system.  For the most part, I have excluded articles, many with useful information, that did not have a headline that speaks directly to the issue it reports on.  I have tried to group these issues.  I have not included any on how the system is falling apart during the current panic.  Please note the dates of these articles.  These problems are not new and yes, they continue today.  Please let this be your entry point into these issues.  There are many more articles and studies written on these.  My comments will be in italics.

Refusal of service

8.3% of Tokyo emergency cases refused by multiple hospitals The Japan Times: Feb. 24, 2009

24,089 cases of multiple ER snubs last year The Japan Times: March 12, 2008

30-hospital denial fatal to woman The Japan Times: Dec. 29, 2007

82-year-old woman turned away by five hospitals dies  The Japan Times: Nov. 15, 2008

Crash victim refused by 14 hospitals dies  The Japan Times: Feb. 5, 2009

Pensioner Dies After Being Denied Treatment at 25 Different Hospitals Mar 6, 2013

Hospitals in Tokyo refusing flu patients  The Japan Times: May 6, 2009    Not just for covid and not new either, folks.

Hospitals turn away patients at record rate The Japan Times: July 24, 2011

Keep in mind this is the denial of a service that those denied have already paid for.

Doctor Shortages

Doctor shortage gives patients runaround The Japan Times: April 12, 2008

Hospital doctors feeling the strain The Japan Times: April 12, 2008

Hospital's docs quit over pay cut  The Japan Times: Nov. 1, 2008

Shortage of rural doctors worsens  The Japan Times:, April 23, 2009

Planned cut in doctors’ overtime hours worries  Japan’s rural hospitals Japan Times May 6.

Doctor’s suicide after monthly overtime exceeded  200 hours recognized as work-related The Japan Times, Date Unknown

A doctor in the house? Do you feel lucky? The Japan Times: Nov. 15, 2008

Hospitals need 24,000 doctors to ease manpower shortage, study shows

The Japan Times: Sept. 30, 2010

Provincial areas experiencing doctor shortages The Japan Times: June 1, 2010

Hospitals stretched to the breaking point  The Japan Times: March 13, 2011  To anyone currently panicking over the Japanese hospitals being overwhelmed by covid, if you’d been paying attention then you would not be surprised.

If you build an emergency room, they will come The Japan Times: July 29, 2009

Students shun nursing care The Japan Times: Sept. 2, 2008 Wonder why?

EPAs clearing way for foreign caregivers  The Japan Times: May 21, 2008 What?  Japan is importing health care professionals?  Why?  Oh…..

Solutions (!?!)

Hospital closures eyed in reform plan The Japan Times: April 29, 2009

Abe-led government panel suggests reducing hospital beds to cut costs Oct. 29, 2019  Yes, everyone knows the solution to turning away patients is to reduce the number of hospital and beds.

Cancer

Japan fatally behind curve on cervical cancer The Japan Times: June 27, 2008

Doctor scarcity hurting cancer care for women The Japan Times: Jan. 29, 2009

Less than 40% of adults get cancer screening: poll The Japan Times: Nov. 27, 2007

Breast cancer threat ignored  Deaths rising but menace kept off the radar: advocate

The Japan Times: Sept. 23, 2005

Patient Costs But, but, it’s free!

Billing Catch-22 traps patients The Japan Times: Jan. 11, 2008

Medical bills about to double The Japan Times: June 9, 1997

New insurance plan ups burden on 'later-stage' seniors  The Japan Times: May 22, 2008

Uninsured matter of death for 33  The Japan Times: Saturday, March 13, 2010

Is aging Japan really ready for all the non-Japanese carers it needs? The Japan Times: June 1, 2008

Seniors to pay more for medical service  The Japan Times: Dec. 1, 2005

Quality

Hospital's surgery on 135 unneeded  The Japan Times: Jan. 8, 2011

Hospitals reused syringes on 10,000 patients The Japan Times: June 5, 2008

Reuse of blood-check devices widespread The Japan Times: Aug. 8, 2008

67 hepatitis B patients sue the state The Japan Times: July 31, 2008 The above case is not the first time needles have been reused.  This is the fallout from a previous instance.

Hospital topped radiation limit for kids' exams The Japan Times: Sep. 2, 2011

Hospital death exposes 'tip of malpractice iceberg' The Japan Times: Jan. 31, 2006

Medical Education

Doctors cite ‘necessary evil’ of med school exam-rigging Asahi Shimbum August 9, 2018 This one is an important read.  Exams were rigged to hinder female applicants to med. Schools.  The “why” is important.

Childbirth

A medical travesty in Nara  (From The Japan Times Sept. 4 issue) A must read.

Woman with brain hemorrhage left untreated for an hour The Asahi Shimbun Oct 21/22 2006 Another must read.

Hospitals need 1,000 more ICU beds for babies, ministry says The Japan Times: July 26, 2008 Lack of hospital beds are often cited as the reason for turning patients away, especially pregnant women.  Remember the article above on the planned reduction in the number of beds to reduce costs.

Nearly half of perinatal centers short on full-time doctors: poll The Japan Times: Oct. 30, 2008

Obstetricians log 300-hour months The Japan Times: Nov. 1, 2008

Miscarriage rate found unexpectedly high  The Japan Times: Aug. 3, 2009

A couple of others

Foreign drugmakers closing labs in Japan, moving over to China The Japan Times: July 28, 2008 Not just foreign companies.  Japanese drugmakers have also moved some manufacturing overseas too.  Result of price controls.  Eventually, the cost to make them domestically becomes greater than what the government will allow them to charge for them.

Depths of a transplant scandal The Japan Times: July 2, 2011

Not Just the Japanese

‘Grandma export’ exposes Germany’s struggle with care. Bloomburg September 24, 2013

Millionaire businessman awarded MBE for charity work bled to death after waiting FIVE HOURS for emergency surgery The Mail 16 April 2014

Children's lives are being put at risk by a 'chronic shortage' of hospital doctors on weekends and evenings The Mail 11 April 2013

Patient waited 62 hours for ambulance  BBC News 23 August 2018

Mother barely conscious with pneumonia was treated in a cupboard because hospital was 'too full' to give her a bed The Mail 8 April 2013

Shocking proof A&E closures cost lives: Death rate jumps more than a THIRD after department closesThe Mail 11 May 2013

Swedes enjoy world-class healthcare - when they get it Agence France Presse Sep 03, 2018

Canadians Are One In A Million -- While Waiting For Medical Treatment   Forbes Jun 11, 2018.

Therefore, to my Canadian coworker’s question I had more than enough to back up my inquiry; “Why is being denied care you have already paid for superior to being denied care you can not pay for?”, a response that elicited a stone face, an about face then a hasty retreat.

This is not to deny that what we had before Obamacare was less than perfect and needed fixing but turning over 1/6 of the US economy to bureaucrats was not the answer, as we have seen.

Besides the costs, the wait times, the poor outcomes for most, those of us opposed to the government being involved in our personal, individual health care is another concern that is now front and center; using nationalized medicine to directly control the population. From denying live saving surgeries to babies and young children because a parent was not vaccinated to doctors writing op-eds that those who refuse to follow the corrupted medical profession’s dictates and their families be denied all health care, both of these situations are from the States BTW, doctors around the world have displayed theIr willingness to do evil for the “greater good” as directed.

Where does one start on just listing the madness these MDs have signed aboard to support? How about “vaccine passports”? What is the purpose of these? It is not as sold as we already have such a system, the long used visa system. To go abroad a visa is required. Depending upon where one is traveling, certain vaccines may be required. One of my trips to Japan required I get the vaccine for Japanese Encephalitis, for example. So why do we need to spend money we do not have to track vaccines for a disease that does not warrant one? Public health is not the reason.

Some may argue that the visa system is no more. Yes and no. Japanese going to the US for short trips no longer are required to get a visa, instead they must get an enesta or some similar sounding acronym; a visa by another name. I will say that I was shocked that vaccines were not required for a trip to Chile in 2018. Still, I needed a visa and the covid shot could easily be added to this as other shots are. We can argue if it should be, I do not think it should, the point is, a brand new gazillion dollar system was and is not needed. Therefore, I must conclude that this new system is for something other than its stated purpose. If so, then the public health apparatus is being used for something other than as intended.

We should all know now either from personal experience or from others we know in places such as New Zealand and East Germany with Koalas just how bad life can be when health safety drives what we are allowed and not allowed to do with our lives.

Sorry folks, you that were and those who are still all in for nationalized health care were/are wrong. We who have been opposing it were and remain right. We do not want this. We do not want what they have in store for us. We do not want access to health care we are forced to pay through the nose for denied because of a Facebook post. That day is coming, if not already here. Those of us who opposed this have won the argument but are losing the war.