Posted tagged ‘New York Times’

The Health Care Headache: Japan’s Thinning The Waistline…Of The Entire Nation?!

June 13, 2008

Konichiwa! Now I know I said I’d speak more on the American health care system first, but this New York Times Article was too good to pass up. So, to begin my dissertation on “The Health care Headache,” I’ll start with the Japanese system and how this “mass weight loss” initiative so keenly integrates itself into the “Health care System of the Rising Sun.”

So lets pretend: Akira Nomoura works for the Nintendo Corporation in Japan, and like the other employees, he’s enrolled in his company’s insurance plan. Now, this plan is not like American insurance companies, no, no. This insurance plan is operated directly by the Nintendo corporation, and each month, about 4.0% of Akira’s salary is paid directly into the insurance plan. Nintendo will make an additional payment of about 5.0% of Akira’s salary into the company’s own plan.

Cool, a system where the companies pay into insurance programs operated by the companies themselves and does better than match the percentage of the salary the employee pays into the respective insurance plan…

…But wait, what about retired people and the unemployed?

Well, in this system, it looks as if unemployed people cannot qualify for health insurance, which is not necessarily a bad thing, considering employment is necessary for a grandeur of other things besides health care (car payments, food, water, rent, etc…)

But the retired are not left out of the equation. Hakura, a retired worker from the Nintendo corporation. Rather than paying into the Nintendo plan (which is only eligible for working employees), Her insurance has been switched to a “citizen’s insurance plan” run by the municipal government in Yokohama, where she decided to retire. Nintendo, however, does care about their dedicated, retired employees and will make payments into the municipal citizen’s insurance plan in Yokohama for Hakura. Hakura is expected, though, to pay an insurance premium to the municipal government’s plan indexed to her salary when she was working for Nintendo.

Interesting. Companies continue to pay into local government run insurance companies for their retired employees. But wait, not everyone can work for a major corporation like Nintendo, what about small business employees?

Good question. Taro works in a flower shop in Osaka that is privately owned. The flower shop does not operate their own insurance plan, but Taro (and the other employees/employer) at the flower shop are covered under the Japanese national government’s operated insurance plan. Taro will pay about 4.5% of his salary into the plan, and his employer will match it. All payments go to the Japanese National Plan.

Japan’s system is rooted in a “mandatory employment based insurance plan” and has been since 1922. Companies with 700 employees or more are required to operate their own insurance plans.

Lets outline the Japanese plan:

Workers in Large Firms -payroll tax-> Society managed insurance plan – Subsidies for retirees-> Citizen’s Health insurance plan.

Workers in Small Firms-payroll tax-> Government managed insurance plan -subsidies for retirees-> Citizen’s health insurance plan.

General Tax Subsidies -> Government managed insurance plan [small firms]-> [see small firms flow]

General Tax Subsidies -> Citizen’s health insurance plan [for retirees and self-employed]

Self Employed and Retirees -income-based premiums-> Citizen’s Health Insurance plan.

So we have covered…well, coverage. But what happens when something medical goes wrong? Well, fortunately (by the way it’s set up) this system places no restrictions on the 1) choice of hospital one goes to. 2) physician one sees. There are 3 general types of health care institutions in Japan: 1) small clinics, staffed by a physician and other employees dealing mostly with outpatient procedures, yet stocked with 1 or 2 inpatient rooms. 2) small hospitals owned by a physician and staffed by a physician staff (inpatient and outpatient). And 3) large hospitals, public and private, equipped with specialty staff and inpatient and outpatient departments. The hospitals and clinics are run, and operated by medical personnel as in…[gasp]… The physicians themselves! The patients are supplied with any and all care that they may need, so long as their paying their plan premiums that their companies (or government[s]) establish.

Physicians are paid by a fee-for-service system regulated by the government. The government also regulates the prices of medications. In Japan, there are no prescriptions. Physicians can distribute medications directly to their patients upon visit. The average patient count a physician has on a daily basis is about 66. 

Now, to the New York Times article: Japan is “tightening the belt” on the nation, not allowing men between the ages of 40 and 74 to exceed a waist size of 33.5 inches, and women 35.4 inches (as established as a guideline for Japan back in 2005 for diabetes and other health risks).

During physicals, physicians are required to measure the waists of its citizens within this age bracket and if they fail “national” inspection, are required to take health classes for 3 months time to encourage weight loss. Dieting guidance and restriction will take effect if the problem is not corrected within this 3 month time.

If you read the article in full, you’ll also learn that some physicians in Japan disagree with the nation’s policy to “shrink” the nation, in that “Japan has no need to lose weight.” Tell that to Mr. Nogiri, “the flower shop owner with a flat stomach and barely discernible love handles”, who clocked in at 33.6 inches. 0.1 inches over the National limit. I never thought I’d see the day…Mr. Nogiri: Illegally Obese.

What do you think about the Japanese Health Care system? Do you think America could benefit from such a program? Why or Why not? And how about this National initiative to “shrink” the national waist line? Is it a positive initiative? or is the Japanese government being too harsh with their waist line restrictions?

Let me know what you think. This is your health care future! If you don’t have opinions yet, find some!!

fredbertino, getting his wisdom teeth extracted tomorrow, signing out. Sayonara!

Research provided by: Understanding Health Policy: A Clinical Approach by Thomas S. Bodenheimer and Kevin Grumbach. (c) 2005

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World Reacts to Obama Nomination

June 6, 2008

The news of Barack Obama’s nomination wasn’t just headlines news here in the U.S. it made headlines all over the world. The man has changed the face, of American politics, literally. When you thought of an American president you generally thought of an old white male, and more recently someone who wasn’t exactly loved by his audience. Now there is a possibility of a young, black president who speaks at events that are more like rock concerts than press conferences. The world is taking note.

French television has already started talking about who would be his VP pick. “Choosing Hillary means choosing Bill too,” said one reporter. Even the French President Nicolas Sarkozy had something to say in a phone interview, he said Barack Obama “embodies the America of today and tomorrow.” According to a New York Times report Patrick Devedjian, the head of President Sarkozy’s center-right political party, called Mr. Obama’s candidacy ‘’a very beautiful image of America, the image of a candidate who transcends race and got to where he is because of merit alone.” According to the same article by Alan Cowell Bertrand Delanoë, the mayor of Paris, declared: “His candidacy carries an enormous hope for his country and for peace in the world.”

In Germany Josef Joffe the publisher and editor of Die Ziet wrote:

“We western Europeans wish for nothing more fervently than Barack Obama leading the USA. But he would be president of a very strong superpower, and that usually means trouble. A commentary.

The spirit of the times blows for Obama – if more softly in Asia, Africa and Latin America than here in western Europe. For us, it may be an optical illusion that sticks in our minds: that comforting picture in which it isn’t America that’s the problem, it’s George W. Bush. Out with the cowboy, in with change and hope, and we can again love America.”


In Kenya when asked about the country’s feelings about Barack being elected as part Kenyan himself
“We are feeling great,” stated Obama’s uncle. Here’s a link to a BBC report about Kenyan reaction.

“Obama’s America on the doorstep of history,” said a headline on the front page of As Safir in Lebanon.

In London the newspapers were covered with images of Barack and Hillary.

It seems the media of the United States isn’t the only one enamored with Barack Obama. The foreign press also seems to love Obama. Simply for the fact that Barack Obama is not Bush. Perhaps America doesn’t have the bad reputation we all think it does globally. Maybe Obama can restore the vision of America as the last best hope. We can only wait and see.

What do you think the world sees when they turn an eye to our political system?

Here’s a link to a related CNN article
http://www.cnn.com/2008/WORLD/asiapcf/06/06/zakaria.obama/index.html

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Clinton to back Obama

June 4, 2008

More news on the democratic primary…. wait no seriously, it’s really over.

Barack Obama has the unofficial nomination of the democratic party. He made a speech yesterday to a roaring crowd of supporters in what could only be described as a rock concert atmosphere.

Senator Hillary Clinton will endorse presumptive democratic nominee Barack Obama on Saturday. According to a New York Times report Howard Wolfson, one of Clinton’s chief campaign strategists said “Senator Clinton will be hosting an event in Washington, D.C., to thank her supporters and express her support for Senator Obama and party unity.”

This comes on the heels of accusations of Hillary being dissonant in a speech to her supporters here in New York City, following the announcement from various media organizations that Senator Obama already had the necessary delegates to clinch the nomination. She sounded defiant by not acknowledging Barack Obama as the nominee and talking about herself. She denounced critics and pundits for never giving her a chance despite them claiming her the next president for all of 2006 and most of 2007. Until a man by the name of Barack Obama started winning in Iowa.

Only adding to what most saw as a belligerent and argumentative speech was Terry McAuliffe’s introduction of Senator Clinton as “the next president of the United States of America.”

It seems that everyone in the Clinton campaign including herself with the exception of a few aides and Terry McAuliffe realized that there was no road to the nomination. The calls from fellow democrats to coalesce behind Obama and unite the party seemed to have finally worked. Howard Dean, Harry Reid and Nancy Pelosi released a joint statement today recognizing Barack as the nominee. They stopped short of endorsing him, but it leads one to believe if they did so simply to give Hillary a chance to do so first.

So mark your calendars, Saturday June 7th Barack Obama will get the endorsement of Hillary Clinton as she suspends her campaign. It seems as if the party is finally coming together, despite the worst predictions out there.

Now people are asking about the VP spot…. really? It just ended lets give it some time.