Mar 16, 2004

Just like those wacko Nucks

Yesterday was tax day. Of course, I filed my return at the last minute, in keeping with long-held tradition. Knowing how much this country enjoys paperwork and arcane forms, the relative practicality and simplicity of the process surprised me. What I earned, divided by four, times 3.2, minus some number and then rounded down gave me my "income." This minus the health insurance premium I paid last year and a standard deduction equalled my "taxable income." After that, one more proportional reduction, subtract withholdings at source, and voila - tax owed or refundable. I get a refund.

(Rie's filing was even easier, because employers often do a "year-end adjustment," in which they take care of the tax calculation for you.)

Having already biked 30 minutes to the tax office out west, and about 25 back home, I figured I'd go ahead and make another 30-minute bike ride in the opposite direction to take care of my other lingering piece of official business, at the Nerima ward office.

You see, I've been without health insurance for the past month and a half. And in Japan that is a big official no-no. The Japanese, like the Canadians, are of the strange opinion that all residents - not only citizens - are entitled to affordable healthcare. And not merely entitled, but obligated to participate in a medical insurance program, either national or through an employer (looky here). Given that, it was really no shock that they're going to collect premium for the month and a half I was "without coverage." For I am now retroactively covered back to February 1.

The American in me wanted to argue, but my brain said to keep quiet and thank the nice insurance people.

During the ride home, I tried to recall the horrible things I heard about socialized medicine about 10 years back, but couldn't remember the exact arguments. Doctors would become lazy... the quality of medical care would drop... no one would have a choice of physician anymore?

I dunno... is Japan's system considered socialized medicine? Because the doctors here don't appear all that lazy, the quality of care I've received has been no worse - and less Big Pharma-dependent - than that in the US, and my choice of practitioner has not been restricted, so far. In fact, the options are even greater - insurance also covers treatments like moxibustion and chiropractic care. Overall, I'd say I'm quite satisfied with my health care experiences in Japan.

Not that I'm trying to suggest one system is better than the other. The insurance environment here is just different from that in the US. People generally eat well, exercise regularly, and, aside from the salarymen, live into their 80s. There are still a considerable number cigarette smokers, but a lot less obesity. (Toss up? Maybe not.) And I'd wager that malpractice and repayment of med school loans have a much smaller impact on healthcare pricing in Japan.

So maybe something like this wouldn't work on Planet America. But then at least everyone would have access to both a lawyer and a doctor.


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