Photo: B. Fertman
Health insurance in Japan actually does a conscientious job of insuring its people’s health. Being a person who now has health insurance in Japan, I decided to go to doctors and actually find out how I am, something I have avoided doing in the United States as my deductible does not cover the first $5000 of my medical expenditures. Yet still the cost of my health insurance in America is double of what I pay for health insurance in Japan. Last week I had a comprehensive physical unlike any I have ever experienced in America. Discovering that, at 61, I am in exceptionally good health, but also finding out what I should keep my eye on, gave me great peace of mind. Strangely, rather than feel happy I felt even sadder than I had been for all of us in America who pay so much for our health care and receive so little health care. And there are the millions of us who cannot afford health care. It’s not easy having a peaceful mind when in the back of that mind we’re worrying about what happens if we or our loved ones get severely sick or injured.
Having been a gymnast, modern dancer, and martial artist, and having survived a couple of car accidents, my body has had a lot of practice at mending injuries and keeping me all of a piece. I’m grateful. I do have a knee that is not like it used to be, and now one hip that is asking for some help. My father had 4 hip replacements over 35 years, and like the rest of us he only had two hips! But now nothing prevents me from going for an MRI which I will do this afternoon. When I had a cold I went to a cold clinic where there were 50 people waiting to be seen, but in one hour I walked out having been thoroughly diagnosed, cared for, and given a prescription for medicine. I walked 50 yards to the pharmacy and in 2 minutes I had my medicine. In one day I felt better. A week earlier, I went to the dentist, which was also covered by my insurance.
If everyone in America could experience what it feels like to receive good health care I have no doubt that we’d have good, comprehensive health care in America. Most Americans don’t know what they are missing. What overwhelmed me was suddenly realizing that I was being treated with respect, that my dignity was being honored, that I was a person of value. I felt a little guilty receiving this kind of care when countless others are not. Knowing more about how I am naturally makes me want to actively take care of myself.
So three times a week I go to a gym, which is a 3 minute walk from my apartment. It costs me $60 a month. I have been swimming, stretching, and using weights, which are helping a lot. The gym is sparkling. You could literally eat off the floor. Really. All the equipment seems brand new. Everything works perfectly. There are daily classes, all free, in Pilates, Tai Chi, Spinning, Dance, Yoga, Swimming, and more. The instructors are very good. And I have super high standards when it comes to movement teachers. These teachers are good. A facility like this in America would be reserved for the wealthy. Here it is available to almost everyone.
Bathing is an art in Japan. Into the steam room, then onto a low stool that sits in front of a mirror, a bucket for water near by and a hand held shower nozzle. Perfect water pressure. Nothing is broken. Everyone takes their time and cleans every pore, shaves, brushes their teeth, only turning on the water when they need it. Your body is warm from having been in the steam room so there’s no need to stay under continuous running water. After this almost ritualistic cleaning, you soak in a communal O furo, a hot tub, really hot. When a family baths at home, the O furo is filled and covered as not to lose heat. One by one, each person takes their time getting cleaner than clean then soaks in the tub. The tub is not as long as an American tub, but it’s higher. In America we lie down in a tub. In Japan we sit in a furo. With less surface water exposed to the cool air, the water stays warmer longer. Once out, the furo is covered, ready for the next person.
In general people in Japan use about a fifth of the energy we use. Yoshiko, my wife, thinks our utilities bills are high. Outside I’m looking concerned. Inside I’m smiling. They don’t, or I should say we don’t heat our homes centrally. We only heat where we are at the moment. This might mean sitting on an electrically heated two foot by two foot piece of carpet. Or it may mean working at a small, low desk, a kotatsu, which is designed such that under the table top surface is a large quilted blanket, and under the blanket is a small heater built into the table. You put your legs under the table and cover your lower body with the blanket, perhaps along with three other people, with their legs under the table, while everyone eats dinner together. Warm, cozy, and fun. Who needs to have all that heat floating up to the ceilings, which also are low, inside of rooms that are small. In Japan we don’t use hot water to clean clothes, nor clothes dryers, nor dishwashers. We use cold water to wash dishes, and we don’t run the water when we soap up the dishes. When I say we I mean 99.9% of Japanese people. It’s taught in school from the get go. Refrigerators are tiny. No huge ovens. No pilot lights for hot water heaters, or stoves. All localized heat. Because of the Fukushima disaster Japanese people decided to use even less energy than they had been using. All but two of their fifty-four nuclear reactors remain shut down, at least for now. A lot of people would like to keep it that way, though given the politics here that is likely not to happen. That is another story. The point is that even in the summer when it is 105 degrees, day in and day out, in super high humidity in steaming cities, no one is using their air conditioners, even old people for whom it is dangerous not to do so. The contrast between Japanese and American culture is enlightening, and challenging.
Then there is simply walking down the street and seeing no overweight people. Maybe one person in every 100 is overweight, and those people are usually under 25 and eating mostly at McDonalds and Kentucky Fried Chicken. The streets are buzzing with people walking in every direction while bicycles weave smoothly and effortlessly in and out. It’s a dance. Who needs a car when you have bikes and trains everywhere? Bikes are cheap. Mine cost $50 and I love my bike. I don’t think I’ve waited more than 7 minutes for a train and that’s after I just missed one. Usually there’s no wait. The trains are quiet and clean. No graffiti. No smell of urine here and there. Yes, sometimes the trains are beyond crowded but people have the courtesy to wear white sanitary masks that cover their mouth and nose if they have a cold. That’s thoughtful. People are taught to be aware of other people, and they are.
The trains and the streets are safe at any hour for anyone, kids included. In 2006 there were a grand total of 2 homicides. There are no guns around here. Little kids walk to school by themselves. If you leave your umbrella next to the ticket counter you can be sure it will have been given to the office. When you go to get it, they person will literally run to get it for you, knowing right where it is.
If you get off the train, let’s say at Osaka Station, and decide to buy some Japanese sweets at a department store, the moment you approach the counter, which has five people in uniform standing side by side, one of them will ask you if they can help you. Once you have bought your sweets they will ask you if you would like them wrapped as a gift. If you say yes you will witness hands that work differently than ours. Quickly and precisely. As you are leaving and ask them where the bathroom might be, they will likely take you there, and then bow and thank you. Can you imagine someone at Walmart or Staples bowing to you and thanking you for buying something at their store?
Ironically, living in Japan I feel how much I love America. I just know we could be better than we are. Living in Japan makes me care more about Americans. About everybody. And I realize how lucky I’ve been to be able to live in two cultures, for real.
For one, I’m not going to wait around for American culture to change. What I can do is adopt what I like about Japanese culture and live my life in a way that feels good and right for me. I can model what I care about.
In America I can practice being more aware of the needs of other people. I can use energy more modestly. I can eat less meat and cheese, more fish and vegetables. I can serve people. Thank people. Apologize when it feels right. I can be on time.
In America I will need to make an extra effort to take care of my own health.
And I will walk down the street unafraid. In a country that has grown so fearful, it will be my practice not to perpetuate fear, but to exude trust, and kindness.