...but would not in the US
Now, I’m not a pessimist, just someone who looks at things as they really are. At 35, I’d already experienced the failures of US government programs as well as the success of foreign counterparts.
As a new Navy veteran in California, residing three time zones away from my native South Carolina, I experienced one of the most frustrating experiences with a US government program. The Montgomery GI Bill, my lifeline to higher education funding, could not be administered successfully at San Diego State University’s feeder school, Grossmont College. Classes approved at the beginning of the semester were disapproved near mid-terms forcing me to drop courses deemed worthless and hastily adding courses to take at an accelerated rate to maintain my funding.
Years later, I finally graduated with my last semester coming out of pocket due to the GI Bill running out. After it was all said and done, my undergraduate studies, all from the California junior college system and the California State University system, two of the most economic viable programs in the country came to the tune of $28K. $14K being paid for the GI Bill, the rest coming from loans and out of pocket. The initial intent of the Montgomery GI Bill was to pay for a veteran’s higher education at 100%, which was the case for veterans of the 1940s and 1950s. As in my case and the case for many others, this program was running at 50% efficiency. This leads me to believe that this government program was once relevant and delivered as promised is no longer the case.
After my graduation at the Great Western Forum, the former home of the Los Angeles Lakers, I was an American expatriate residing in Japan. I supported myself as an English instructor and utilized my membership at the Navy Federal Credit Union by sending international money orders to their branch in Yokosuka to be deposited to repay my $14K loan. Every month, my employer in Japan garnished a portion of my paycheck for socialized health care, just as it was done with my private health care when I was working in the US. Along the way, reoccurring foot problems led me to a nearby clinic for medical assistance. With the assistance of my wife to translate due to my limited Japanese ability, I received adequate health care from the Japanese health care system, a successful health care system that operates socially, not privately. Here’s why social health care works in Japan but will not work in the US:
• In Japan, most everyone pays into the social health care system. The amount paid is based on your income from last year. It is required by law.
• If you are unemployed, your health care premium is added to the monthly budget just as your rent, groceries, etc.
• If you are retired, your health care premium is added to the monthly budget just as your rent, groceries, etc.
• The Japanese culture leads people to believe that they are mainly middle-class, but in actuality, those at the lower end of this group are not. Those Japanese people at the lower end of the spectrum will find money from relatives for example to remain current with their health care status.
• Those that cannot remain current will be forced to pay for medical treatment in full, not at 30% co-pay like I did for my foot problem.
• Those Japanese who cannot pay for their medical bill since they have not remained current with health care premiums, will be allowed to pay off their bill in monthly installments.
• Those that cannot pay off their bill in monthly installments will be forced to hire a lawyer to accompany them at their local city office where they will have to plead their case which would dismiss them from their responsibility to pay for health care at the set installments of their peers forcing them to be shamed. But if it cannot be helped, the Japanese government will relax their stance on one of their treasures, the Japanese social health care system, and allow these shamed people to pay for health insurance at a subsidized rate. If these people show up without a lawyer, they will be turned away and told, "You have relatives. Ask your parents. Etc."
• The number of these shamed people is minimal due to the Japanese culture of everyone claiming to be middle class forcing those that may not be to come up with the money in other ways to remain responsible citizens in the eyes of their peers.
• Those that are responsible and maintain their health care premiums in Japan easily absorb the loss taken from those who had to sacrifice their pride in the eyes of their peers.
• Other things to note are that doctors in Japan are mandated to charge a set fee for a particular procedure based on a universal book located in every practice throughout Japan. This regulates health care costs and will keep doctors at the top of the Japanese middle class. A Japanese doctor will not see the likes of an American doctor in terms of wealth until they start their own practice or clinic at the end of their career, where a number of young doctors work for them. Limiting an American doctor’s wealth will force the cream of the crop to pursue other careers or to practice in a different country. This would force less than the best practitioners to operate in the US and would not provide an outlet for those outside the US to receive treatment not found in their home countries.
The American culture simply does not have this culture set where the status quo is being responsible and accountable as the overwhelming determining factor. With more and more Americans robbing Peter to pay Paul on the basics, the average American’s credit score in the doldrums, and more foreclosures on real estate than any other generation since homes started to be sold on a 20-year mortgage, being responsible and paying one’s fair share into a social health care system is low on the average American’s totem pole. If it is a matter of all Americans that are authorized to be in the US having health coverage, this already exists. The American health care system has a government program for the poor, the elderly and the entitled veterans. If it is a matter of health care reform where all Americans have access to affordable health care, then the issues of private insurance companies being allowed to provide coverage across state lines, being able to operate without the pesky state government's mandates and tort reform against the lawyers. After all, this current president's administration did promise change. Their current proposal is highly flawed and does not address the current government programs mentioned earlier and how ineffective they are currently operating.
With the recent economic meltdowns, it is a matter of time that the responsible Americans that choose to work and not rely on the impotent bureaucrat would pay for the Americans that can’t meet their obligations would be outnumbered equaling an American taxpayer backed health care system doomed for failure.
If you feel that I’m wrong, refresh your memory with the aftermath of Hurricane Katrina in New Orleans, a city that many consider a welfare state. Far too many in New Orleans are on some sort of government assistance. Those in New Orleans that were not on some sort of government assistance had enough sense to leave town when Katrina came forcing one of the most embarrassing events in recent American history. As a 32-year-old American expatriate in Japan, I was asked repeatedly, “Are black people in the US poor?” as the Japanese news showed images of people trapped on rooftops while the federal government fumbled around with no success until the military was brought in. Regrettably, the Japanese are not as politically correct as they should be and have some negative views on minorities in Japan and abroad. Nevertheless, if another Katrina were to happen again, four years later, the same results would take place. Problems revealed have not been corrected, even with the change of presidents and leadership in Congress.
In closing, it is up to us, the American individual, to ensure that our well-being is taken care of. We cannot rely on Uncle Sam, as I did as a new veteran on the GI bill, for health care or anything else. It is time for Americans to become more responsible and focus on those once relevant government programs, GI Bill for example, and those broken government programs, Social Security, for example and those government programs that cause the American economy to be disrupted, Fanny May for example to be corrected.
Here's the New York Times' take on the issue
http://prescriptions.blogs.nytimes.com/2009/08/25/health-care-abroad-japan/
The Divine Wind Vault
http://divinewindvault.blogspot.com
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