Health Insurance 「健康保険」

Coming back to Massachusetts in the middle of April, I had a heck of a time getting Health Insurance.

I'm sure that just about anyone can agree that medical costs in the US are insane.  At some point, all of the various interests involved hammered out some sort of agreement in Massachusetts that requires everyone to have health insurance--and limits enrollment opportunities to certain periods of the year.  The closest enrollment period to my arrival, it seems, begins on July 1st.  There is, of course, public health insurance available for people, but my eligibility for that insurance is open to question (my application is currently pending).  Now, to all of you reading this who think "Of course you can get insurance; I know plenty of people who have done so," and to all of you who have already said that to me, I say: try it yourselves.  Go live in Japan for a few years with a respectable salary, leave your job voluntarily and move back to Massachusetts, then call up and ask for health insurance.  Go ahead; see what they say to you.  Then you can talk to me.

Yes, I'm a bit sharper than usual on this point, but it got a bit irritating to have people say "oh, it's such a so simple, just do such-and-such," right after I did exactly that such-and-such and had the representative say "You're not eligible."  So, in the end, I went down to the Community Health Center and met with a very helpful person who helped me to fill out an application.  I then had to wait a week to hear whether my application was accepted.

Soon after, an envelope arrived telling me that I was eligible and could now choose a plan.  The letter encouraged me to enroll online, but when the website soon proved to be more opaque and confusing than Myst, I decided to make a phone call.  After hearing all of the different options of plans and learning that only one of those options was recognized by my choice of hospital, I made my selection and then waited for my enrollment card to arrive.  I soon found myself in possession of a number of different cards and a large book detailing my plan, along with one more piece of surprising information.  My coverage wouldn't begin until the first of June.  That's right: I set about getting health insurance as soon as I set foot on native soil, but the soonest I can be covered is a month and a half after my arrival at home.

So, why this someone uncharacteristic rant on a culture shock blog?  Because health insurance is so much easier in Japan.  When I had a month in which I wasn't working, I simply went to the town hall and asked for one month of private health insurance.  I paid the fee (about $150 dollars) and was insured.  Fully insured, by the way--no talk about various plans with varying benefits.
Which was good, because that was the month that my appendix burst.

Of course, even without health insurance, medical care in Japan is quite affordable.  Case in point: I went to the dentist and had my teeth cleaned, got an x-ray taken, and had a flouride treatment.  The hygenist apologized profusely when handing me the bill, saying that I would probably be shocked because the treatment cost so much.  I looked at the bill and laughed.  Thirty dollars.

Oh, and that's not just dental work.  My burst appendix (which, by the way, is quite a story in and of itself—perhaps I'll tell it sometime)?  What would my medical bill have been for invasive surgery, lots of medicine, and 15 days in the hospital, had I not had any insurance whatsoever?

$6,500.

Needless to say, with my insurance, it was much, much less.

Say what you will about nationalized health insurance.  I've had it, I liked it, and, for the record, I never had trouble getting treatment or seeing the doctor I want to see.  Granted, the workings of Japan's health program extend far beyond simple national health insurance.  But it's a system that I liked quite a bit.

Restaurants 3: Tips 「レストラン３：チップ」

When I went to that sit-down restaurant with my father the other day, I looked at the bill and was suddenly faced with something I had forgotten about: tips.

Restaurants in Japan do not use tips.  Neither does any part of the service industry, for that matter.  You won't find anybody tipping bellhops or hairdressers or chartered bus drivers in Japan.

Wait; perhaps I'm being hasty: I once saw someone tell a taxi driver to keep the change.

In general, however, good service in Japan is expected.  Tipping your server is actually perceived as an insult, something that I was unfortunate to discover on my first trip to a restaurant in Japan.  You see, tipping the waiter for good service in Japan implies that you were surprised with the quality of the service—that is to say, you weren't expecting to be treated well when you walked in the door.  It also cheapens the service by suggesting that the waitperson only worked so hard because he or she was hoping for a good tip.  Think about it: have you ever been treated exceptionally well by a waitperson or a taxi driver, and thought, "Wow, that person must really want a good tip."?  I'm willing to bet that you have.

Well, consider this: The best waitservice that I've encountered in the United States pales in comparison to some of the service that I saw in Japan.  There, good service is a matter of course.

Does that mean that I think that tips should be abolished in the States?  Not necessarily.  I've worked in the service industry before (as a theatre usher), and I know how demanding—and rude—some customers can be.

"I'm sorry, sir, but drinks are not allowed inside the theatre" seem to be fighting words for some people.  It's amazing the lengths some people will go to in an effort to take their diet cola inside a theatre, only to spill it on the hundred-year-old seats and have it run off the mezzanine onto the head of some poor customer below.  And, yes, that really happened.

What does that have to do with tips?  Well, I didn't get tips for that job, and I didn't need them, because I was paid well by the theatre.  Restaurant waitstaff is not.  Many employers count tips as part of the wage in the service industry, and reduce their own contributions accordingly.  When I compare the wages that I saw advertised in Japan to what people get in most of the United States, I understand why people in Japan don't need tips.  Which brings to mind another question: do you think that perhaps waitpersons in Japan are so courteous because they're paid decently?