Sometimes you find yourself wandering along a beach, marveling at the beauty all around you and then life comes at you with a whoosh and suddenly you find yourself standing on the opposite shore scratching your head and wondering how you got there.


Rochi has had an ear problem for months now. We saw five different doctors in Hawaii and nobody could fix it. All along we’ve been paying cash for these services because we can’t even apply for insurance until open enrollment in November. That insurance doesn’t take effect until January, and when/if we finally do get it, the monthly premiums cost as much as our Tokyo rent used to cost except that rent did not also demand deductibles and co-pays and other fancy words that boil down to “shut up and do as you’re told.” Until then, I had been feeling smug that I had bought a house and, for the first time in my life, was not paying rent. Lesson learned.

The last doctor we saw said we’d done everything we could do at the clinic level. The next step would be a CT. Without insurance, the test alone would cost at least two months’ rent. She told us point blank that we’d be better off coming back to Japan.

So that’s what we did. We arrived on a Tuesday night. By Wednesday lunch time, he had insurance, we had seen doctors and been given medication. Total cost: about $50. A week later we spent a full day at the hospital, he had multiple examinations, two CT scans and prescription medications. Bill for the day: almost $200.

As we were riding the shiny new escalator toward the exit from the clean, modern hospital, we were both doing the math in our heads. In the States, that day alone would have cost us two trips to Japan, flying business class and staying in fancy hotels, maybe even a Rolex or two. Or about 2.5 years’ rent.

In the United States, people die, they DIE, because they’re afraid to go to the doctor. It’s not the pain that is so scary, it’s the bills that arrive weeks later, unexplained but final. Thou shalt pay. End of story. They even send email with the heading, “Great news! You have a new e-document.” I understand these documents are sent by computers but at some point, some actual semi-human organism must have written those words with that intended purpose. “Great news! You’re still sick and now you owe a bazillion dollars! Yay!” This is cruelty that borders on sadism. But the real irony, and the ultimate insult, is that there is nobody to explain and nobody to blame. You can call every number they give you, but everyone you speak to will tell you the same thing: “We don’t make the rules. We just send the bills.” I keep hearing voices in my head saying, “I’m not responsible. I was just following orders.” Where have we heard that before?

I have even sensed an undertone of, “You should be grateful you got to see a doctor at all.”


Are we talking about the same United States? The land of the free, where we have a right to the pursuit of happiness but not to basic healthcare? Is this the same home of flag-wavers who claim a love of God and equality for all but run for cover when we talk about universal health coverage? I thought we were talking about the United States where we have indoor plumbing and clean running water and safe food and cell phones and WiFi and Sunday football. But I guess these pleasures don’t extend to anyone who is running a temperature.

It seems fundamentally wrong that we have so many basic freedoms, things we take for granted, when millions of people around the world go without milk or shoes or education. We complain about slow Internet while people in our own country, maybe even next door, die of a simple infection they can not afford to treat.

We are lucky. We had the Japan option. But what happens to people who don’t? Not for the first time, I am ashamed of the country I represent.

4 thoughts on “Insurance

  1. There but for the grace of God… I got my husband on my insurance at work after he got kicked off his ACA plan (we make too much money, which is not really very much). 15 days later, he was diagnosed with a $70k problem that, fortunately, was fixable, and also (thank you, Mr. Obama) was a pre-existing condition they could not refuse to treat. If we didn’t have my job and insurance, we’d be fucked. So very fucked. So yeah, the U.S. is based on a very screwed up system. If you don’t participate in the corporate cog machine, you get broke or you get dead, or both. And even if you do participate, it’s maybe 50/50 that you will not end up broke or dead or both.


    1. We thought about all of that a lot before we decided to more and we love it in Hawaii, but I’m starting to understand why people decide to leave. It is unconscionable that people can be ruined financially by illness in a country that has so much wealth and so many resources. I’m so very glad things worked out for you and your husband but disgusted with the system in general.

      Thanks for the comment. Hope to see you back here.


  2. Ok, I’m going to be the unpopular opinion here probably.

    The idea of universal/low cost health care is a wonderful dream that I just don’t see working in America. The large amount of unemployed or low income and illegals who don’t pay taxes just is a real problem. Who is going to pay in for their contribution? America is not a wealthy country, it is in debt up to its eyeballs and healthcare for all paid by the government is going to mean a huge jump in taxes only on those that do earn a decent living. Add to that the lawsuit happy populace forcing Doctors, Hospitals, etc to have expensive insurance policies in place and law firms on retainer is a big problem and one of the main reasons I think we have such high costs for health services. Healthcare for all is a lovely idea but it isn’t free, not for everyone – only for those who don’t pay taxes and some feel that the idea of living in a free country means the government isn’t completely in control of every piece of your life, including forcing those who work hard to pay for those who play the system (and yes, i get that not everyone unemployed is playing the system but it’s a big percentage, just look at the welfare system). I understand the issue and believe it needs resolving regarding people not being treated because they can’t afford it but there needs to be a better fix than universal care for all paid for by the few. I would be curious to see how people would react though, if told they could not sue anyone in the healthcare business anymore to keep costs down. That would be something.


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