Zairyu card request at Hospital

[Deep Blue]

Obviously the vast majority of fraud is committed by the 97% of the population, not the 3%. Even if foreigners are 10x as likely to commit fraud (which is absurd) more fraud would still be done by the Japanese patients.

If anyone really is concerned with reducing fraud in the system it makes no sense at all to visually profile the 3% and discriminate against them with extra checks.

[Bubblegun]

Obviously the vast majority of fraud is committed by the 97% of the population, not the 3%. Even if foreigners are 10x as likely to commit fraud (which is absurd) more fraud would still be done by the Japanese patients.

If anyone really is concerned with reducing fraud in the system it makes no sense at all to visually profile the 3% and discriminate against them with extra checks.

I am inclined to agree somewhat but I don’t know if the Japanese system is based solely on contributions or solely on residency.
Some systems cover everyone via taxation, others via residency or a combination.Although I do believe everyone has contributed via taxation. Either by sales or income tax and should be automatically covered or atleast have affordable care. But some people do fall on hard times and may need a break. But we shouldn’t allow people to walk off a plane, and use the national health service we all contribute too, or someone pretend to be resident when they are not. So we do need some checks and balances. I think the tax office in Japan as powers to deal with people who refuse to pay or scam i in Japan, but I think the tax office has less of a reach to the person walking off the plane and into hospital. We can all agree on everyone who is entitled to care should get care. But those who are not entitled (depending on circumstances) should not get care.
(There should be exceptions to this rule).Some people don’t need to pay and I’m good with that , as a society that is! Because sometimes the benefits out way the costs.
I suppose a good question to ask is, what are the wealthy prepared to do for the poor? And what are the healthy prepared to do for the sick.

[Deep Blue]

Yes, I don't disagree with any of that - as a British person I've used to healthcare being a unversial human right and free at the point of delivery.

I also agree non-residents shouldn't be allowed to turn up and use the healthcare system for free.

What I don't agree with is the best way to achieve this bring to racially profile and harrass people when they try to use the system.

[Bubblegun]

Yes, I don't disagree with any of that - as a British person I've used to healthcare being a unversial human right and free at the point of delivery.

I also agree non-residents shouldn't be allowed to turn up and use the healthcare system for free.

What I don't agree with is the best way to achieve this bring to racially profile and harrass people when they try to use the system.

Totally! I guess then it comes down to money. One way or the other. Either we make the whole population pay for a photo I.D that proves we’re entitled to use the national health service. Whether that be japan, Germany France or uk) etc etc or we pay knowing that some people will use and abuse the system. Again costing the public money.
So I guess it comes down to which is cheaper? Paying out for every national to have a photo I.D, (renewable) or swallowing the cost of people getting of a plane and abusing the system and may have to include the cost of racial profiling.( and that could come from not just appearance but also language ability) but again some people aren’t ever going to speak Japanese, even though they are resident.
I’m not sure what the answer is, but I wonder if we should ask the 99% who follow the rules to pay up for an I.d card or pay up for racial peace and possibly having some thing we run a World health service and not a national health service. My guess is, it’s better to piss off a minority (including me) but I’m at peace with it, to protect a health service we can all access. Even the sick, poor and even some scammers. (Depending on the condition). I say that because some conditions can pose a threat, to the population. Eg. T.B, Polio, HIV. It’s better to treat them, for the greater good. Some of us might never have met people with polio infections, TB or HIV infections. I guess there is no perfect system but there is one system we all agree on that’s the worst is the US system.
https://youtu.be/wfsJXo1h1G0?si=om5Zs0Wfh9YiUlEX

[Deep Blue]

The choice has already been made. Access to healthcare will be by MyNumber card as posted several times in this thread…

[captainspoke]

.. Some of us might never have met people with ..., TB ...

I was once a "Tuberculosis Control Worker", '74-'76 in the mountains of Korea (peace corps). Many pep talks (don't forget to take your meds), and a brief talk to 1st and 6th graders in schools, and then PPDs (1st grade) or BCGs (6th) for everyone. Also passing out meds at the govt clinic, patient records (family contacts) and followup, and of course, sputum collection and testing.

Trivia: TB and leprosy bacteria stain and look the same under a microscope, TB goes to the warm areas of the body, while leprosy--Hansen's Disease--goes to the cold. But at that time the only way to 'culture' the leprosy bacterium was by infecting armadillos. Tho most all Korea peace corps health people cross-trained for both of these, most only worked as TB workers. We did a week initially at the national leprosarium in Carville, LA (now a museum--they had an armadillo 'farm' then), and in Korea spent a week on an island off the south coast (Sorakdo).

[AreTheyTheLemmings?]

Excellent digression!

TB goes to the warm areas of the body, while leprosy--Hansen's Disease--goes to the cold.

What are the warm and cold areas of the body? The organs and extremities, respectively?

[Bubblegun]

The warmest areas of body I your core, so in terms of TB your lungs are the warmest and moist, with a high blood flow. This all perpetuates the spread with coughing and spitting. The hard part of that disease is the silent spread, where people don’t know they have or actually thing they’re cured while still spreading it.(hence the problem with drug resistance variants)
Hansons is another bacterial infections that affects the the skin, nerves and lungs. Cold areas…mmm… well your nose is still warmer than the lungs. But one function is to warm the air entering the lungs with the high blood flow. Eyes…. Again….. warm/cold ….????? But I guess we’re more aware of the skin type, nose type, facial type we see in films.
I don’t think I came across Hansons disease patients but when HIV came along we saw big resurgence of TB so we had to brining back our infectious disease wards.
Basically the extremities will get colder first but the core temperature is very stable. Just remember if they pop a thermometer with a red dot on it…… it’s not for your mouth. lol. That’s for your core temperature. Bottoms up!!!!!
But I digress. lol

[captainspoke]

It's been ~50yrs since then, and I had almost zero medical or even general science training when I started that (other volunteers were mostly done with pre-med, using peace corps to travel and for life experience before returning to med school). So take that blanket statement of mine with a grain of salt. All the TB I saw was pulmonary, and I think more advanced types infect (via lymphatic system) bones and brain, maybe other organs. (Paging TokyoWart, please pick up a white courtesy telephone.)

The drugs were free, but needed discipline/persistence on the part of the patients. One reason I was there was to reinforce that. There were three drugs. For the first two months it was a shot of a gram of streptomycin in the buttocks. Daily. At the same time a drug call PAS (para aminosalicylic acid), and the challenge with this was that it was like 20 huge pills/day for six months (indigestion was common), which came in brick-sized bags, and patients would maybe get two bags a month. The third drug was easy, INH (isoniazid), a small pill once a day, for two years. The problem was that patients would feel much better in a month or two, and stop or interrupt their treatment--and then reappear a couple months later or so when they were sick again. Some patient records were pretty long, and this had happened a number of times for too many. (I heard that a couple volunteers did turn positive (not active), and they took INH for a couple years.)

Three or four of the pre-med people from my group (20-25?) stayed on in korea and went to med school there, then back to the states to take a test (ECFMG?) and became doctors there.

I think leprosy is mainly skin and nerves. If you know the one on your elbow that (in the US) is called your 'funny bone', that is one nerve and one place affected, similar somewhere in the legs. One type of damage in those places results in being able to close your hands, but not open them, and for legs something called drop foot--the muscles to raise the front of your foot don't work. Also, and this is what causes a lot of secondary damage, you lose pain sensitivity in your hands and feet--so any little problem (a blister or sore, broken nail, a cut) you don't feel it, and so don't naturally take case of it. Then, those sores get worse, and (IIRC), something called absorption starts happening. You start losing toes and fingers. So it's not actually leprosy that causes the disfigurement, it's the secondary effects.

Tho it's dated, and was when I read it, an excellent book on epidemiology is Rats, Lice, and History.

[AreTheyTheLemmings?]

Really interesting. Thank you.

I remember being shocked, genuinely shocked when a work colleague got tuberculosis. "T-bloody-B? In Japan?! But this is the 1990s!"
I had believed that TB had been all but eradicated, at least from the developed world; to me it was something that old people talked about as "consumption."