The Michael Moore documentary Sicko paints a bleak picture of the US health care insurance system.

It shows the suffering of people unable to receive satisfactory medical treatment in a country that fails to provide universal health cover for all its citizens.

Particularly harrowing is a scene in which a man with a gaping wound in his knee sews it up himself with a needle and thread rather than go to hospital for treatment.

Another case study in the documentary shows a married couple in their 50s who are forced to sell their home to enable them to pay for medical treatment.

No matter how many times I watch the film, it leaves me feeling shocked.

Debate on bills to reform the US medical insurance system, an issue that US President Barack Obama has made his top domestic priority, is intensifying.

Health care insurance reform is a divisive issue in the United States. Its staunch opponents include supporters of the Republican Party, who are dead set against big government, and the insurance industry.

It remains to be seen whether a system of public health insurance directly managed by the US government will be implemented.

Currently, one in six US citizens is said to be without medical insurance cover. Even those with cover do not have peace of mind as insurance companies make strict assessments of claims, meaning that unsatisfactory treatment is an everyday occurrence.

While Americans are known for upholding self-reliance as a virtue, a US political scientist finds it hard to understand why many of them dismiss universal health coverage as “socialised medicine.”

John Campbell, a professor emeritus at Michigan University and an expert on the health care systems of Japan and the United States, also sees flaws in the arguments of opponents to its introduction.

“Americans don’t all think that way,” Campbell said. “Here’s proof: Our Social Security (or public pension) system includes everybody, whether an employee or self-employed, and it redistributes income...It actually is a socialist system. But (it is very popular, and) criticism of it isn’t about politics or ideology, it’s just over finances.”

Uninsured children

Many Japanese who saw Sicko may feel relieved they were born Japanese, and that the United States’ problems are an ocean away.

But even in Japan, where we have universal health cover, an unsettling situation is emerging.

About 20 per cent of households covered by National Health Insurance have fallen into arrears on their premium payments, leaving, as of 2008, more than 30,000 children uninsured.

It seems as if the worsening of the nation’s employment situation has left many households struggling to keep up with premium payments.

In April, the government implemented relief measures for children who are no longer covered because their parents are in arrears on premium payments. Yet, the measures only apply up to the age of graduation from middle school.

It is heartbreaking to hear reports of children using the nurse’s room at school instead of going to hospitals for treatment.

Shining example

Recently, I visited a museum in Nishiwagamachi, Iwate Prefecture, that is dedicated to the pioneering efforts of the late Masao Fukasawa, a former mayor of what used to be Sawauchimura.

The village was a pioneer in providing free health care to elderly people in 1960 and infants the following year, notching up the considerable achievement of a zero infant mortality rate.

The residents were highly susceptible to disease because of heavy snowfall and poverty in the small village.

Fukasawa, who served as mayor at the time, decided to make health care free after seeing elderly people and babies dying because residents were unable to pay medical fees and visit doctors.

Critics accused Fukasawa of violating the National Health Insurance Law, but the former mayor rejected these claims, saying the measures were in line with Article 25 of the Constitution, which states, “All people should have the right to maintain the minimum standards of wholesome and cultured living”.

Fukasawa also promoted activities to prevent sickness, such as having public health nurses instruct people on their diet and how to improve life at home.

While arguments linger over whether free medical care should be provided for the elderly—something the government implemented for a period in the wake of Fukasawa’s efforts—his ideal of respecting life still captures the hearts of people today.

Indeed, the village has been the subject of several films and books.

Knowing this historical background, it makes me uncomfortable to think of the future of health care in Japan, which has begun to show signs of decay.

We need wisdom and cooperation to ensure that no one slips through this “life safety net”.

I am not so adept at needlework. Nonetheless, I hope the only time I have to use a needle and thread is when I stitch my clothes. (By Ritsuko Inokuma in Tokyo/ The Yomiuri Shimbun/ Asia News Network)