🧵 View Thread
🧵 Thread (19 tweets)
Ruriko: You are sick. Go to the doctor. Me: I’ll call them. Ruriko: Just go. Me: That is unlikely to be successful in this country. … Ruriko: Did you call them? Me: Yes. It was a bit of rigamarole. Ruriko: How? This seems very straightforward. You are sick. He is a doctor.
Me: Well their first answer was that I am not a patient. Ruriko: You are clearly sick. Me: Ah yes but they think I am not *his* patient. Ruriko: He is your doctor. You are his patient. That is how these words work, in English. Me: The database disagrees. Ruriko: Get better OLs.
Me: The person answering the phone probably doesn’t work for him. Ruriko: What. Me: Probably chain-wide staff. They have very little ability to do anything the computer won’t let them do. Ruriko: So you convinced them to give you an appointment right. Me: Well not so simple.
Ruriko: How is this not simple. Me: Well first I needed to convince them to assign him as my doctor. Ruriko: He is already your doctor. Me: Yes and so there was a rather substantial discussion about insurance at this point which you don’t care about. Ruriko: We do have insurance.
Me: We do but it is one of the annoying ones. Ruriko: What is the not annoying one? Me: Ask me after we get back to Japan. Ruriko: OK fine so you did the insurance thing and then you got an appointment. Me: Not so much no. First available appointment was in December. Ruriko: …
Me: Yeah, not helpful for a routine probably viral thing. So I will instead go to urgent care. That is the thing you usually go to in America to get seen today, unless you go to the emergency room. Ruriko: That will charge you $600 to say you probably have an infection. Me: Right
Ruriko: So why did you need 30 minutes on the phone? Me: Signing up as a new patient, so I have a doctor in the future. Ruriko: You have a doctor. Me: But now the database knows. Ruriko: Good. Me: (Probably.) Ruriko: *glowers* Me: And I get an annual physical slot in December.
Ruriko: That probably costs like $10,000. Me: Oh no that’s if you get the executive health check thingee. Which I should probably do. But this physical is free with insurance. Ruriko: Probably cost you $10k a year. Me: If only.
“How does this work in Japan?” Me, to doctor’s office across the street: Hi I’m sick. OL: Sorry about that Mr. McKenzie. Have we seen your insurance card this month? Me: First time. OL: Got it let me copy that. Wait over there; we’ll call you. *30 minutes later* Doctor: Virus.
Me: Drats. Doctor: I can give you some kanpo but no medicine since virus. Me: Sure. OL: That will be $40 (for co-insurance). Me: And then you send a bill for a random amount 10X that 6-30 weeks later right. OL: ?! Me: Sorry; wrong country. That is it then.
(I don’t think one could simply fix systemic issues by getting “better OLs”, incidentally, but one real factor for why Japan does “retail” encounters better is what an economist might call a “persistent human capital misallocation.”)
(This is less pronounced in 2024 than in previous years, but broadly, the level of education/intelligence/drive/etc that gets The Sort to never ever have you talk to retail clients in the U.S. has not reliably done this in Japan.)
(My feelings on “misallocation” are complicated, partly because I think there is a dignity to work anywhere on ladder, partly because I did quite enjoy years of work with clerks that were quite competent at their jobs, and partly because I wish for more for many peers there.)
(Had I continued being a salaryman rather than diverging sharply from that path in 2010, I’d currently be celebrating my promotion to team lead, capable of managing simple engineering projects, and rewarded with the lavish salary of ~$50,000.)
~8 more years to kacho, 15 to being CEO of the American subsidiary, assuming I am remembering a conversation from my twenties accurately and that the company was accurate in its estimation of its future evaluation of me playing the game for 30 years.
Hmm 50 sounds too old for Kacho; that should be mid-fourties. I have a good memory but there were 10 numbers thrown out once in a discussion in my second language ~20 years ago; don’t make major life plans based on my recollection of them all being exact, please.