Podcast was decent. Some of his medical commentary was overstated (eg. estimating the majority of population will take weight loss drugs, when less than 2/3 of us take all prescription medications combined; risks of diabetes, including how much it shortens lifespan), but overall good summary, with a couple issues I hadn’t considered.
The end about Japan was really interesting. I’ve come under fire complimenting their culture on this forum, but suffice it to say, they’re waaaaay different than Americans. So I doubt the things they’re doing would fly here. And the measures they’re taking are effectively preventative: we’ve already got an obesity problem that needs our immediate attention, long before any policy changes can be implemented.
I think I’m the only person that has commented about the Japanese culture (maybe?). I find it hard to complement a culture that allows doctors to refuse to see patients with a high BMI. Discrimination is alive and well in Japan. Of all the people that need help, I would say those are the people. Furthermore, the Japanese reporting standards are skewed/odd. If you are not treating the people that need help, then there is no problem and that’s what is reported. If you walk around Japan, you will unfortunately see that the younger generations are moving towards the cusp of an obesity problem. I’m pretty sure it has everything to do with introducing the Western diet into Japanese culture as evidenced by the lines at KFC and Popeyes.
I do applaud the Japanese euthanasia/death with dignity laws. I wish the US would move more towards that mentality.
Not sure how common Japanese docs are refusing to see high BMI patients, though I expect it’s uncommon. That said, the same phenomenon occurs in the US, as some surgeons won’t operate/perform procedures on morbidly obese individuals.
This is from the Japan civilian medical advocacy group (Facebook) that is lobbying Congress right now. This is what is going on with the 110,000 military/dependants/civilians stationed in Japan and Japanese local nationals. Refusing to see high BMI patients (both US and Japanese) is common enough, that US civilians/military are asking the department of defense for adequate medical help on base.
DEAR COMMUNITY,
Military and civilian patients in Japan face alarming gaps in emergency care, making preventive care extremely important. Yet our trust in the quality of care we receive is dwindling due to dismissed concerns, long wait times, and staffing shortages. What happens when your care falls short?
Your stories reveal misdiagnoses, delayed treatments, and ignored test results:

ON BASE MISDIAGNOSIS: Cancer missed due to imaging and sample errors. Severe pneumonia dismissed as minor symptoms. Fractures reported as sprains, causing permanent damage.

OFF Base Limitations: Referral hurdles block off-base care. Even when you can be seen off base, issues include medication errors, BMI discrimination, and denied appointments.

Empowering Solutions:
CIVILIANS:

Seek FREE second opinions from major insurance providers. They can send your records to a major hospital in the states for another look.

Report denials of care and hardships - we track and report them anonymously to Congress and oversight bodies, fighting for more healthcare resources.

Reach out to state representatives - we can help you every step of the way with pre written letters and request a meeting on your behalf.
MILITARY:

You have the right to appointments within 28 days (faster if it’s urgent; 24 hours - 7 days). Contact your MTF Patient Advocacy program and say "my Access to Care standards are being violated". They can get you in quicker or have to refer you off base.

Tricare offers second opinion appointments with a different provider.

Tell us about denials of care and hardships. We get your stories to the top, anonymously.

Voice concerns at PFPC meetings and through ICE comments.

Resort to Joint Commission complaints (can be anonymous), IG reports (protected from retaliation), and legal action if needed.

YOUR VOICE MATTERS: Don't suffer in silence. Together, we can make a difference for everyone's access to medical care.
In Service,
Japan Civilian Medical Advocacy