99% sure you passed through a transfer gate in Tokyo station that requires you to produce two "tickets" (physical or virtual)—one for subway and one for Shinkansen. Always plenty confusing. I have to hold my phone (Suica app) and an EX card (Shinkansen card) together for a dual-NFC tap. I always forget one or the other.
For a long time in Japan, the physical cards were limited because of IC inventory shortage. There was a big push to get people to use their phones during this time.
Also, travelers beware: some of the special "Suica" sold at Haneda (and maybe Narita, too?) expires and is completely dead after 30 days, even if it has a balance. I found this out the hard way. Buy a proper Suica at Shinagawa or another non-airport station.
That’s the red “Welcome Suica”. Green or any other IC card at any other location like ICOCA don’t expire functionally ever. The stated time on some cards is 10 years since last use, but they’re practically infinite in that they can be used even after this point.
Well, not assigned by the hospital or your parents, but being a DNA-based lifeform a genetic baseline is a safe assumption. Experiences vary after that:
Japan has seen millennia of huge cultural shifts. Its strength is its ability to adapt and survive with some measure of continuity, even while embracing the new reality. Go watch some Ozu films. They're all about the "hollowing out" of traditional small-town lifestyle and culture. It isn't so much a problem as a feature of the landscape that reminds people about how transient their reality can be.
Also Keihan. And most, if not all, of these companies have huge land and real estate development projects generating non-rail income all up and down their lines.
This doesn't hold up for me in Japan. My apartment is in a building that's 10 years old now, and I've been here since it was new. Japan famously builds for a 20-ish-year depreciation schedule, although buildings like mine often stay in operation for 40 or more years. The build quality is honestly through the roof. Even the materials that are "builder quality" like unit kitchen and bath or veneer floors are still built to last, with minimal maintenance, and maximum convenience. As for the neighbors, they're mostly passing strangers. A few of them are busy bodies who love to force management to post "reminder" letters on the bulletin board. In other words, typical ultra-passive-aggressive-obsessive types. But most people that I encounter are delightful, and everyone just stays out of each other's way. Building maintenance is an old lady who tried to retire, and the building residents literally demanded that she un-retire and come back. This building is absolutely spotless and everything is ship-shape at all times. Most people own their units. I rent from the owner. In the time since I've lived here, I've bought multiple other properties, but I remain here because it's so damn easy and great.
Same in Germany, I have been here for 11 years and no issue. Only maybe the balcony that could use new floorboards but I don't care too much.
But why is she talking about broken treadmills? If I want to go to the gym I go to an actual gym... everything else is just an excuse to jack up the rent?
How brainwashed by the healthcare machine do you have to be to think that catching asymptomatic medical issues is a bad thing? The argument against is literally:
- patients will worry too much, and
- it will cost time and money to investigate.
Both spurious rationales cooked up by an industry that is at least as hostile to humanity as it is helpful.
Exposing asymptomatic potential issues leads to medical care that often does not meet out standards for medical tradeoffs. Chemo is nasty, even the most minor surgery has risks. We endure the risks because we are addressing either major health issues or other dire uncertainties. Using our heavy duty treatments for issues without any symptoms at all would, normally, cause the patient suffering in excess of what would be justified. Chemo is a life saver when it's saving lives -- if the alternative is no symptoms, it just ruins your life for a profoundly uncertain upside.
Well, you've reduced a rational position to absurdity here. The concern isn't that someone is going to require chemotherapy. The concern is that an asymptomatic condition will go undisclosed until it is symptomatic, at which point preventative treatments are futile.
Even if we accepted your example, there is a fundamental inconsistency, since doctors in America regularly prescribe very serious drug interventions for patients who essentially self-diagnose for being neurotic/adhd/etc.--actually a much worse problem than the one you're so eager to curtail.
There exist both type I and type II errors, yes. But it's not absurdity, the South Korean Thyroid Cancer "epidemic" is one of the classic examples of the dangers of using traditional treatments on the lower-severity cases more advanced scanning uncovers. It was a public health disaster with lifelong consequences for those impacted, and was, legitimately, people getting cancer treatment for small cancers so harmless that they would have died of something else before becoming symptomatic.
If you seriously think this is a realistic scenario, you should call your doctor and tell him you've decided you have cancer and would like to order chemotherapy. See what he says.
Nobody is deciding for themselves to do chemo because they think something looks funny on a scan. All the scan gives them is a reason to talk to their doctor, who will do all the usual due diligence before deciding on treatment, if any.
And on the flip side, I hear stories all the time of people who DO have symptoms but they get dismissed by their doctor as stress or food allergies or whatever until it's too late. Maybe if patients were armed with a scan that shows a mass at the site of their abdominal pain, there would be fewer of these horror stories.
"What possible use could there be for doing this?"
I've encountered this attitude before, and I always find it perplexing that there are people who are annoyed by, even hostile to, the idea of frequent health telemetry.
What possible use? How about giving people greater visibility inside their own bodies without having to navigate the labyrinth of the healthcare machine and without having to justify themselves to actuaries?
A counter point: a fixation on medical diagnoses can be counterproductive to living a good, happy, and healthy life. My implication is that data will lead to self-diagnosis, when maybe it’s not necessary.
There’s a reason most people don’t get medical scans every checkup, they’re simply not necessary for the majority of (healthy) people.
In Japan, the government gives everyone a battery of full body tests at least once per year. I guess you know better than Japan, right?
The whole argument that "you'll worry yourself sick" is such patronizing trash. It's obviously programming that came from the insurance industry, and you lapped it right up.
> The Ningen Dock is a comprehensive health checkup system that includes a battery of tests, including blood tests, chest X-rays, and ultrasound scans, among others as well as advanced diagnostic tests as Magnetic Resonance Imaging (MRI), Computerized Tomography (CT) or Endoscopy. These tests can help detect potential health problems early before they become more serious or difficult to treat.
I think there’s actually a difference between getting a battery of tests from a set of doctors (overseen by the government) tailored to your risk factors and a company trying to sell a fully body scan which they think you should casually get all the time.
I don't think there's much difference? The technicians that perform the tests are not doctors. You usually see a doc for 5 mins at the end, to discuss any anomalies. Even then, they're just going to refer you to see your GP or a specialist. At the end of the day, the ningendoku is just information that your doctors can access. I'd much prefer a high-resolution full body scan.
Either way, the patient should make the choice about whether they want that info, not an insurance company or a know-it-all armed with a dubious study concluding that asymptomatic conditions are better left undiscovered.
I have thought about your position more and I realize I basically agree. More data isn’t strictly good, but in the right hands it is useful, and that choice should be left to individuals.
Also, it makes sense to me that, as technology improves and becomes cheaper, we should utilize it more. It may take time to come up with the proper process to maximize usefulness and reduce false positives, but it’s the path of progress.
I hope that in the future, humans consider it barbaric that we weren’t aware of things like cancer and tumors at the earliest stages, even if in many cases there’s no treatment necessary.
because it has negative effects. Over scanning leads to, in particular with the economic incentives of the healthcare system at large not to mention a company like this, over-treatment. It's one of the reasons countries have scaled back mammograms because women have been forced into surgery and treatment with no meaningful improvement in outcomes. Prostate cancer being another one.
My wife's a cardiologist and hypochondriacs with smartwatches have become a frequent occurrence because healthy young people despite regular check ups have convinced themselves their watch telling them their pulse got high that one time must mean they're dying and they'll show up not one but five times.
The same is happening with so called "sleep optimizations" which themselves can produce insomnia as people start to self-monitor and enact sleep efforts.
Rather than dealing with the issue—hypochondriacs or whatever—you prefer to remove the option for the non-hypochondriacs?
The fact that doctors like your wife think that people who are concerned about their health and want more information is a problem tells me everything I need to know about your (and her) worldview. You've dressed it up as being pragmatic, but the reality is that you're arguing for censorship and against freedom of information.
>that people who are concerned about their health and want more information is a problem
It is a problem because there's evidence based standards for when examinations are indicated and prolong or improve a person's life. You being extremely concerned doesn't move that needle and subjecting you to tests simply because you're anxious is blatantly unethical and harmful to your psychological wellbeing.
And nope this isn't censorship, it's being mathematically literate and understanding how data production works. Here's an actual real world example. There are aids tests that are 99% accurate. About 30 in 1000 people in the US have AIDS. 99/1 is great odds, let's test everyone, data doesn't hurt right? Except as it turns out if you test a thousand people randomly you'll have 10 false positives and 3 people with AIDS, Bayes in action.
So if you sent every American through body scanners, which are less reliable than that test btw, you'd have quite literally millions of people in follow up procedures for diseases they do not have with their mental health ruined and the system ground to a halt, because producing information is not always the right thing to do.
That's definitely an important point to consider, in fact something I think everyone in these conversations should be cognizant of, and also why it makes me believe the actual conversation should move to whether the device improves false positives/negatives rates or not (or at least has a chance to), which then might warrant wider access/use.
A better question is if people are going high-res, why not go high-res with tests whose accuracy is known, and for which there are useful, data-driven treatments?
Instead of casting a net of unknown quality every month, comparing against a null dataset (there does not exist a large dataset of these scans with outcomes for given markers).
Why not advocate cheap, easy blood/urine tests with higher frequency? Those tests do have large reference datasets with outcomes. And they have prescriptive value: there is likely more benefit to catching hypertension or diabetes earlier in more people.
Something doesn't add up. The entire Japanese healthcare system is built around the idea that preventative testing for asymptomatic conditions is effective. You can read all about it, if you want.
Personally, I think you've swallowed some kind of health insurance industry black pill, whether you know it or not.
I don't need to, I've lived in Japan and done the Ippan Kenshin which is the once a year health checkup. It consists of getting your weight, height blood pressure measured, an eye test, urine tests for diabetes and a blood test for cholesterol. That's very reasonable.
The one thing some doctors still tend to do is a chest-xray, which is not reasonable. They do it because tuberculosis was widespread in post-war Japan and they just kept doing it, but it has no positive impact on mortality rates.
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