[From the President’s Desk] ② The U.S. Health Insurance System
My last entry was written in October 2025, and before I knew it, 2026 had arrived.
In fact, after back-to-back business trips to Japan and Houston in November, I developed acute cholecystitis. At the time, I did not take symptoms as seriously as I should have. I felt extremely unwell, but having always considered myself physically resilient, I decided to wait it out and see how things went.
After returning from my trips, I rested at home for about two days. When I felt well enough to go out, I got into my car and headed toward the office. Not long after I started driving, however, my entire body suddenly began shaking uncontrollably. I pulled over and waited in the car until the shaking subsided. Once it did, I gave up on going to work and decided to drive home instead. While driving, I lost consciousness and rear-ended a car stopped at an intersection.
From what I can piece together afterward, I was transported to the hospital by ambulance. When I regained consciousness, I was lying in a hospital bed, receiving intravenous antibiotics and nutrients simultaneously. Bacteria had spread throughout my body, and my liver function had deteriorated significantly. It took eight days to remove the infection and stabilize my condition, followed by gallbladder removal surgery about two weeks after discharge. Thankfully, I have now fully recovered and am in good health.
“Cheating death” is the only phrase that truly captures what I experienced. This incident, while stemming from ignorance, forced me to confront my overconfidence in my own health. Many of the warning signs my body had been sending were symptoms that could have been easily identified with a simple online search.
When your body signals danger, do not hesitate. Do not prioritize work. Go see a doctor, go to a hospital. Looking back, 2025 was marked by unhealthy habits rooted in complacency about my own wellbeing. Yet I believe that before the worst could happen, God intervened — perhaps to tell me that I still have a mission to fulfill in this life.
The hospital closest to me, where I was admitted on an emergency basis, was Hoboken University Hospital, which happened to be in-network under my health insurance plan. This was incredibly fortunate. When a hospital is in-network, an upper limit is placed on out-of-pocket expenses, and patients are protected from receiving astronomical and unpredictable medical bills.
Had the hospital or physicians been out-of-network, the situation could have been drastically different. In the United States, out-of-network providers can set their own fees at their discretion, which means patients always face the risk of exorbitant charges.
The U.S. does not have a universal health insurance system. Public programs such as Medicare for seniors and Medicaid for low-income individuals do exist, but everyone else relies on private insurance. Even then, private insurance plans vary widely by insurer, and the distinction between in-network and out-of-network coverage adds another layer of complexity. The existence of medical billing and insurance specialists speaks volumes about how difficult the system is to navigate.
Although the Affordable Care Act (ACA), commonly known as Obamacare, expanded coverage requirements and organized insurance marketplaces, many challenges remain unresolved.
In countries like Japan and Germany, universal health insurance ensures that all citizens receive a basic level of medical coverage. By contrast, the United States, despite being a developed nation, also exhibits characteristics more commonly associated with developing countries.
This is not limited to healthcare alone. Across nearly every sector, America is an extraordinarily unequal society. Corporate profitability, shareholder returns, and executive compensation are prioritized, and medical costs will likely continue to rise. In some ways, this may be an inevitable outcome in a country that sits at the very center of global capitalism.
In December 2024, the fatal shooting of the CEO of UnitedHealthcare, a major American insurance company, on the streets of Manhattan remains a striking and unsettling reminder of the deep tensions surrounding the U.S. healthcare system.
Written by Masato Fujihara, President
Interesse International Group
Came to New York as an expatriate for an HR company in January 1994. Became independent in 1996 and started own business in defiance of return-to-Japan order by the company. Currently, Interesse International Group has 11 locations in the United States and established a Japanese subsidiary in 2022. With 30 years of knowledge and experience in the HR industry, Interesse International Group delivers practical insights to clients.
