The Longreads Blog

How Japan Prepared to Care for Its Rapidly Aging Population

As far back as the early 1960s, the government became aware of the imminent ageing problem and began to establish nursing homes and home helpers. In the 1970s, benefits for retirees were more than doubled and a system of virtually free healthcare for older people was established. In 1990, Japan introduced the “Gold Plan”, expanding long-term care services. Ten years later, it started to worry about how to pay for it, and imposed mandatory insurance for long-term care. All those over 40 are obliged to contribute. The scheme’s finances are augmented with a 50 per cent contribution from taxes and recipients are charged a co-payment on a means-tested basis. Even then, there have been financing problems and the government has had to scale back the level of services provided. Still, Campbell calls it “one of the broadest and most generous schemes in the world.”

As a result of these and other adaptations, he argues, Japan has struck a reasonable balance between providing care and controlling costs. Other countries, including Britain, have studied Japan closely for possible lessons. Of course, 15 years of deflation have left Japan’s overall finances in lousy shape, with a public debt-to-output ratio of 240 per cent, the highest in the world. Spending on healthcare per capita, however, is among the lowest of advanced nations, though outcomes are among the best. That is partly down to lifestyle. Most Japanese eat a healthy, fish-based diet and consume less processed food and sugary drinks than westerners. Obesity is far less common. So are violence and drug abuse. But even taking into account such factors, Japan gets a big bang for its healthcare buck. Every two years, the government renegotiates reimbursement fees with doctors, hospitals and pharmaceutical companies, routinely imposing restraints or reductions. Primary care is given priority over specialist treatment: the Japanese visit the doctor far more often than Americans but receive far fewer surgical interventions.

In the Financial Times, David Pilling looks at Japan’s aging population and what the country has done to take care of their elders. More stories about Japan.

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Photo: George Alexander

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A Universe of Failed Unions, Dreams and Abandoned Hopes

The young men frequented the kothas to learn the bearings of polite society, the older men to socialize, or rekindle the memories of their lost youth. Whenever one of them fell in love with a tawaif or a nayika, his affairs provided a spectacle and entertainment to the rest of them, until he was cured of his passion. Those who could not survive it did not return. A tawaif who fell in love had only two choices: she could either put an end to the association, or leave the kotha to pursue a life outside — if one was offered her. Implicit in the latter choice was the understanding that she would never be readmitted to the kotha if the promise of the new life failed her. There was a universe of failed unions, dreams, and abandoned hopes that started in the kothas and trailed off into the anonymity of the city’s dark alleys. It was said — with some justification — that only the fickle survived in the kothas, and only the pitiless prospered.

—From Between Clay and Dust by Musharraf Ali Farooqi, a novel with extraordinary characters in the twilight of their lives. Read more fiction in the Longreads archive.

Photo: British Library, Flickr

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Swiping Right in the 1700s: The Evolution of Personal Ads

Noga Arikha | Lapham’s Quarterly | 2009 | 13 minutes (3,200 words)

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I.

In 1727, a lady named Helen Morrison placed a personal advertisement in the Manchester Weekly Journal. It was possibly the first time a newspaper was ever used for such a purpose. As it happens, Morrison was committed to an asylum for a month. Society was clearly not ready for such an autonomous practice, especially on the part of a woman. But personal ads quickly became an institution. Heinrich von Kleist’s celebrated novella The Marquise of O, first published in 1810 (and said by Kleist to be “based on a true incident”) opens on the newspaper ad placed by “a lady of unblemished reputation and the mother of several well-brought-up children,” to the effect “that she had, without knowledge of the cause, come to find herself in a certain situation; that she would like the father of the child she was expecting to disclose his identity to her; and that she was resolved, out of consideration for her family, to marry him.” Read more…

From Facebook Reject to Purchased by Facebook for $19 Billion

Over the next nine years the pair also watched Yahoo go through multiple ups and downs. Acton invested in the dotcom boom, and lost millions in the 2000 bust. For all of his distaste for advertising now he was also deep in it back then, getting pulled in to help launch Yahoo’s important and much-delayed advertising platform Project Panama in 2006. “Dealing with ads is depressing,” he says now. “You don’t make anyone’s life better by making advertisements work better.” He was emotionally drained. “I could see it on him in the hallways,” says Koum, who wasn’t enjoying things either. In his LinkedIn profile, Koum unenthusiastically describes his last three years at Yahoo with the words, “Did some work.”

In September 2007 Koum and Acton finally left Yahoo and took a year to decompress, traveling around South America and playing ultimate frisbee. Both applied, and failed, to work at Facebook. “We’re part of the Facebook reject club,” Acton says. Koum was eating into his $400,000 in savings from Yahoo, and drifting. Then in January 2009, he bought an iPhone and realized that the seven-month old App Store was about to spawn a whole new industry of apps. He visited the home of Alex Fishman, a Russian friend who would invite the local Russian community to his place in West San Jose for weekly pizza and movie nights. Up to 40 people sometimes showed up. The two of them stood for hours talking about Koum’s idea for an app over tea at Fishman’s kitchen counter.

Parmy Olson, in Forbes, on the early failures of WhatsApp founders Jan Koum and Brian Acton, who just sold their messaging service to Facebook for $19 billion. Read more on Facebook.

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Photo: abulhussain, Flickr

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On Aging and the Memories We Look Back On

What I’ve come to count on is the white-coated attendant of memory, silently here again to deliver dabs from the laboratory dish of me. In the days before Carol died, twenty months ago, she lay semiconscious in bed at home, alternating periods of faint or imperceptible breathing with deep, shuddering catch-up breaths. Then, in a delicate gesture, she would run the pointed tip of her tongue lightly around the upper curve of her teeth. She repeated this pattern again and again. I’ve forgotten, perhaps mercifully, much of what happened in that last week and the weeks after, but this recurs.

Carol is around still, but less reliably. For almost a year, I would wake up from another late-afternoon mini-nap in the same living-room chair, and, in the instants before clarity, would sense her sitting in her own chair, just opposite. Not a ghost but a presence, alive as before and in the same instant gone again. This happened often, and I almost came to count on it, knowing that it wouldn’t last. Then it stopped.

People my age and younger friends as well seem able to recall entire tapestries of childhood, and swatches from their children’s early lives as well: conversations, exact meals, birthday parties, illnesses, picnics, vacation B. and B.s, trips to the ballet, the time when . . . I can’t do this and it eats at me, but then, without announcement or connection, something turns up.

In the New Yorker, Roger Angell discusses what life is like at 93 years old. More stories from The New Yorker.

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Photo: Elliott Brown

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The True Cost of Our Almond Addiction

The global almond boom is being fueled in part by sleek marketing campaigns that have made almonds the nut of choice for consumers. Subway stations in China are blanketed with billboards proclaiming almonds to be a heart-healthy snack that makes people “perpetually feel good” (almond exports to China have more than doubled in the past five years). In Korea, California almonds have been integrated into the storyline of a popular prime-time television show. And in Europe, French and British TV personalities have lauded almonds as a healthy alternative to processed foods.

In the United States, almonds have become a staple for many health-conscious consumers. In its raw form, the “power food” is said to lower cholesterol, spur weight loss, and provide powerful antioxidants such as Vitamin E and manganese. Products like almond butter and almond milk have also become increasingly popular in health food stores.

But growing almonds in an arid climate requires lots of water. In fact, Westlands’ almond orchards suck up nearly 100 billion gallons of water a year. Cotton, by contrast, needs 40 percent less water per acre, and tomatoes require about half as much water as almonds.

Also, unlike cotton and tomatoes, almonds are a “permanent” crop, meaning the land they’re grown on can’t lie fallow when water is scarce. “It means farmers really do need to get a hold of water in dry years in order to keep the trees alive,” explained Ellen Hanak, a senior fellow at the Public Policy Institute of California and an expert on water.

Joaquin Palomino, in the East Bay Express, on what the California drought means for the almond business. Read more on agriculture.

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Photo: healthaliciousness, Flickr

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Gary Shteyngart on the Highest Form of Tragedy

The funnier you are, the more I think there’s a tragic undercurrent. … I think humor is one of the highest forms of tragedy there is. People talk about the serious novel and these sort of hallowed tones and how important it is, but I think a lot of humorous stuff — books by writers like Sam Lipsyte and even writers like Mordecai Richler in Canada, who is no longer with us — these are some of the most funny and tragic books I know because humor doesn’t work unless you’re making fun of something that keeps paper cutting you throughout your life, something that keeps hurting and hurting you; and that’s why parents, and relationships, and the political system are all such delicious targets.

—Gary Shteyngart, author of Little Failure, on the To the Best of Our Knowledge podcast, talking about humor as tragedy. See more podcast picks.

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Photo: Wikimedia Commons

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On White Hip-Hop Artists Performing for White Audiences

In 2013, for the first time in the 55-year-history of the Billboard Hot 100, not one black artist lodged a number-one single. (Of the eleven songs that held the spot for some portion of the year, four were hip-hop, and four featured black singers or rappers in guest roles.) There’s been round, sustained clamor over Macklemore’s Grammy haul, which was all the more glaring because it came at the expense of fellow nominee Kendrick Lamar, a (frankly) far more talented artist, who is black. (Macklemore handled the situation awkwardly, too, writing Kendrick a text message that said, “I wanted you to win. You should have. It’s weird and sucks that I robbed you.” And then posting a screenshot of that text to his Instagram account, so everyone could see how magnanimous he is.) Macklemore admits that white privilege is a factor in his success. “I benefit from that privilege,” he has said. “And I think that mainstream Pop culture has accepted me on a level that they might be reluctant to, in terms of a person of color.” But that doesn’t change the facts on the ground: A new white hip-hop superstar has been anointed, one who does not live up to most rap critics’ definition of excellence. (Eminem is widely considered to be an extremely skilled rapper.) Some have even gone so far as to anoint Macklemore some sort of savior of hip-hop, a Great White Hope who will help the genre evolve into a more enlightened form. A recent Dallas Morning News headline sums up this perspective: “Macklemore shows hip-hop doesn’t need to be homophobic, violent in Dallas concert.”

Dave Bry, in a short essay for The New Republic, on the state of rap music. Read more on music.

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Photo: sffoghorn, Flickr

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The Shadow Legal System on College Campuses, and What It Means for Reporting Sexual Assault

"Patrick Henry College is not alone in internally adjudicating sexual assault. Every college and university maintains its own shadow legal system—and many secular colleges have a terrible track record of investigating and punishing sexual assault. But Patrick Henry College is one of only four private colleges in the United States that eschews federal funds in order to avoid complying with government regulations. This poses financial hardships for students and their families—PHC students are prohibited from accessing FAFSA loans, Pell Grants, state funds, scholarships, or the G.I. Bill—and it makes the institution particularly dependent on its conservative evangelical donor base. Homeschoolers see this as a worthwhile price to pay for freedom from government intrusion. The financial-aid page on PHC’s website notes, “In order to safeguard our distinctly Christian worldview, we do not accept or participate in government funding.”

This also means PHC isn’t subject to the Clery Act, Title IX, or the more recent Campus Sexual Violence Elimination Act. The Clery Act requires schools to issue campus crime reports. Title IX says schools must hold an investigation independent of a criminal investigation and ensure that victims can change dorms and class arrangements, get campus restraining orders, and receive help filing a police report if they choose to do so. The Campus Sexual Violence Elimination Act mandates that schools have prompt disciplinary proceedings and inform victims of their rights and options under Title IX. These regulations are no guarantee that sexual-assault accusations will be handled properly, and students at dozens of schools have recently filed Title IX and Clery Act complaints with the Department of Education that document widespread victim-blaming, mishandling of reports, and impunity for perpetrators. Yet, PHC students lack even that legal recourse. (The school says it tries to “generally follow the principles of those laws,” but it is not legally bound to comply with them.)

“As a private campus, it’s outside of federal influence. They can do whatever they want,” says Brett Sokolow, an attorney and president of the National Center for Higher Education Risk Management. “If you’re a female student, and you elect to enroll at a campus that does not provide any of the federal protections that attach to other colleges and universities, you need to know that going in.”

Kiera Feldman, in The New Republic, on Patrick Henry College, an evangelical school in Virginia accused by former students of victim-blaming and covering up reports of sexual assault. Read more from Feldman.

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Photo: Wikimedia Commons

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The Financial Power of 1,000 True Fans

If you had 1,000 people who were your true fans—and I define them as people who would buy whatever it is that you produce at any time and would not only buy the paperback but also the hard cover and the digital version, who would not only buy your CD but would drive 100 miles when you were on tour. Those are your true fans. If you had 1,000 of them, and you could get $100.00 from them a year for what you were producing, and you got it directly, then you got $100,000 a year from only 1,000 true fans.

The concept was this interesting middle place. You didn’t need to have a million fans to survive or make a livelihood. You needed more than one fan, but you could do it with this interesting moderate number, which is an imaginable number. It’s hard to imagine a million fans, but you could imagine getting 1,000 people who would really follow you.

If you could and you had direct relationship with them, and you got the money directly from them, then you could make a living—maybe not a fortune, but you could make a living—with 1,000 true fans.

Kevin Kelly, on the New Disruptors podcast, on the power of a few devoted fans. See more podcast picks.

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Photo: michellemilla, Flickr

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