Introduction
A well-known American talking head and ardent advocate for the unregulated free market, Rush Limbaugh once famously observed that, “Nobody has the right to good health.”[1] According to media scholar Robert McChesney, “In the view of ‘free market’ conservatives, the market (i.e. business) should rule and the political system should logically deal with how best to protect private property and not much else.”[2] Limbaugh’s assertion seems apparently easy to make in a public discourse loosely controlled by a Federal Communications Commission (FCC) infiltrated over the decades by corporate interests. His ideas also appear to be a clear reflection of the kind of economic beliefs that neoliberals everywhere maintain, where the “operation of a market, or market-like structure, is seen as an ethic in itself, capable of acting as a guide for all human action and substituting for all previously existing ethical beliefs.”[3] This ethic, of course, extends to Limbaugh’s conception of the way in which societies ought to manage healthcare for their people.
In Okinawa today, if the local neoliberal social architects have their way for new geographic and economic spaces cleared by Futenma’s eventual return to local control, Limbaugh’s ideas may well find their way into practice. The Trans-Pacific Partnership (TPP), the terms of which Japan’s membership are still in negotiation but which it still aspires to join,[4] promises great economic benefits for the national economy, but the greatest beneficiaries would appear to be a handful of multinational corporations — notably the pharmaceutical giants who now command much respect in the halls of power in Washington, DC. The contemporary American portrait of managed healthcare, largely sketched out by big pharmaceutical interests, is in stark contrast to that of Japan’s (and Okinawa’s) healthcare model.
During the reconstruction years after World War II, Japan embarked on an impressively egalitarian path toward social healthcare coverage. The history of the present system has its roots in the 1948 Health Insurance Reformation (医療制度改革), among the finest achievements of the U.S. military occupation.[5] The Japanese government worked hard in the decade that followed to introduce a universal healthcare system that went into effect in 1961 and provides equal healthcare and financial risk protection to all members of society. Many other countries such as the former Soviet Union, New Zealand, and Scandinavian countries, as well, developed healthcare systems that respect Article 25 of the United Nations Universal Declaration of Human Rights, signed by all nations in 1948. Article 25 declares that, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”[6] Despite the apparent altruism in this declaration, it has hardly been put into practice in most nations around the world — a reason all the more to protect Japan’s present system.
The way of providing Universal Health Care differs across national boundaries, but according to the Ministry of Health, Labour and Welfare (MHLW), Japan manages to do so by employing the Compulsory National Health Care System, which is administrated by municipal governments and which enables all citizens to receive fundamental healthcare with an extremely low financial burden on the individual. Up to 90% of medical payments are covered by the national budget, i.e. taxes, in order to reduce the economic risks for families and individuals and to achieve overall positive outcomes for the health and well-being of every citizen (and even legal resident). According to Dr. Hitoshi Kono, a physician with a 20-year practice in Tokyo, the system serves, “Anyone, anywhere, anytime.”[7] A direct result, then, of the philosophy that explicitly informs Japanese healthcare practices, the people continue to enjoy some of the world’s highest longevity rates.
The flier, pictured herein,[8] had appeared routinely in recent weeks in the daily newspapers Ryukyu Shimpo and Okinawa Times. It was published by a local citizens’ group which is headed by the wealthiest citizen in Okinawa, who also happens to be the head of the largest construction company, Kokuba Group (國場組). It is worth noting that the particular name of this citizens’ group — Prefectural Citizens’ Group for the Rapid Realization of Okinawa’s 21st Century Vision (沖縄21世紀ビジョンの早期実現を求める県民の会) — is actually a clever euphemism for a private association of individuals whose primary expressed concern lies in building more U.S. military bases. The name of the group also contains Governor Hirokazu Nakaima’s famous slogan, “21st Century Vision” (a.k.a. “Nakaima vision”), which he has attempted to use (with little effect) to point the electorate toward a future more developed in terms of both militarism in the North and, as we shall explain, corporatism in the South. Indeed, his views are a near mirror reflection of 1996 Special Action Committee on Okinawa (SACO)[9] Final Report, which had called for the return of Futenma and a consolidation of bases south of Kadena — if Okinawans could surrender to the Marine Corps’ plan for Henoko, known then as “the heliport” and “sea-based facility” (SBF).[10] Specifically, while the Committee’s agreement in 1996 included not a single Okinawan voice concerning the future of Henoko,[11] the results of the recent election, despite the widespread propaganda, exemplify a small victory for direct democratic action. The win also seems to shed light on an electorate that was largely well engaged in understanding both the history of the 1996 SACO decision and how this vote would shape the future. During the heated gubernatorial campaign leading to election night, the slogan, incessantly repeated in the streets through loudspeakers and in fliers distributed by the group, seemed to resonate with some voters, despite the Governor’s inability to draw on ideas outside of the 1996 agreement. In American parlance, this “citizens’” group would equate to a Political Action Committee (PAC), which takes on the work of gathering funds and supporting their particular candidate for public office.
After implementation of the 1994 Political Funds Control Law (政治資金規正法), corporations were restricted from directly supporting candidates for public office. To circumvent those restrictions, corporations employed an unsophisticated, but nonetheless practical, approach to political funding by teaming up with other like-minded corporate entities, raising funds, organising support, and having their CEOs present gifts of money to the chosen candidates. Though this practice wasn’t necessarily illegal, it was ethically questionable, as corporations, in effect, sent their emissaries disguised as private citizens, but with much louder voices than individuals, to curry future political favor. Nevertheless, thanks to fairly recent changes in the Law, announced on June 13, 2014,[12] corporations now have sweeping discretion in the funds they allot to candidates.
The recent election for Okinawa’s governorship saw the effects of this new law played out during the campaign when eleven citizen associations and private businesses,[13] the largest of which were Ryuseki (りゅうせき商事), Kokuba Group (國場組), and Okinawa Electric (沖縄電力株式会社), supported Governor Nakaima’s re-election bid. It is certainly interesting that these three most powerful corporate entities in Okinawa (with economic interests in the U.S. military presence) are in the petroleum trade, in construction, and in electricity, respectively, and were all in league with the Nakaima regime and Tokyo’s plans for Henoko. While these companies and associations used the full weight of their economic power to support the LDP and benefit in varying degrees from the military-industrial status quo, it is quite telling that Nakaima still failed to secure a re-election victory. Though Onaga’s election appears at present to be a solid victory for the power of the popular vote, it remains to be seen how powerful democracy will be in the weeks to come when Tokyo, goaded by Washington, will feel some pressure to move forward on the Henoko military “development” project.
As regards the election itself, perhaps one possible and compelling parallel exists between the recent change in Japanese campaign law and a 2010 U.S. Supreme Court decision in the case of Citizens United (a conservative lobby) vs. the Federal Election Commission (FEC). In that closely contested decision (5-4), the Court, “ruled that the government may not ban corporations from political spending on elections.” The decision, observed Noam Chomsky, “…heralds even further corporate takeover of the U.S. political system.”[14] The results of the local election in Okinawa raise interesting questions. Is free speech enacted by powerful corporate persons as powerful as Chomsky suggests it is? In light of the sustained advance of neoliberal economic policies on governments across the globe, as seen in Nakaima’s direct support from huge corporations, a more in-depth analysis of the changes in election law in Japan might illuminate the actual power of neoliberalism to undermine democracy.
Turning again to the propaganda in the flier included above, the headline calls immediate attention to Nakaima’s so-called 21st century vision. The message in the Nakaima name itself presents a simple black-and-white decision for citizens to make. Vote for him, and the Futenma base will disappear, replaced by Tokyo’s special vision of a new corporate health care colossus whose details are elaborated throughout the flier. Vote for Onaga (or any other candidate), and receive no future economic benefits. This is the underlying message of neoliberal rationalization — an effort to destroy logic and replace it with rules written by long traditions. Over the past 69 years, Okinawa has traditionally been the place to base the major bulk of U.S. garrisons, a place to rationalize the destruction of towns, of geographic spaces, and ecosystems and to ignore the logic of preserving basic human rights to live in peace. Futenma MCAS is one of many local symbols of that rationalization, a location despised for its ongoing dangers to the public and the military tradition of displacing people and their livelihoods that stand in the way. Okinawa is the place where the powerful elites in Washington and Tokyo can work in concert to rationalize the limitations of the important public debate where the U.S. Marine Corps should next take up residence.
The rationalization is also communicated in a carefully chosen color. Directly below the headline is the flier’s subtitle in bold green, declaring “Okinawa medical island design,” symbols that call up positive images of well-laid plans. The gradations of green color in the kanji characters blend nicely with the cultivated self-image that local people have of themselves and their gorgeous sub-tropical island where warmth and life remain highly valued.
Reinforcing these positive notions are well-placed catchphrases just below the subtitle: a) “Life is a treasure” (命どぅ宝) — a commonly understood metaphor rooted in the deep past when Shuri ruled the Ryukyus; and b) “A bridge to many nations” (万国津梁) — another metaphor that recalls Okinawa’s past kingdom as a hub for trade among many other neighboring nations. It is worth noting, too, that these phrases are cast in a variety of Uchinaguchi — a collection of indigenous languages long suppressed by the forces of colonialism, but a feature of the culture nonetheless that calls forth positive images of Okinawan self-determination and identity. To those who see below the surface of the propaganda, this use of the Okinawan language is especially offensive since the language itself is used in a way that masks a deeply vexing reality in which outside interests manipulate local aspirations for control over the land, air, and sea.
The descriptions that follow “life is a treasure” aim to play on the enduring myth that Okinawans still enjoy the world’s highest longevity rates, despite their marked declines since the end of WWII, when the insatiable appetite for fast food cultivated under American and then Japanese rule began influencing local cuisine and local eating habits. Once the holder of the highest longevity rates on earth, Okinawa has slipped considerably (according to the most recent government statistics) to 30th for men and 3rd for women out of Japan’s 47 prefectures.[15] This translates to 79.4 years for men and 87.2 for women. Despite the slip for Okinawa, the nation of Japan still ranks third highest in the world in terms of longevity.[16]
The descriptions that follow “A bridge to many nations” recall ancient times when Okinawa saw visitors joining in the great culture of trade among nations. For Nakaima, though, trade is now a part of the global empire of western medicine funded by corporations profiting from highly complex and expensive treatments for the chronically ill. The description in the flier lays out the goals to see western physicians and researchers teaming up with local researchers seeking new and improved treatments for disease within the western paradigm. Ironically, the traditional East-Asian practice of living life in Okinawa to its fullest included a diet rich in organic foods produced locally that sustained life and maintained health — a culture that has largely been crippled by the weight of the western diet and subsumed by the great network of food globalisation. Another related statistic that the propaganda in this flier glosses over is Okinawa’s other dubious distinction in overall health, the highest rate of citizens suffering from obesity of any other Japanese prefecture — a likely effect of the combination of the local car culture and fast food industry working in congress on waistlines. Besides the unmistakable presence of the bases of American empire, remnants of the occupation still remain and are maintained by an ongoing tourist fascination with A&W and Blue Seal Ice Cream — now local symbols of 1950s Americana.
The Nakaima proposal also features details about the cooperation envisioned for the 21st century where big pharmaceutical companies, the University of the Ryukyus’ Department of Medicine and the Hospital itself, the Okinawa Institute of Science and Technology (OIST), and the United States Naval Hospital collaborate in the interest of developing new therapies and medicines for the international marketplace. It is worth reminding readers at this point that OIST comes out of Tokyo’s official efforts in 2009 to internationalize Okinawa, to build a bigger bridge of trust, so to speak, between Tokyo and Naha. Officially, OIST was conceived in order to (a) “establish an international hub for scientific research and education;” (b) to develop “jobs in scientific and technological industries;” (c) to “nurture human interest in science and technology;” and (d) to “nurture an environment of international curiosity around the campus and transform Okinawa’s industrial base.”[17] It also exists, though, in the minds of local people as an expensive enticement where Tokyo continues to dump millions of Yen into this experiment — precisely because the U.S. military continues existing in Okinawa. OIST is, in effect, a very well endowed quid pro quo for Okinawa’s long burden of bearing the imposition of foreign bases. As a symbol of strong central planning in Tokyo, the OIST project presents opportunities for potentially fascinating studies of the power of the political “sweetener,” an enterprise in Okinawa where local citizens themselves are largely on the fringe of this important work, assuming positions as clerical support while mainland Japanese and international scientists dominate both the teaching posts and administration.[18] Though OIST has also become a source of great pride for local people, anecdotal observations suggest that scarcely anyone in the broader populace understands or experiences its tangible benefits, let alone knows of its existence.
The final significant image in this flier features the National Institutes of Health in Bethesda, Maryland. Nakaima’s vision includes the construction of Japan’s first national research institute modeled directly on the NIH and which is intended to take up residency on land occupied by the former U.S. Marine Corps Air Station. It promises to be a base of medical research controlled by the nation’s top social and scientific planners in Tokyo. Although the plan, purported to be another benefit to Okinawa, isn’t necessarily militarism in the direct sense, this space (should the plan proceed) will be remade and re-occupied by an endeavor shared by the Tokyo government and the new U.S. Naval Hospital, presently finalizing construction on Camp Foster in close proximity to MCAS Futenma. According to an unnamed official with the Okinawa Medical Association of doctors (沖縄県医師会), a co-sponsor of the Citizens’ Group propaganda, the plan was conceived by Shigeru Ishiba, Head of the LDP in Tokyo, and presented in 2012 to the local LDP committee in Okinawa as a codified direction (like the plan for Henoko) which is to be followed without question.[19]
Premised upon the plan is the common understanding that Okinawan people highly covet the position of number one, in terms of longevity. To effectively persuade local people that the national plan is beneficial, the details are wrapped in language that appeals to the deep emotional connections that people have toward living a long and fruitful life. The propaganda supporting the international medical hub purports to profit the local people by returning them to first place in longevity. Most interesting about the process of propagandizing, though, is the template used by the LDP, which seems to mirror the one they had designed for Henoko. The Tokyo LDP instructs the Okinawa LDP to gather the necessary experts in a particular area of business (in this case medicine) so as to generate propaganda to present to the larger populace in the right symbols and language that will stimulate their compliance with Tokyo’s plans. On the surface, the LDP’s plan appears to be superb in every sense of the word, especially in the area of medicine and medical research, but the plan also speaks of Tokyo’s continued uses of power, pressure, and control over local issues. The development of Henoko, for example, initially challenged by Naha, is now cast as a Naha LDP project.
The power of the central government subsumes local wishes to chart new paths of development beyond the rationalizing explanations for sustained military occupation offered up consistently over the years. The research that must have gone into the proposed medical hub itself and the resulting propaganda is quite methodical, as the connection between the U.S. Marine Corps and the National Institutes of Health extends back to 1798 when President John Adams, “… signed an act for the relief of sick and disabled seamen.”[20] Positive images of the current “medical bridge” (医療津梁) flood the minds of citizens who see the kanji symbols in the propaganda but who can’t quite envision the military bridge upon which the plan is built.
Conclusion
We noted in the introduction that Rush Limbaugh is a staunch advocate for free speech, especially if it benefits the bottom line of his legion of corporate sponsors. Governor Nakaima’s sponsors, who remain committed despite his recent reelection loss, are just as keen to continue supporting plans that further the massive business interests working to generate the pro-Henoko propaganda and to clear the way for the eventual corporate takeover of Futenma. These interests appear to include uncritical acceptance of the terms of the TPP that allows big multinational business firms to sue the governments of foreign nations that resist plans for the ongoing development of business ventures.[21]
In secret negotiations among TPP signatories over “Patents and Patentable Subject Matter” (November 13, 2013), leaked documents reveal that long-held protections regarding equal “access to affordable medicines worldwide”[22] have been consistently opposed by the United States Trade Representative (USTR). As of this writing, it is unclear from these leaks whether Japan, a co-proposer, has since moved beyond merely “considering this provision”[23] in 2013 to formally endorsing it. What appears clear enough is the United States’ eagerness to help nurture a pharmaceutical hegemony that would
… expand pharmaceutical patenting and create new drug monopolies, by lowering patentability standards;[24] eliminate safeguards against patent abuse, including among others the right of third parties to challenge patent applications (pre-grant opposition);[25] risk facilitating patent abuse by requiring countries to condition marketing approval on patent status (patent linkage);[26] and expand exclusive control over clinical trial data including through an extra three years of data exclusivity for new uses of known products.[27]
In contemporary Japan, with its new Constitutional provisions for an expansive military added to the nation’s growing interest in the TPP, the Nakaima plan for Okinawa is a societal disaster in the making. The propaganda foretells a future where the U.S. military continues its decades-long imposition and where multinational pharmaceutical companies are free to work within the terms of the agreement to remodel Japan’s superb public healthcare system into some private corporate venture. To exemplify the current resistance, nine nations oppose the U.S. and Japanese proposal to “impose patents for new uses … of old medicines, [which] can facilitate ‘evergreening’ — a form of abuse leading to long drug monopolies.”[28] The proposal stands in contrast to India’s famous rule, “which has helped protect access to affordable medicine worldwide,”[29] much to the dismay of the big multinational pharmaceuticals. The American and Japanese position, it’s also worth mentioning, is not unlike Chomsky’s earlier characterization of the sort of damage that NAFTA has done under the tutelage of the WTO: “The outrageous patent principles, for example, designed to grant monopoly-pricing privileges to immense private tyrannies, far in the future, and to stifle innovation and development, in their interests.”[30] These sorts of corporate efforts in ultimately monopolizing market share, masked as they are with the clever euphemisms of “free trade” and “smaller government,” are typical of what John Feffer sees in neoliberalism:
… all barriers to the flow of capital and goods must fall, governments must withdraw from the economy, and labor must become more ‘flexible.’ In other words, East Asian economies should remake themselves in the image of the U.S. or British economies.[31]
Beyond the monopoly of military power the U.S. has maintained over the decades in Okinawa, the issue of pharmaceutical monopolies now appears on the horizon for Japan and its citizens. This will invariably drive up healthcare costs. Today, the out-of-pocket price of a simple aspirin, presently at 4 cents[32] per tablet in Japanese hospitals across the nation, could rise to 21 dollars[33] and beyond, which is the average cost to patients in American hospitals. This stark disparity in costs for such a simple medication seems, at first glance, to be absurd and implausible, but the world today shows no shortage of cases where so-called free trade agreements have “elevate[d] companies to the same level as sovereign governments, [and] effectively enable[d] them to circumvent domestic laws and courts”[34] to get their way.
As of this writing, the recent gubernatorial election certainly produced a clear political winner for the governor’s seat in Naha, but Tokyo and Washington’s plan for Henoko began creeping forward again just one day after the champagne bottles were emptied. According Suga Yoshihide, the Chief Cabinet Secretary in charge of overseeing U.S. base issues, observed somberly that despite Nakaima’s loss, the government will nonetheless move forward, albeit surreptitiously, with plans for the development in accordance with the signed contract.[35] It is interesting, though, how an impending general election, called by Abe just last week, can move even the most powerful politicians to delay their most important plans. Perhaps Okinawa, during this present reprieve, can lobby to have that contract renegotiated.
Maki Sunagawa is a first-year researcher in the Graduate School of Intercultural Communication at Okinawa Christian University where she is taking up studies in social semiotics and the signs for development that prevail in public relations literature. She is presently working towards a graduate qualification focused on the McDonaldization of Okinawan culture influenced by long-standing conditions of foreign occupation.
Daniel Broudy is Professor of Rhetoric and Applied Linguistics at Okinawa Christian University. He has taught in the United States, Korea, and Japan. His research includes the critical analysis of media discourse, signs, and symbols. He is co-author of Rhetorical Rape: The Verbal Violations of the Punditocracy (2010), serves as a managing editor for Synaesthesia communications journal, and writes about current discourse practices that shape the public mind. He is the co-editor to Under Occupation: Resistance and Struggle in a Militarised Asia-Pacific.
Notes
[1] For further details, visit http://www.rushlimbaugh.com/
[2] McChesney, Robert Corporate Media and the Threat to Democracy (New York: Seven Stories Press), 15-16.
[3] For further details, visit http://web.inter.nl.net/users/
[4] According to the The Nikkei Asian Review (日本経済新聞), “Japan and America will cooperate further in negotiations in order to realize an agreement on the terms of the TPP” (November 16, 2014). Original text follows: 早期妥結に向けていっそうの努力をしていくことを確認した。
[5] Sugita, Yoneyuki. “Universal Health Insurance.” In Democracy in Occupied Japan: The U.S. Occupation and Japanese Politics and Society, edited by Mark Caprio and Yoneyuki Sugita, 160-1. Oxford: Routledge, 2007.
[6] For further details, visit http://www.un.org/en/
[7] For further details, visit http://www.npr.org/templates/
[8] Access to the digital copy can be located here: http://www.okinawavision.net/
[9] Special Action Committee on Okinawa (SACO) was formed, partly, as a response to the 1995 rape of an elementary school girl by three American servicemen. The committee, which included not a single Okinawan voice, laid out designs for the future force structure of the American military on Okinawa and to reduce the “footprint.” These designs included the development of Henoko in the North as a suitable replacement for MCAS Futenma in Ginowan City.
[10] For further details, visit http://www.mofa.go.jp/region/
[11] Broudy, Daniel et al. 2013. “Introduction.” In Under Occupation: Resistance and Struggle in a Militarised Asia-Pacific, edited by Daniel Broudy, Peter Simpson, and Makoto Arakaki, 4. Newcastle upon Tyne: Cambridge Scholars Publishing.
[12] (最終改正：平成二六年六月一三日法律第六九号) For further details, visit: http://law.e-gov.go.jp/
[13] Ryukyu Shimpo (print version) 琉球新報９月２日りゅうせき１１社仲井真氏を推薦。りゅうせきグ
[14] Chomsky, Noam. “The Corporate Takeover of U.S. Democracy,” In These Times, February 3, 2010
[15] For further details, visit http://www.mhlw.go.jp/toukei/
[16] Central Intelligence Agency “The World Fact Book”
[17] For further regarding origins and aims of OIST, see page 69 at http://www.sangiin.go.jp/
[18] For further details regarding OIST demographics, visit http://www.oist.jp/oist-
[19] Anonymous spokesperson, telephone interview with author, November 27, 2014
[20] For further details, visit http://www.nih.gov/about/
[21] Further details regarding the power of corporations to attack nations can be found at http://www.citizen.org/Page.
[22] Further details regarding recent USTR proposals can be found at http://www.citizen.org/Page.
[23] Public Citizen, “What’s New in the Wikileaks TPP Text” (2013), 1.
[24] Kılıç Burcu, Kim Mi Kyoeng, and Maybarduk Peter, “Challenges for Health and Innovation Policy in the Trans-Pacific Partnership Agreement (TPP): Comparative Analysis of the United States’ Intellectual Property Proposal and Japanese Law” Public Citizen (2014), 7.
[25] Kılıç et al., Ibid, 16.
[26] Kılıç et al., Ibid, 8.
[27] Kılıç et al., Ibid, 11.
[28] Further details regarding TPP and patent right, including medicines, can found at: http://www.citizen.org/
[29] Public Citizen, Ibid.
[30] Chomsky, Noam “Resistance to Neoliberal Globalization” Zblogs (2005, Jul. 23) Retrieved from https://zcomm.org/zblogs/
[31] Feffer, John. “Gunboat Globalization: The Intersection of Economics and Security in East Asia” Social Justice. (27)4. (2000), 53-4.
[32] Further details regarding relative costs can be found at: http://www.qlife.jp/meds/
[33] Further details regarding relative costs can be found at: http://www.dailynews.com/
[34] Silverman, Ed. “Eli Lilly vs. Canada: The Patent War Moves to Washington,” The Wall Street Journal (April 14, 2014)
[35] Original text follows: 菅義偉官房長官は１７日午前の記者会見で、沖縄県知事選 で米軍普天間飛行場（同県宜野湾市）
