Our views on Health Care

First of all . . .

We wish to stress that we are in no way opposed to Japan's social/nationalized health care system. Unlike the U.S. where there is widespread lobbying to prevent universal health coverage, we have no problem with the idea. For the most part, this is a system that has generally worked for Japan's citizenry and if they wish to support it, they will receive no argument whatsoever from our foundation. Additionally, if there are expatriates in Japan who also find this type of health care attractive and wish to enroll, we feel strongly that they should have equal access to the system.

International doctors in Japan fill a much-needed void.

We also acknowledge the Japanese Government's stance that all non-Japanese must have some form of health insurance while in Japan. To be without insurance coverage is irresponsible not only to oneself but to others. The Government's viewpoint on this is not at all unreasonable. An uninsured expatriate, whether a short-term or long-term resident is a potential liability for a hospital or government body in the event of a serious illness or injury.

However . . .

When it comes to choosing one's doctors or health care plan, we strongly believe that decision should be up to the individual, based on what he or she believes is best for his or her own health needs. Foreign residents, by virtue of the fact that they come from other cultures with different political and social norms, typically have different needs, problems and concerns than do Japanese residents. The Japanese lifestyle is often very different from the expat's country of origin. The food is different, the environment is different, and so is daily life in general. This can have a severe, and not always immediately recognizable, impact on his or her well-being, both physically and mentally.

This is not at all unusual. The Japanese are a good example of a society that considers themselves unique. Japanese are known to feel that they have special needs, and that foreign products and produce be tailored to their uniqueness. For instance, when living out of their own country the Japanese may be prone to stomach problems, while a person of a different ethnicity may have a tendency to develop other problems when living away from his or her native land. The point is that all of us may develop special problems while living abroad - we are, after all, only human.

Also . . .

Although few in number, foreign doctors practicing in this country fulfill a special niche. Some have spent decades in Japan treating expatriates and are familiar with many of the symptoms they are inclined to develop when living in Japan. A number of non-Japanese have written Free Choice indicating to us their problem in communicating with Japanese doctors, sometimes resulting in misdiagnosis. Foreign doctors are also able to prescribe medicines that they know are better suited to benefit foreigners, especially Westerners who often need stronger doses than are normally given to Japanese. In some cases, doctors practicing in the social system are unable to prescribe stronger dosages due to the fact that the social system won't let them even if they know it is necessary to properly treat the patient.

Many foreign residents get the treatment they need when visiting international clinics where non-Japanese doctors practice, despite the fact that they often practice outside of Japan's social medical system. The social and national health insurance programs do not cover these expenses. Therefore, it is only natural that many non-Japanese prefer, indeed need, private health care plans. Additionally, there are certain things a private health insurance plan may cover that are not only important to the needs of non-Japanese, but also are not offered by the government programs. For example, expats are generally more mobile than the average Japanese citizen and often need an insurance plan with considerable international coverage. Emergency evacuation and/or repatriation of remains are not benefits that one can expect from Japan's public insurance coverage.

The Japanese health care system was designed for the Japanese, and there certainly is nothing wrong with that. But expatriates in Japan have special health care needs. For a foreign resident with a Japanese spouse and a family cemetery plot, who plans to retire and live in Japan for the rest of his or her life, public insurance might be ideal. But not everyone fits this description. As such, we hope the government will understand these facts and allow us to choose the doctors we wish to see and the health care plans that we wish to join. Indeed, it must consider and become aware that 'free choice' is a necessity for many expatriates.

  • “International citizens need coverage that extends beyond that of Japan's national health insurance. Alternatives to the national program are needed and should be authorized in its place.” -Norman R. Solberg, Attorney at Law [Osaka]
  • “Many non-Japanese citizens have been members of private health insurance companies for years or decades and have acquired rights and advantages. It would be unfair if they should loose those.” -Daniel AVIOLAT, Lecturer [Hyogo]
  • “I support this petition even though I am covered under the public option. It is definitely not one-size-fits-all, and I understand that many non-Japanese wish for more coverage than is provided under public health care. It is wrong to tie it to immigration status in any way.” -A.I. [Kanagawa]
  • “Like many military retirees in Japan, I receive all my medical care from US Forces Japan medical facilities. To pay for Japan's social insurance would be throwing mooney away. I will never utilize Japanese medical facilities because my care at US Forces medical facilities is a benefit of my military service.” -T.W., Professor [Kanagawa]
  • “I am for it! I pay both now and it is killing me!” -G.Y., Recruiter [Tokyo]
  • “I agree with your stance that people should have the right to choose their own health care system, especially, if they will be paying for it out of their own pocket.” -David [Tokyo]

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