Expatriates voice their views on health care in Japan

We would like to extend an open invitation to both the foreign community and Japanese public to voice their thoughts and share their stories.

 

“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]

“I don't mind getting my photograph and fingerprints taken upon re-entering Japan, but this is going too far.” -Stefhen Bryan [Hyogo]

“The Japanese government has the moral responsibility to consult at length with foreign communities in Japan before creating policies that will significantly affect those communities.” -M.A., Journalist [Chiba]

“I have been living here for more than 20 years. I am on the NHI and do not find anything objectionable about Japanese hospitals or physicians. However, I do understand why a foreigner who is only going to be here a few years would prefer a private or international insurance plan.” -Name withheld upon request [Hyogo]

“Could someone please explain to me why I am forced to spend more money to buy a government insurance plan that only pays for 70% of my medical expenses, when I can spend less money for a private insurance plan that pays 100% of my medical expenses? Not to mention that the government insurance will not pay for a licensed foreign doctor in Japan while private insurance will. Where is the logic in this?” -Dean [Tokyo]

“The rights, circumstances and needs of the non-Japanese working in Japan should be carefully considered by the Japanese Government before enacting such regulation. Health insurance and visa renewal are separate issues and should be addressed separately and not forced upon expatriates” -E.T.[Tokyo]

“I worked for many years in a part-time position for a major Japanese-owned English school chain where I was not required by law to join the health or pension plans. In Japan, I have always had private health insurance, for the reasons indicated in this petition. I've lived in Japan since 1993. I married a Japanese citizen and I have a spouse visa. I always pay all applicable taxes. I abide by all the rules. The Japanese government now imposes health-insurance visa-renewal requirements. The Japanese government has not provided any information to non Japanese residents! The government thinks it is okay to surprise visa-renewal applicants at the time of renewal at the immigration center counter. The whole scenario is the first time I've felt that I'm not wanted in Japan. The Japanese government treats me and other non-Japanese in this manner. It disgusts me.” -M.W. [Tokyo]
Editor's note: The Justice Ministry very quietly put an 8-point guideline on their site from a rather obscure link.

“Surely it is obvious that non-citizens should not be required to pay for two major medical plans.” -I.P., University Lecturer [Osaka]

“I have been well-served by private health insurance in Japan for more than a decade and I would miss out on many useful features of that coverage if I were to be forced into one of the government plans. In fact, I would probably (and regretfully) leave the country if it comes to that.” -J.B. [Hyogo]

“Surely it is unethical to force people to contribute a considerable amount of salary to a system designed without them in mind and that drastically reduces the choice of where and how they receive healthcare. This system only benefits those foreign workers who plan to stay in Japan for the rest of their lives, and if so, by all means they should be free to join such a system. For those of us who do not see ourselves staying here for the next 40 years, this guideline is another backwards step in our being accepted in a country where we are perpetually seen as somewhat unwelcome outsiders.” -C.T., Consultant [Tokyo]

“Forcing immigrants to have insurance that a lot of Japanese don't pay for isn't fair.” - D.L. [Tokyo]

“The only way international schools will be able to support the enormous costs involved should it become mandatory, is to raise school fees, making it impossible for individuals, and smaller companies to support educational costs. Ultimately, expatriates will leave Japan, and this will impact on business and the economy of Japan.” -Name withheld upon request [Kanagawa]

“Although considered as a full-time employee by my company, I am officially registered as part time and, as such would have to join the National Insurance as a self-employed person. This means that I would have to bear the costs totally on my own, while my company makes no extra contributions. How is this fair? I am very happy with my private insurance and feel that I would have to continue to subscribe to it even if I were obliged to join the National Insurance, as this does not meet all my needs. The cost of paying into two schemes would indeed be a heavy burden.” -A.S. [Tokyo]

“As a permanent resident married to a Japanese national I've been enrolled in the Japanese National Health Insurance scheme for over 30 years. It has served my family well for most health issues, but there have been many times that I (as the foreign member of our family) have used private English speaking doctors here in Japan or even returned to my home country to consult with doctors, and of course have paid these fees out of my own pocket. While we live here in Japan we'll continue to pay into and make use of the Japanese health care system, but I can fully appreciate and understand the concerns of the majority of foreigners here who wish to have "free choice" regarding the health care system they pay into. I resent the government even considering basing something like visa renewal on enrollment in the Japanese health system which does not meet the needs of so many foreign residents here. I sincerely hope that this petition and comments from foreigners will move the newly installed prime minister and his cabinet to consider the health care rights of foreigners to choose the health plan best suited to each individual.” -S.S., Teacher [Tokyo]

“This is the worst law ever! Get rid of it! I have two kids and I need health insurance that covers me around the world.” - K.T., Librarian [Tokyo]

“I've been using a private health insurance plan for the past three years, first, while working for a major school chain, and then while working for a much smaller private school. It worked very well for me. I would like to keep my private insurance, but I'd consider moving to the public health plan if I was required to. BUT, if I'm required to pay back premium payments, I'll have to leave Japan. I simply don't have enough money to make such payments. I love living and working in Japan. I work very hard here, and try to be as respectful of Japan, it's culture, and it's laws as possible. It would truly be a shame if I and many like me were forced to leave this country because of this requirement.” - A.A., English Teacher [Kanagawa]

 

“My free choice is that my university enroll me into the social insurance like they do the Japanese instructors. This is a form of discrimination and it makes me feel like a second-class citizen.” -Name withheld upon request [Kyoto]

“This unfair legislation may force me to leave a country that I have loved and helped contribute to its citizen's education for nearly half of my life. This legislation may seriously hamper the quality and quantity of non-Japanese who contribute positively to Japanese society. ” -A.C. [Saitama]

“It is a disgrace and a continuation of discrimination against foreigners. Japan is in breach of many of the UN human rights laws when it comes to foreigners and they continue this because no one takes them to task.”-S.B., Teacher [Tokyo]

“My wife and I are both permanent residents, we own our own home and may even live here permanently. But in my profession, we travel to a lot to developing nations where the quality of medical care is not always that good. We are on a private major medical plan with worldwide coverage. It covers us for many things we need which we would not get if we were on the social system (emergency evacuation, repatriation, etc). We have been on the plan for more than 8 years and wish to continue to do so. Since we don't know whether we will be here for the rest of our lives, we feel more secure on a plan that has worldwide coverage. ” -Mr. & Mrs G. [Tokyo]

“Perhaps the one thing I dislike more than anything is having to go to a Japanese hospital for treatment. They NEVER fail to embarrass me in front of the other patients. There is little privacy and the doctors act like they are God's gift to the earth. Lately, I have been going to see a British doctor in Tokyo and he's been more like family to me.” -K [Saitama]

“I fully support free choice for expats in Japan to be able to choose their own health care plan. If government wants to ask us to show proof of our plan, fine. But let us choose our own.” -P.W. [Kanagawa]

“As a mother living here with two young children - having access to an international clinic and English speaking doctors is crucial not just for our understanding of any health issues, but also for the children's comfort and support - paramount at a time of distress. Why should we have to pay additionally for a system that we never use. We have been sent papers to have check ups at Japanese institutions but never use them. Let us pay for our own private health care and opt out of the Japanese system. Save this money wasted on all this admin for medical care for the Japanese or those who opt in.” -A.R. [Tokyo]

“I have been living in Japan 3 1/2 years now and always been on private insurance. In fact, when I was hired by my employer, they said we were ineligible for shakai hoken because we would only be working 29.5 hrs. a week. We were encouraged to buy private insurance. I was completely UNAWARE that NHI was compulsory. As of now, I don't think I should be penalized with backpay etc. for something I was kind of lied to about. If I am forced to backpay NHI premiums I will simply leave Japan. I can't afford it.” -J.G. [Osaka]

“In addition to living in Japan , I have to travel often to other countries and therefore need to be on an international health insurance plan which has comprehensive coverage such as medical evacuation and repatriation. Provided I can prove that I have sufficient coverage to not be a burden to Japan in my health needs, I see no reason why Japan should be concerned how I provide health coverage to myself and my family.” -S.M., Business Manager [Tokyo]

“To target only non-Japanese is discrimination. Unless, of course, the government is planning to ask Japanese citizens to show their health cards when they renew their driver's licenses or apply for passport renewals.” -Martin Lovatt [Fukuoka]

“I need insurance that will cover me for the 4 months that I reside outside of Japan. I can not afford to pay for both public and private insurance.” -Rob, University Professor [Tokyo]

“I find it unfair that visa renewal is tied to enrollment in the public insurance. A more acceptable requisite would be to have some kind of health insurance coverage, be it public or private. As a long- time resident of Japan, three years ago I tried to join the NHI but the penalty was so high that I could not afford it; therefore, I have continued with private insurance. If the bill is enforced, I suppose enrollment would be free of penalty.” -C.K.U. [Tokyo]

“I believe Japan needs to adopt a more sensible reflective approach to health care for non-Japanese, one with choice for its recipients.” -David, University Lecturer [Tokyo]

“While I am not adverse to the payment of government insurance, I do very strongly object to paying 2 years back payments for something I have never used and have taken no benefit from. It is analogous to someone going into a restaurant for dinner, and then being charged for lunch as well.” -B.C., Teacher [Chiba]

“I am already on the national system and have permanent residence, but I abhor the heavy-handed way the government is treating expatriates in this issue.” -N.F. [Kanagawa]

“I think my Japanese health insurance is great. The system may even work better than the system in the UK, but I can see that it would not be so good for temporary residents and I think people should have the right to choose. If they are going to check all non-Japanese, they should certainly check all Japanese too.” -A.C. [Tokyo]

“Most part time foreign teachers at national and private universities are teaching more classes per week than their full time colleagues - for less money and no benefits. Therefore, it is grossly unfair to pressure these foreign part-time teachers to then pay into an underfunded Japanese health system, without first insisting the employers (public and private universities) pay half the health care contributions for their part-time employees, who on average earn less per class than a full time employee to begin with. The EMPLOYERS not part-time EMPLOYEES should be targeted.” -W.R. [Osaka]

“Ultimately, the passage of this short-sighted act will hurt the Japanese economy, as it will drive away many non-Japanese workers. Aside from the obvious human rights infringement, I appeal to the government to consider such long range consequences.” -Patrick Smyre, HR Manager [Tokyo]

“Why can't it be "compulsory health insurance", instead of "compulsory social insurance"? If we have some kind of cover, isn't that all that matters? I need my private health care and don't see why I should have to pay for a service I can't or won't use.” -T.E., Student [Tokyo]

“The Japanese health insurance system presents serious deficiencies for many foreign residents, as clearly outlined in the FreeChoice position statement. If Japan is ever to achieve its goals of being a top international business center, it needs to understand these deficiencies and stop creating problems and obstacles that drive potential foreign residents to more welcoming alternatives like Singapore and Hong Kong. In any case, linking health insurance coverage with visa eligibility is highly inappropriate and is, in my view, a clumsy attempt by the government to create a bludgeon that it can use against "undesirable" foreign residents.” -J.T., Business Manager [Tokyo]

“Visas and health care are completely separate issues, and thus should not be tied to together. The government's attempt to make visa renewal contingent on public health care enrollment is a blatant abuse of power. We must NOT allow this to happen!” G.W., Univ. Lecturer [Chiba]