By Yuta Abe / Yomiuri Shimbun Staff WriterThe decision by the government and the Liberal Democratic Party to tighten the criteria for the nation’s public health insurance system and rectify the deficiencies of the current system falls in line with the prospect of accommodating a greater number of foreign workers.
A series of problems related to the nation’s social security system has been raised among local governments and other entities that deal with foreign residents.
There have been reports of foreign nationals coming to Japan ostensibly to obtain residence status as students or technical interns, though their main purpose is to receive medical treatment.
The current health and welfare system allows anybody who is covered by the national health insurance policy, the National Federation of Health Insurance Societies, or the Japan Health Insurance Association to have 70 percent of their total medical expenses covered. The National Federation of Health Insurance Societies covers those who work for large corporations while the Japan Health Insurance Association covers those who work for middle and small sized companies.
There is also a High-Cost Medical Expense Benefit for extremely expensive treatment, whereby the cost is subsidized based on a patient’s income. A government official has said that the Japanese medical insurance system is “prone to abuse, because of its generosity.”
There have been cases of patients visiting medical institutions and presenting another person’s insurance card.
An LDP working group researching on the healthcare of foreign residents heard from a Kobe city official in August this year about a case of impersonation, in which a Vietnamese woman illegally living in the city used her sister’s insurance card to receive HIV treatment for two years.
This case was discovered in 2014, and the total expense of the treatment, which the patient had partially paid, cost more than ¥10 million. Her sister was a member of the national health insurance system.
It is difficult for medical institutions to verify the identity of patients as insurance cards do not bear ID photos.
The Health, Labor and Welfare Ministry began this year to investigate such fraud cases. But they have made little progress due to the difficulty of establishing the health conditions of foreign nationals and their family members prior to arriving in Japan. They are yet to identify any cases of fraud.
The LDP’s Health, Labor and Welfare Division called on the government to make efforts to explain thoroughly to foreign nationals the mechanisms, as well as the application procedures, of the pension and medical insurance systems.Speech