No evidence of abuse of Japan national health insurance by foreigners


Concerns over the abuse by foreigners covered by Japan’s National Health Insurance programme Kokuho have been raised but even a political working group could find no evidence.

The taxpayer funded Kokuho system includes foreigners residing in Japan for three months or more. Of 30.13 million people insured 990,000 are foreign residents.

Media reports accuse foreigners of going to Japan hiding their true intentions. Reports suggest that some claim to be there for educational purposes while others run a business and stay just long enough to acquire eligibility for Kokuho, then seek expensive medical services.

Specific cases included foreigners who entered Japan without revealing pre-existing medical conditions, which would otherwise make them ineligible for Kokuho coverage. They underwent costly medical treatment soon after qualifying for Kokuho and paid very little from their own pockets thanks to their Kokuho status.

It is possible for a person from abroad to go to Japan after being diagnosed with cancer in their home country, qualify for Kokuho, and receive medical services in Japan, and then quickly return home.

It is not illegal for a person from abroad to receive expensive medical services using Kokuho shortly after arriving in this county, so long as that person has complied properly with the procedures to acquire status as an insured under the Kokuho plan and pays its premiums.

Other Kokuho benefits under discussion include payment for overseas medical expenses.

Under the existing system, a foreign woman can receive the lump-sum birth allowance even when giving birth in her home country, if she qualifies for Kokuho coverage. She can also receive a refund for overseas medical expenses should she need a medical procedure, such as a Caesarean section, while outside Japan.

Some politicians want to stop granting the lump-sum birth allowance and refunding overseas medical fees to non-Japanese.

The system of having the overseas medical bills refunded was originally created under the assumption that the Japanese could obtain a refund for medical care received abroad. Definitive criteria have yet to be worked out when it comes to Kokuho covered medical services and related allowances for foreign residents.

Politically motivated attacks on the perceived abuse by foreigners of national health insurance schemes is common, and is used to deflect focus on poor government provision of healthcare.

The new Japanese government is probably going to set up an official review that may take years to complete.



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