TOKYO -- The government's draft revisions to the Health Insurance Act will restrict dependents eligible for national health insurance coverage to those residing in Japan in principle, in response to changes in immigration policy slated for April to accept more foreign workers into the country.
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In response to the recent revisions to the Immigration Control and Refugee Recognition Act to expand the number of foreign laborers, the government has been considering revisions to Japan's public health care system to prevent its misuse. The limit to dependents in the country is the main pillar of these changes, and the government plans to submit a bill to this effect to the ordinary session of the Diet set to open later this month.
Under Japan's public health insurance system, foreign nationals who have come to Japan for work or study are required to sign up to health insurance based on their residency status. As the revised immigration law stipulates expansion of the acceptance of foreign laborers, such workers should enroll in the health insurance offered by their employers. As workers are enrolled through companies and other businesses, it does not fall under "fraudulent medical purposes," but family members residing in a foreign citizen's home country are also eligible to enroll. Due to this fact, many worried that foreigners may claim someone was family back home in order to falsely have the individual covered by the Japanese health care system.
According to the draft revisions, the Ministry of Health, Labor and Welfare will add the stipulation that the dependents of foreign workers must be "residing in Japan" in order to enroll in the health insurance system. In this case, Japanese children who go abroad to study or other dependents that accompany an employed family member on foreign assignment will also be excluded from eligibility for the domestic health care system. However, if among these persons, "family recognized as living primarily in Japan" stay abroad temporarily, they will be recognized as dependents in exception to the rule. Those eligible for this exception will be decided at a later date by a ministry order.
Additionally, concerning lessening the individual burden for health care costs under the government's "high medical cost system," concerns were raised during Diet debate for possible cases of foreign nationals coming to Japan on false residency statuses or other conditions and enrolling in national health insurance through their municipal government and misusing it. In response to this, the draft revisions call for the expansion of surveys by local governments to request the attendance records and other information about foreign students enrolled at Japanese language schools.
The government also plans to tighten up the selection process for the distribution of a one-time payment for the birth of a child in the case that the mother was a dependent who gave birth abroad. Even for those living in Japan, in order to prevent misuse of the health care system by impersonation and other fraudulent acts, requiring the submission of identification along with health insurance cards for confirmation is also being considered.
(Japanese original by Masahiro Sakai, Medical Welfare News Department)