Alleged abuse of national health insurance system sparks probe into foreign patients

The Health, Labor and Welfare Ministry is checking with municipalities to investigate cases involving foreign visitors who inappropriately acquired residential status to make themselves eligible for public health insurance so they can skirt costly medical fees, the sources said.

The ministry will compile the findings this autumn and discuss prevention steps. The insurance system was not originally designed to take into account a time when foreign people would be receiving medical services.

Japan had about 2.56 million foreign residents at the end of 2017, a number that has climbed every year since 2013, according to the Justice Ministry. Nearly half are Chinese and South Koreans, at 29 percent 18 percent, respectively, with Vietnamese and Filipinos following at 10 percent each.

The national health insurance program requires that policyholders shoulder 30 percent of their medical costs, in principle. The remainder is covered by the policy, which is funded by the payment of monthly premiums.

By taking advantage of the benefits of a special Japanese scheme for exorbitant medical bills that caps the size of monthly payments, policyholders can reduce the cost of expensive treatments by several tens of thousands of yen a month.

A Chinese man in his 60s made himself one such beneficiary of the scheme.

Shortly after coming to Japan, the man visited a hospital in Tokyo last summer, accompanied by his son, who resides here. The man was listed as a dependent, thus entitling him to health insurance benefits.

After undergoing surgery and postoperative chemotherapy, his medical bill came to ¥3 million. But thanks to the special scheme, he only paid ¥80,000 and promptly returned to China, leaving the insurance system to pay the rest.

Experts believe such practices, whereby people who have never paid insurance premiums can receive expensive medical treatment on the cheap, hurt the public health insurance system.