More about the Japan health care dodgers.

I wanted to say a few things about the incoming Kan Government here, but I’m having quite a back-and-forth on the comments of an earlier post about what Japan National Health Insurance costs for someone making 3,000,000 yen a year.

What surprises me is everytime I speak up about the benefits of enrolling in regular Japanese health insurance, I get a heated response out of certain quarters (this time: someone associated with Interac, someone with Nishogakusa University) why people should not enroll.

What I can’t quite figure out is why it should matter to these guys. It’s along the lines of “doing someone a favor by giving out real world advice”, but it seems more motivated by the fear that if everyone were doing what they were supposed to, these fellas would stick out more like sore thumbs.

It’s like tax cheaters encouraging other people to cheat, too, and then that way it won’t seem so bad that they are doing it.

If comprehensive Japanese health insurance really doesn’t cost that much more than the gap policy, and keeps people “clean” insofar as the government won’t be looking for them to back enroll in the program at a later date, then why wouldn’t you encourage people to do this?

The objections take three forms:

1) One says that if the employer won’t enroll them in the proper insurance, then they aren’t about to join the National Program. However, the cost of the employer program would be at least what they would be paying to the National Health Insurance—so it’s money they’d have to pay up anyway. It’s easier to get into an employer program if the local ward desk has you in the National program anyway, so what is the point?

2) There is some argument that “if a person doesn’t intend” to stay a long time in Japan, then “it isn’t worth it”. But the problem here is that since it’s a requirement, the longer someone stays, the longer the meter has run. In fact, it would be the exact opposite, wouldn’t it? If you only plan to be in Japan a year or two, it doesn’t make sense to screw with the system. But rather, simply to join. Then, if you turn out to stay longer, you don’t have to worry.

3) In the third instance, the argument goes to whether there is a rule to make people join, or if there is enforcement to make people join. And the “proof” is simply to say that in the past, the rule was weakly enforced.

Well, it is the rule, and from everything we’re seeing about proposed reforms from Labor and Health, it’s highly unlikely that anyone is going let people do a multi-year skirting of social insurance in the future.

So whatever happened in the past might not be argued with, but it’s not the best fact pattern to guess what might happen in the future. In fact, I’d say it’s the least likely alternative.

And from what it sounds like, the people who say they’ve managed to dodge the program for 10 or 20 years have only done so by lying. Either saying they were covered by a valid program when they weren’t, or pretending to be leaving the country when they wanted to get out of a valid coverage.

Aside from the fraud aspect, what these folks are suggesting is that you will be able to continue, in the future, to dodge the program with a similar set of lies. That’s a guess and a big risk.

One thing you have to realize is that for some people here, whatever they are up to depends upon other people also doing the same thing. They might be part of a English business that cheats on Shakai Hoken and needs other companies to do likewise—lest they stand out like a sore thumb. They might be people who’ve dodged tens of thousands of dollars of health insurance contributions, and so need to have these hundreds of non-enrolled out there, year after year, as a cover for the fact that they really owe the government serious money.