Why you want to sign up for Japanese health insurance.

I am not even going to put a “part number” on this one, since it’s at least number ten.

Whenever I blog about the issue, I notice I get this up-tick in hits. I dunno! What, do you people have me tagged for the one issue in Google Reader or something? How do I trigger that? By category?


Last year, when that whole Free Choice Japan thing was going strong, I mentioned about two major trends:

1) The new DPJ government coming in, which has happened;


2) The new Zairyu card.

I want to now add a third:

3) American regulation of “mini med” policies starting on January 1, 2011; with the inevitable requirement to have a real policy of coverage by January 1, 2014.

Your own country might have some different arrangement, and you might be able to work some kind of coverage as gap. I am mostly writing for Americans, or at least that’s my assumption.

[UPDATE: But, as Reader “Ken44” points out, and I elaborate below, there is an exemption available to you if you can prove either of the Section 911 “physical presence test” or the “bona fide resident test”. Since most overseas Americans forget to file a U.S. tax return, good luck with that one. Plus, at the outset, you don’t know how long you might stay in Japan. If you fail to meet the test, you’d still be hit for the $695.]

Now, here’s what you have: inevitably, the Minshuto government is going to reform health care coverage in Japan. Here, the reform is probably going to be that everyone goes into regional exchanges. The separate kosei kenko hoken plans [in the various industries] will get nationalized into the local-government run kokumin kenko hoken (since one group has all the surplus money and the other has perennial deficits), and this notion of falling through the cracks (like with the pension) is just going to be less acceptable.

This is going to happen for the Japanese, which means it’s going to happen for you.

When the current Alien Registration Card disappears in a few short years, there will be the replacement “Zairyu Card”. The government has already said that it is going to track things like health care and pension enrollment on it. Well, if you’re not enrolled, guess what?

And now, finally, for Americans: the federal government is going to have you certify on the 1040 that you have the medical coverage. Forget about this non-filer game that goes on overseas–they’re targeting that, too, and I’ll put up a link when I get a chance. The penalty for not having the insurance will go to $695, (which incidentally, is more than it costs for the first year coverage in kokumin kenko hoken.) There is no criminal penalty for not having the insurance. (There IS a criminal penalty for not filing a required tax return, by the way!)

So at some point in the future, it means two governments are going to be asking about whether you are covered or are free riding the system.

So in a few short years, it will look like this:

1) Shakai hoken gone, replaced by mandatory health coverages that aren’t work-based, and a pension system that my guess is will look like Canada’s;

2) A new gaijin card that is going to tie to a database showing that you are in the right health care coverage;

3) the U.S. government asking you if you have your health insurance, where the gap policy will not work as a “yes”.

So if these three are on the horizon, wouldn’t you want to have your ducks in a row now? Especially, when you consider that the Japanese can always back-enroll you and stick you with a huge bill?