It sounds like some municipalities are being much more proactive about making sure that foreigners are enrolled in the proper Japanese health insurance program.
From my analysis, it’s about time. For too many years now, non-Japanese have not enrolled–which is against the statute. But the enforcement has been so weak, that, effectively, the non-Japanese has gotten to “choose” whether or not they “wanted” the Japanese insurance or not.
As you can imagine, for someone who did enroll, and all those foreigners who do, this made it tougher for us.
1) It was more likely that an employer would NOT hire someone in the foreigner community who had the correct insurance. Because, there was some chance that that same foreigner would go into Employer’s Health Insurance, depending on how strict the ward desk was. It also means that the non-insured can underbid you.
2) At the emergency room reception, (and I know from a bad flu Christmas 2008), the staff would have a deer-in-headlights look when a foreigner shows up. They worry that the individual does not have the ability to pay the full bill right then and there. Most of these private insurances that cater to foreigners, what I now call hokey hokens, make it that the bill must be paid in full first, before they compensate. So you know, this means that there are a number of foreigners who show up with cash. The minute you pull out a company insurance card, or the local ward one, you feel the tension dissipate. They can give you what you need, without this barrier created by others.
When I lived in Japan, one of the things I was not comfortable with, was this lack of equal protection. Very quickly in the summer of 2005, I discovered that there was the real rule, and then some quirky and corrupt sh*t that got created in the foreigner community—usually for the benefit of some foreigner in a stronger position.
When Obamacare kicks in next January, the Japanese who are stateside will get covered in it, if they don’t have a company policy or one from our own private market (which we do have, but is not really allowed in Japan). There won’t be this multi-year game about how the Japanese have to have this special carveout, which allegedly is for “convenience” or “choice”, but really will just be a shadowy way to screw them while they’re here.
Good to see this development, if true. It’s one less thing to bring up to Secretary-designate Kerry’s people when we start trying to find out who in Washington is supposed to be assuring that Japan lives up to its end of totalization.