Visaless foreigners to be denied national health cover

by Tomoko Otake

After the Supreme Court ruled last month that it is illegal to bar visaless foreigners from the national health insurance scheme, the health ministry is mulling the creation of an ordinance to do just that.

The top court for the first time recognized that foreigners who overstay their visas have the right to join the national health insurance plan as long as they are likely to maintain a stable living, have registered with the municipalities where they reside and have applied for special residency permits.

The Supreme Court ruled as illegal a 1992 notice issued by the head of the health ministry’s national insurance plan section that excluded foreigners with visas valid for less than a year from the nation health insurance plan.

At the same time, however, the ruling states that national and local governments have the right to revise existing legislation or issue new ordinances to exclude visaless foreigners from the scheme.

“I’m not sure things will get better” for overstaying foreigners, said Kensuke Onuki, one of the lawyers who represented plaintiff Li Hsueh-shan in the case.

“The ruling basically says, ‘It was wrong to deny Li’s application based on a rule made by a (ministry) section chief; it is OK if the rule is legislated.’ “

According to Onuki, a Diet lawmaker told him that the ministry is planning to issue an ordinance “within the next one month or two” that would be similar to the section chief’s notice of 1992.

Li, a South Korea-born ethnic Chinese who has lived in Japan since 1971, had demanded that the state and the city of Yokohama, where he and his family lived, compensate him for his son’s huge medical bills, which he owes due to the city’s rejection of his application for the national health insurance plan.

The compensation demand was rejected.

The Health, Labor and Welfare Ministry declined comment on whether it plans to draft a new ministry ordinance that bans overstaying foreigners from joining the insurance scheme.

“We are still considering” whether or how to revise existing rules in response to the ruling, ministry official Yosei Kudo said. He said the ministry will soon make public its position on the issue.

Medical coverage is an issue of great concern for many overstaying foreigners, who numbered 220,000 as of January 2003, according to Justice Ministry figures.

The lack of health insurance coverage has kept many from receiving treatment at hospitals until they become seriously sick, Onuki said.

A 1994 report by Saiseikai Kanagawaken Hospital submitted to the courts by Li’s lawyers shows that many visaless foreigners had fallen into critical or terminal condition by the time they got to the hospital. The report says some patients had been refused treatment at other hospitals, even though doctors are banned from denying treatment to anyone.

The ministry has long denied insurance membership to visaless foreigners, arguing that they join the plan only after their injuries or illnesses become serious. But many municipalities nevertheless grant membership in cases of emergency on humanitarian grounds.

“Those (local officials) who deal with such foreigners in person feel they should be included in the system,” Onuki said.