The Cabinet of Prime Minister Shinzo Abe approved a bill Friday that will make Japan’s health insurance program for employees applicable only to workers and their dependents residing in the country, to prevent abuse by people from overseas.
Japan is seeking to revise the system as it prepares to open up and accept more foreign workers from April. The planned revision is aimed at blocking the use of the national health insurance by foreign nationals who have never lived in Japan, including relatives of incoming laborers. The new insurance system is expected to take effect in April 2020, a year after Japan starts accepting more blue-collar workers under a new visa program aimed at tackling labor shortages caused by the rapidly graying population.
The employee health insurance system covers workers’ dependents living abroad, but authorities have faced difficulty when checking whether the dependents are actually kin or just people who are financially dependent on the workers.
Medical workers have reported cases in which foreign nationals received expensive health care treatments or services while claiming to be family dependents of workers in Japan but were not. In those cases the costs were partially covered by the Japanese insurance system, prompting some conservative lawmakers to call for a revision.
As exceptions, the health ministry plans to introduce ordinances to allow health insurance coverage for those temporarily living overseas for study or work, regardless of nationality.
The Cabinet also approved a bill to amend legislation so people can present their national My Number ID cards in place of the standard health insurance certificates for the state-run program. Japan plans to introduce the system from March 2021.
Through another law revision, the government also aims to link state medical and nursing care databases, and provide anonymized information to users such as research organizations and drugmakers for a fee.
In the face of a graying population and falling birthrate, the Diet passed a bill in December to attract foreign workers to labor-hungry sectors including construction, farming and nursing care. It marked a major policy shift for the country, which had effectively granted working visas only to doctors, lawyers and others with professional knowledge and high skills. The number of foreign workers in Japan had tripled over a decade to a record-high 1.46 million as of October, according to the labor ministry.
The new visa system allows foreign workers aged 18 or older to apply for two new resident statuses — Type 1 for people who will engage in work that requires a certain level of knowledge and experience, and Type 2 for work that requires higher skill levels.
Those with the first type, which is valid for up to five years, will not be allowed to bring family members to Japan. Those with Type 2 status will be allowed to do so, as well as renewing their visas indefinitely.
Under the new visa system, Japan will accept up to around 345,000 over the next five years. But it is far from certain that the numbers entering will reach the level desired by the government.
For example, the government has said it expects to accept up to 60,000 caregivers over five years — a projection some experts call overly optimistic in the face of competition from other countries, such as Germany, Singapore and the United States, which also have a shortage of care workers.
Without taking into consideration the expected influx of foreign workers, a ministry panel forecast that the country’s workforce could drop 20 percent by 2040 from 2017.