Unfortunately, the letters of David Bennet and Lee Hull (July 16) miss the point of my July 9 letter, "Added burden on hospitals." As mentioned, hospital care is provided to illegal immigrants and those approved with no right to stay, so from that standpoint, Japan indeed is quite humanitarian. But Japan is not among those countries that offset uncompensated charity health care with tax breaks.
Public hospitals can always tap central or prefectural government coffers to sustain operations. Private hospitals have no such recourse and are not tax-exempt even though they are nonprofit. With hospital closures/bankruptcies common today and most operating at a loss, this hemorrhaging of revenue has a major impact on both public and private hospital operations.
If Bennet and Hull are advocating free medical care, schooling and public services for those entering on forged passports or who intentionally overstay and live undocumented on the margins of society, then Japan might as well advertise this internationally to all who cannot afford care in their home country, and watch Japan's system collapse. The other choice is to enforce immigration laws and enroll legal immigrants in national health insurance as well as confirm their eligibility for public services.
The hospital where I work provided uncompensated or partially uncompensated in-patient care to more than 250 patients in fiscal year 2008 at a cost close to ¥40 million. This number is increasing annually. Japan may be a rich nation, but the citizens are not rich, with many elderly and unemployed people unable to pay the co-payment required, adding to the burden of providing uncompensated care to the 60,000-plus documented illegal immigrants permitted to overstay and the huge and growing number of undocumented illegal immigrants.
Something must be done to compensate hospitals before they start reporting illegal immigrants to the police/immigration authorities when they seek medical care, deny all but emergency services, or curtail vital services to the community due to insolvency. It is a problem that needs a national solution.