Why the penalty for latecomers?
Regarding the Oct. 11 letter "Same access as Japanese citizens" (from the hospital worker whose name was withheld by request): I appreciate the insight afforded by 20 years of experience in Japanese hospitals. I have no doubt that the writer has observed many instances of foreigners failing to pay their medical bills. Clearly, the failure to pay for goods or services rendered is a crime and should be dealt with as such.
I am less appreciative of the sweeping generalization the writer makes with regard to foreigners who have not subscribed to Japan's national health plan. When I arrived in Japan 15 years ago, my employer did not make health care information available. Since I had no intention of remaining in Japan long-term, and was still paying for national health insurance in my own country as well as carrying private insurance, it never occurred to me to investigate the national plan in Japan.
Through the years I have maintained private health insurance and paid for 100 percent of my medical costs upfront and in cash when visiting Japanese hospitals, clinics and dentists. After we had a child in Japan — which required an upfront payment of several thousand dollars — my wife urged me to subscribe to the national health plan, so I visited my local ward office to investigate my options.
It was made clear to me by the gentleman at the counter that I had been an illegal freeloader for more than 10 years. I protested that I had freeloaded nothing and had my medical receipts to prove it. Nonetheless, I was told that to get on the system I would be required to submit five years of back payments upfront.
I have two questions for "Name Withheld": If it is illegal to opt out of national health insurance, why then was I able to get multiple visa renewals and finally permanent residence without ever having subscribed? And if the national health insurance system is falling apart, as some say, why would the government not welcome anyone willing to start paying in?