Let's Japan.org Debunking Eikaiwa and Ramblings in Japan

If you haven't heard by now, the Immigration Bureau has officially deleted Guideline 8 and replaced it with:

"In order to promote signing up for social insurance, we will ask (foreign residents) to present their health insurance card starting April 1. We will not reject renewal or change of visa status for failing to present the card."

In other words, if you aren't enrolled in shakai hoken or kokumin kenko hoken when you go to renew your visa this year, your application will not be refused nor will they try and boot you out of the country.

The headline to The Japan Times article--Foreigners get nod to skip social insurance-- is misleading because the deletion of Guideline 8 has nothing to do with being able to opt out of social insurance. While the Free Choice Foundation is celebrating this as a victory, the law of land still obligates you to enroll in a national health insurance plan. While you'll get your visa, Immigration is still going to ask to see your health insurance card anyway.

For more, Hoofin has been all over this issue (and Ronald Kessler's case) and his latest is worth a read.

Good news if you're worried about the possibility of your visa renewal being denied due to your lack of national health insurance coverage:

The Immigration Bureau is planning to change a new guideline for foreign residents to ease concerns that those without social insurance will be forced to choose between losing their visa and entering the insurance system, a bureau official said Monday.

[...]

"The bureau will delete item No. 8 by the end of March, and 'lightly mention' the need to present a health insurance card in the introductory passage of the guideline," Immigration Bureau spokesman Yoshikazu Iimura told The Japan Times. "The wording will be in a manner to eliminate foreign residents' concerns that their visas won't be renewed if they don't have insurance."

So now the Immigration Bureau will "lightly mention" that you should be
enrolled in shakai hoken or kokumin kenko hoken. Curiously, the article passes off the change as a victory:

Foreigners and their supporters have protested the new
guideline as an infringement on freedom of choice.

I'm late talking about this, but it's worth noting given Hoofin's recent comments on freechoice.jp and health insurance in Japan. After I was asked to take down a letter from a private insurance provider that I posted here, Hoofin went out and did some digging, and came up with a lot of interesting stuff.

1. He found that freechoice.jp's Ron Kessler is connected to HealthOne Japan.
2. In addition to HealthOne, Freechoice may also have links to other sites, including Legend Travel, Legend Travelers, and Nationalhealthinsurance.jp.
3. After Hoofin starts connecting dots, Nationalhealthinsurance.jp goes offline.

If Hoofin's findings are accurate, it makes you wonder if Kessler is honestly fighting for the right for foreigners to choose between national and private health insurance schemes or if he's fighting to protect his health insurance companies or the stakes he may have in them.

The letter that I removed from the blog concluded by urging readers to visit http://www.freechoice.jp/immigration2.asp for more information.Although the page is about "breaking news," as far as I can tell, you can't access it from anywhere within freedomchoice unless you've received the letter or were told about the page by Kessler. Despite the internal fax that apparently softens Immigration's stance on having to enroll in either shakai hoken or kokumin kenko hoken, there's been no independent verification of this to my knowledge. As it stands, the revisions to Guideline 8 are still in effect and immigration offices have signs up reminding people of the changes starting in April.

Moreover, it's difficult to think that Kessler is lobbying the government for change in good faith when he writes on the main page of his website, "Free choice means having the right to choose. A non-Japanese who desires to be on public health care should also not be denied access to it." He's full of it. Foreigners are not being denied access to healthcare in Japan. It is your right and obligation to be enrolled in shakai hoken or kokumin kenko hoken If anything is wrong, it's two things: 1) ignorance by employees and 2) far too many employers, especially in eikaiwa, intentionally not informing their employees of their right to healthcare and foisting some other plan upon them that is no more than travel insurance in disguise.

Can we trust anything on the freechoice website? His claim about Guideline 8 being put on hold hasn't been verified by any other source. Given that he may have incentives to skew things toward private insurance due to his possible connections to HealthOne, the answer has to be, "No."

An LJ reader sent me this letter from his insurance company regarding the new immigration guideline which appears to confirm that the stance on the guideline has been softened. As the letter points out, not being enrolled in a public health plan is insufficient grounds for declining a visa renewal application. It looks like a lot of instructors can breathe a sigh of relief.

Update 11/28: Hoofin makes some salient points on this issue. The focus on Guideline 8 is misplaced in that it doesn't supersede the fact that the law still compels you or your employer to enroll in a national health plan while you are working in Japan. Instead of faxes from Diet members and comments from the Immigration Bureau, we should be seeking answers from the Health Ministry and Social Insurance Agency who have authority over this matter.

Update 12/7: Dmca.com has contacted Let's Japan and informed me that their client requested that this URL be taken down since I posted private and confidential correspondence intended for their client only. On that note, I've removed the letter from this post.

As you are aware, immigration guidelines are set to be changed next April so that you will have to show proof of enrollment in shakai hoken or kokumin kenko hoken when you apply to renew your visa. This is a huge issue for eikaiwa instructors as most are not enrolled in either health plan and are faced with the possibility of having to make hefty back payments upon enrollment.

This change might be on hold, though. According to Ronald Kessler, head of the Free Choice Foundation, which is campaigning for foreigners to be able to opt out of Japan's national health plans and buy their own private coverage, the revisions to the immigration guideline may be scrapped.

The Free Choice Foundation has just received word that an unpopular Immigration guideline is to be repealed.

The news was relayed via a phone call from the office of an Upper House lawmaker* immediately after he had spoken with the Justice Ministry regarding Immigration Guideline No. 8, the mandate that would have required visa applicants to present their social insurance ID cards at the application window. The lawmaker was informed that due to the large number of complaints registered - as well as the communiqué received from the Kobe City Assembly - the Ministry will be deleting (sakujo) Guideline No. 8 from the list of eight guidelines.

Kessler says that the Justice Ministry was overwhelmed by the resistance to the changes and decided to delete the guideline for the time being. No doubt a lot of instructors are going to be very relieved to hear this news.

(h/t ripslyme in the forums)

The Japan Times ran a couple of articles last week on the coming changes in health insurance for foreigners in Japan.

As you are probably already aware, starting next April, you will have to show proof of enrollment in shakai hoken (SH) or kokumin kenko hoken (KKH) when you apply to renew your visa. Jenny Uechi reminds us of the law:

If you are working for a company in Japan, chances are that you are (or need to be) enrolled in shakai hoken, in which you pay half of your health insurance premiums and your company pays the rest. There isn't much ambiguity about shakai hoken: If a company employs more than five people, and an employee is working more than 20 hours a week for a period longer than 2 months, the company is obligated to submit paperwork for an employee's health insurance and pension to the Social Insurance Agency within five days of hiring. With shakai hoken comes the kosei nenkin, or pension plan; the two are a set, and enrollment is mandatory whether you plan to retire in Japan or not.

Meanwhile, people who are unemployed, self-employed, employed by a small firm or retired should be enrolled in kokumin kenko hoken (national health insurance). People paying into this system have to sign up on their own for kokumin nenkin (the national pension) at their city ward office.

Unfortunately a lot of English instructors are unaware of the law and find themselves in a position like "Patrick Johnson:"

Patrick Johnson (not his real name), an assistant language teacher, has recently had to fork out over ¥700,000 in back payments for the last two years he has been living in Japan without national health insurance. He has just paid his final monthly installment of ¥75,000, he explains with a tired sigh of relief. He used to pay for private insurance, but has left the scheme now he is covered by kokumin kenko hoken.

Johnson, who works for a large corporation with far more than five employees, is well aware that he should technically be enrolled in shakai hoken, where his company pays 50 percent of his premiums. But because his contract states that he only works 29.5 hours — well over the 20-hour limit but .5 of an hour below the limit that usually triggers a government crackdown — the company can instead oblige him to sign up for the other option, where he has to bear 100 percent of the cost.

"You know how the system works," he says wearily, as though hour-fudging is a given in Japan's language-teaching industry.

Johnson reflects on his experience with more resignation than rage. Last year, he says, the city started sending letters asking him to pay health insurance. Since he already had private coverage through his company, he did not think much of it, but started panicking when the city approached his company asking for his bank information. Then one day it happened — he saw ¥50,000 had vanished from his bank account

His experience is typical of most instructors. They are generally unaware that their employers should be enrolling them in an insurance scheme and are surprised to learn that they owe up to two years in back payments when they finally do get properly enrolled. This is also one of the reasons why many would like to avoid SH or KKH--they are expensive.

Which brings me to Ronald Kessler's Zeit Gist column in which he argues that foreigners in Japan have special healthcare needs and that for vital reasons of communication, level of service, and repatriation of remains, foreigners should be able to presumably opt out of SH or KKH and choose their own plans.

There are a few problems with Mr. Kessler's argument, however. First, enrollment in SH and KKH is mandated by law, and, lke taxes, you can't choose to not pay. He also forgets to mention that if foreigners do need extra coverage, they can get it from one of Japan's private insurance companies. This is in fact what many Japanese do to cover the gap between SH or KKH should they be hospitalized for an extended period of time. Moreover, he fails to provide any specifics as to what other health insurance plans make them preferable to Japan's public ones. What are the cheaper and more comprehensive health insurance plans? Are they universally accepted across Japan?

One point I agree with him on is that it is curious that Immigration, not the Social Insurance Agency, will effectively be enforcing enrollment. This shifts the burden of enrollment on the instructors, not their employers.

If the government wants to enforce enrollment in this odd manner, then that's there prerogative. Personally, I don't see this an issue of choice insomuch as it is a labour issue. As has been mentioned on LJ before, employers play fast and loose with working hours, drawing up 29.5 hour work weeks so they can avoid having to enroll their instructors in a health plan even if their instructors are physically at school on a full-time basis.

Instead of putting the burden on instructors to enroll, the Social Insurance Agency should be cracking down on the schools who shirk their legal obligations.

One thing is for sure, there will be more than a few instructors who are hit for back payments when they are ultimately forced to enroll. There may even be a few who are unable to renew their visas.

It's time for instructors to be prepared. If your visa is up for renewal next spring, make sure you have some money set aside in case you are have to make back payments. While costly, you can negotiate with local governments and set up a payment schedule that fits your budget or even get your payments reduced.

It's also time to start making some noise about your working conditions. Even "Patrick Johnson" knew his employer was gaming the system yet he turned a blind eye. Don't let your employer rob you of your right to healthcare in Japan. For all its warts and deficiencies, SH and KKH cover you, no questions asked. The choice involved here is not which plan is better for foreigners in Japan, but choosing to stand up to your employer and demanding your right to healthcare coverage.

The Japan Times has a good summary of the issues surrounding the changes to the visa renewal process starting in April 2010. I blogged about this a while back, but the Japan Times column covers some of the implications of having to enroll in an insurance scheme in order for foreigners to renew their work visas.

Louis Carlet, deputy secretary of Nambu, laid it down for everyone in the room to understand. There are a few basic things that all foreigners in Japan have to know, he explained: first, that everyone over the age of 20 in Japan is required to enroll in an approved Japanese government health insurance scheme and pension fund. If you are under 75 and working at a company that employs more than five people, this most likely means the shakai hoken (social insurance) program; if you are unemployed, self-employed or retired, the equivalent system is the kokumin kenko hoken and kokumin nenkin (national health insurance and pension). The only people exempt are sailors, day laborers, and those working for companies employing less than five people, or for firms without a permanent address (e.g. a film set).

The two systems cover different ground, all of which is explained in detail at www.sia.go.jp/e/ehi.html. Roughly, shakai hoken consists of two parts: kenko hoken (health insurance), which covers 70 percent of your medical costs and 60 percent of lost wages due to illness, and kosei nenkin (pension insurance), which provides a pension after age 65 for those who have paid into the system. The two are inseparable, and anyone enrolled in shakai hoken through their employer automatically pays into both. The kokumin kenko hoken (national health insurance) and kokumin nenkin (national pension) package offers similar coverage but is not provided through an employer.

The bottom line is that all residents of Japan (except those mentioned above) have to be enrolled in one or other of the two systems. The revised visa laws, therefore, should pose no threat to anyone's visa renewal, because every foreigner in Japan should already be enrolled.

It has long been standard practice within eikaiwa to skirt enrollment of instructors by limiting the working hours in contracts. For example, the contracts Chris and I signed back in the day stated that we agreed to teach up to 28 hours of classes a week. The 28 hours is important because the law stipulates that companies must enroll employees in shakai hoken if the employees work 30 or more hours a week.

In 2005, NOVA brazenly changed working conditions by shortening lessons to 40 minutes and adding 2 minutes of "planning" on either side of each lesson. The net result was more unpaid free tie between classes and instructors working fewer than 30 hours per week. It was a move that supposedly saved NOVA at least ¥1 billion a year in insurance contribution payments.

Enrollment in social insurance is not without its drawbacks. Many would question the wisdom of having approximately ¥30,000 deducted from their paychecks every month, especially if they know they won't be living in Japan long enough to collect a pension. Moreover, if you've never paid into shakai hoken, you may wind up paying up to 2 years in back contributions.

That said, the benefits outweigh any initial pain. For one, you will be enrolled into a health and pension plan you are legally entitled to, and you'll avoid looking foolish like the people at the beginning of the article who didn’t know anything about social insurance in Japan or were dissuaded from joining it.

There is also recognition. Recognition that you are a full-fledged employee entitled to the same benefits as other Japanese workers. This could translate into better working conditions and improved job security. Most importantly, you are covered. No more worries about hospital visits and fewer worries about pension contributions. As the article points out, pension contributes can be refunded, but the maximum amount tops out at 3 year’s worth of contributions.

That doesn’t mean all is lost for long term residents, however. You need to check with your government and find out if it has a pension agreement with Japan. For example, Canada and the UK have them, meaning that contributions paid in Japan count toward your pension back home.

This is a positive development for workers, but it does make you wonder what took so long for this to become a reality.

This should be a story about a candidate for the Darwin Awards:

With a belly full of food and sake, Armand Nelson Schneider just wanted to get rid of his nausea and empty his stomach before hopping on a train back to his study-abroad home in Yokohama, Japan.

Schneider, 22, was throwing up over the platform when a high-speed commuter zoomed into the station and smashed into him.

Fortunately for Armand, someone pulled him back just enough to save his life. Unfortunately, the train hit him so hard that it's left him a little delusional:

"It's a miracle," his mother said. "This kid should be dead."

Schneider said he doesn't struggle with alcohol and has always been a safe drinker -- his mother calls him "Mr. Responsibility."

"There's no denying I was very drunk," he said. "But I don't think the accident was caused by that."

Riiiight. Alcohol had nothing to do with sticking his head over the tracks and puking. But the point is not to ridicule Armand. Rather, this passage caught my eye:

His recovery, however, wasn't as fast as he had hoped. Schneider stayed in the Japanese intensive care unit for 12 days, kept his spot in the ward for four weeks and was moved to a nearby rehab facility for another four weeks. Nelson stayed by his side -- along with the Japanese nurses and doctors who "fell in love with him" -- for a month.

Endless droves of friends and his Japanese family members visited him often. His Oregon study-aboard peers folded him 1,000 origami cranes, following an ancient Japanese fable symbolizing a speedy and safe recovery.

Nelson returned to the United States after "I saw him get out of that hospital and go upright." When she returned to Japan weeks later, the doctor gave Schneider the surprise go-ahead to return home with his mother.

Nelson said she was prepared to make a hefty payment -- above $300,000 -- for the months of care. Instead, she said, they informed her of the national health care system and asked her for about $3,000.

"Twelve days in the ICU would have cost a quarter million in the United States," she said.

There were some trade-offs for the less-expensive treatment, Schneider said. For instance, he had to pay for meals and to use the TV and refrigerator. He also had to share a bedroom with six people, and pay for his pajamas and diapers.

"But you're happy not to have the frills to walk out with no bills," Schneider said.

And, he said, his treatment was unparalleled.

"I thank God he was in Japan when this happened," Nelson said.

The United States is currently grappling with health care reform that would introduce some kind of universal coverage, with Canada's system frequently held as an example. The typical arguments against universal coverage range from 1) it's run by the government and therefore bad, 2) long wait times for elective surgery, and 3) it costs too much. These "arguments" are all silly. First, the Canadian government doesn't run health care, it pays for it. Doctors bill the government and doctors what treatment to give. At no time does the government step in and decide who gets treatment and who does not. Wait times are an issue in the Canadian system, but waiting for an elective procedure is far better than not getting any treatment at all. Costs, too, are always an issue, but even though there are more Americans without health care than there are Canadians covered, Canada still manages to spend less per capita than the United States.

Had this accident occurred in the US, the mother would probably be paying off the bill for the rest of her life. As a Canadian, I can't figure out why the US hasn't gotten around to adopting universal health care. This accident seems like a good reason for it--you shouldn't have to face financial ruin to get medical treatment.

(via FG)