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Letter from an Insurance Company Regarding Guideline 8

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.

Comments

I always found the Free Choice Foundation arguments a bit strange. Despite their attempt to mask them in high and mighty moral terms, distilled it always came down to "I'm too bloody cheap to pay".

Now with that letter from the insurance company praising Free Choice's hard work I wonder if private insurance providers were funding or assisting the foundation in any way.

Is there any information about this issue from sources OUTSIDE the Free Choice Foundation?

They have a big interest in getting the directive scrapped - and whouldn't you know it - all the news about it being scrapped is from them!

Why would the government scrap the guideline? Because of a few objecting non-voting gaijin? It would boost the numbers of people enrolled in Shakai Hoken which they desperately need - Kokumin Hoken as well.

I wonder if the Free Choice Foundation feel the same way about National Health in the UK?

http://hoofin.wordpress.com/2009/11/27/japan-social-insurance-kessler-fr...

Like I've been saying on the blog, regardless of what the Justice Ministry or the immigration bureau says about Guideline Eight, it will still be up to the Labor and Health Ministry as to whether so-called private insurance is OK.

What Kessler's group is doing is confusing historical Labor and Health ministry non-enforcement with this "being OK" to "opt" for private insurance.

Come April (or before), it could be: here is your visa, here is your bill.

Kessler won't contact Labor and Health to get the definitive answer. Why not?

I also agree with your suggestion that corporate sock puppetry mayb be going on. The insurance guys don't want to lose that nice business, especially since the real health insurance backstops them on catastrophic losses.

The deal with the government is that they're not overly keen on seeing a bunch of foreigners sign on to National Health for a year or two and then claim back whatever contributions they've made at the end of that period (it's really f---ing troublesome for them).
What many foreigners might want to realize sooner than later is that private insurance is ultimately not such a great deal: you'll never be too sure what you're covered for (since few people ever check the fine print) and your health insurance needs are in the hands of a private, for profit organization... Is this really a good idea? Unless you're young and healthy (and I mean under thirty and fit as a marine) you'll want to consider your health insurance needs more seriously.

I've been with the national since I got here 6 years ago (wether I was paying on my own or with a company) and it's been good. I show my card, they take it, I get what I need, and that's that. No problems trying to figure out if my insurance company will cover the expense or not, and no having to front to cash either. It costs a little money (premiums are more expensive usually), but that's the last of your worries when you suddenly need a doctor. This is definitely one area where you should not cut corners.

National Health might be OK for regular ailments, but for bigger things like operations or long-term illness, you might find yourself running into problems with regular Japanese doctors who aren't well-versed in the different needs of foreigners. In that case, you'd be better seeing a private specialist who knows more about treating foreigners, or maybe even returning home for treatment. And with Shakai or Kokumin Kenko, you won't be covered for those things.

As you said, maybe not so bad if you're young and healthy and only in Japan for a short while, but otherwise, Social/National Health Insurance may not cover all your needs.

Just out of curiosity, what kind of different needs are you thinking of? Pre-existing conditions?

Shawn
Let's Japan.org::Blog

One problem I've seen is that Japanese medication doesn't always have the desired effect on Western body types due to different genetics (there were some posts on this in the forum a few months back). Having said that, I'm not familiar with the set-up with the private clinics in Japan and how well equipped they are to deal with that.

I also get the impression that Japanese operations aren't up to what you can get in the West. Some of ops that they do in Japan are like what you got back home about 25 years ago, and require a longer hospital stay, convalescence and time off. I think in those cases - big operations or long-term illness - you're better finding a doctor in Japan experienced in those types of Western-style ops, which might not be easy, or else going back home to get it done.

What exactly makes Japanese medicine "inferior" because of Western genetics? It sounds like something McCoy would say on Star Trek about Spock.

I don't want to imply it's total nonsense (hogwash, etc., ehem) without a response, but "genetically" Japanese only showed up, what, 1500 years ago as a distinct ethnicity? What is it about Japanese physiology that makes the medicine more effective? Dark hair?

In terms of technology, I was suprised to have my molars X-rayed and the shots e-mailed to me a couple years ago by a Roppongi dentist. In 1984, (25 years ago), no way could you get a low-invasive x-ray at all.

No offense, but people who don't want to pay a health premium they can get out of become very creative with the excuses.

Although the Immigration Dept can't deny a visa "solely" on the basis of not having national health insurance, can it be one factor that some immigration bureaucrat will use in some unwritten score/point system, the sum total of which determines whether you are worthy? Still, there probaly won't be a flood of visa denials, but case-by-case, a good number of people are probably going to get grief from the semi-random application of rules by the individual bureaucrats. Giving them another "guideline" or non-guideline, just gives them yet another excuse to make applicants jump through hoops.
[This coming from me, who had to visit the immigration office 7 times just to get a visa staus change, because they kept changing the requirements arbitrarily, and then finally just had me renew under my original status with a single 1 page form. I hate Immigration bureaucrats!]

I suspect this is especially true in the nebulous Permanent resident visa process.
If you're trying to get a PR visa and not enrolled in national health, can't they just take that (correctly) as a big sign that you're "not integrating" into Japanese society?

Hoofin,

The medicine in Japan is weaker. I don't know the specifics but if you look it up, I'm sure you'll find what I'm talking about. Some kind of genetic difference which makes chemicals act more quickly on Asian body-types than on Caucasian. It's the reason Japanese generally can't handle their drink, and why medicines can be not-so-effective for Westerners.

The same thing works in reverse. A Japanese living in the West will most likely find that the medicine is very strong and fast-acting.

I'm not saying you should definitely go private because of this, but it's something you need to be aware of, especially if you're putting 8% of your hard-earned cash into the Japanese health system. Likewise, I wouldn't just go private because of it until you've researched what private health clinics in Japan can offer you, and for what cost.

I've heard stories about the medicine being weaker than in the West, but I've yet to read anything to confirm that. I also have my doubts about hospital care, too. I can only judge it from my own experiences and overall it isn't so bad. My family and I have always received good treatment and the doctors explained everything. I agree that when it comes to long-term care, you may be better off returning home simply to avoid any language issues, insurance problems, and to be closer to friends and family.

Shawn
Let's Japan.org::Blog

Medicine in USA is in some ways more effective. But the main reason is NOT the medical/insurance system itself. In the USA (I'm from America) people are much fatter. That and the fact that people have more high-speed accidents keep orthopedic surgeons quite busy (regarding obese people: wearing out hip joints, for example). I read that to specialize in orthopedic medicine in USA you have to be accepted into a very competitive field and it could take an extra year compared to other specialties. I heard from a Dr/student of mine that orthopedic medicine is not as intense here in Japan -with obvious reasons.

Saturday night at the ER would seem to be quite quiet in a Japan ER while in Los Angeles, for example, you have gun fights, stabbings, drunk driving accidents, bar fights, and so on. And obesity obviously brings on a lot of other ailments other than worn out hip joints. In at least one US state there is no helmet law so that keeps the skills of surgeons who specialize in head trauma quite tuned. Trauma docs train in level 1 trauma centers before going to Iraq/Afghanistan and NOT vice versa. It's true Japan can in no way compete with USA with trauma care because Japan does not have so many trauma cases to warrant such an expensive part of a medical infrastructure. Ain't it great? Life is so safe here!!! But I'm sure if somehow drunk driving crashes increase by 10,,000% the J. govt. would focus resources to take care of these people (I mean injured accident victims).

Any developed country will attempt to focus on an urgently needed and lacking medical need to (again attempt to) bring it up to a world standard. I remember reading Japan was lacking in neo-natal care so the J. gov put some resources in it. In Germany I was really impressed with the rescue system for Autobahn accident victims. And so on. Japan has a great system. But if you are non-Japanese and quite obese and expect a lot of future problems from that then maybe you are better going back home-assuming you can get medical coverage that won't make you go bankrupt. One more example. My friend back west had testicular cancer (not so common among non-whites) so if you are a white man in Japan with aching balls then you might not be in the right country- but still major cities like Osaka/Tokyo (I heard) have major cancer centers which can help you out.

If you have a serious medical worry in Japan then it's probably best to go to a big central hospital.

I agree medicine in Japan is weaker. I guess Michael J. would know about that. So would Anna Nicole Smith (and her son). But others would say that in other countries like USA people are really drugged up (which I agree that I would rather take care of myself so I don't need so much of that pharma crap in my body)

Doesn't matter what the medicine is, you will get the same whether you have public insurance or not.
By the way, Public insurance does cover a percentage of the medicine too.

And in these days of companies going bust left right and center, how sure are you that your insurance company won't be next?

My vote is for Shakai Hoken over private (or Kokumin) health insurance any day.

Some of the arguments on here and other sites seem motivated by certain agendas, namely the lefty Union agenda that all companies should enrol their workers and not get away with breaking the law; or the righty "free choice" agenda that it should be left up to individuals to choose for themselves. One side pushing for the more socialist way of things, the other the more conservative/libertarian way.

I started out on JMA then Interglobal, then later moved on to KKH, basically because I think that following the law usually saves you less hassle in the long run (such as being stung with 2 years of back-payments if the govt ties it to visa renewal).

Having said that, I don't think non-permanent residents should be made to enrol in it. I know people working for foreign companies in Japan with private medical schemes that get provided by their company, at no cost to them. Is it right that the health service would also get 8% of those people's wages for themselves, when those people aren't going to require govt. insurance and aren't permanent residents?

Doesn't matter what the medicine is, you will get the same whether you have public insurance or not.
By the way, Public insurance does cover a percentage of the medicine too.

The evidence I've seen suggests that the medicine is weaker. In which case, if you've only got Japanese social insurance, get sick and get put on a course of medication, it could well take longer to recover, or even not at all.

There's certain "foreigner-specific" problems which I don't think the Japanese system is equipped to deal with.

Are you saying these "foreigner-specific" problems IN JAPAN could be dealt with IN JAPAN but only if you are NOT in the Japanese single payer system? So in other words if you are enrolled in private provider like Global (and you are a non Japanese) they can somehow get you better treatment (in Japan) that is out of reach for people enrolled in the national system?

What evidence? Or specifics? I have one. I know that there is Oxycodone available in Japan but it is very tightly controlled and one of the few places you can get it is at an Oncology Dept (source: from my private student who works in pharma). Vicodin is illegal due to a compound that is illegal in Japan. So you can't get that anyway even if if a private insurer was willing to pay for it. If you have that much pain then they give you more personal medical service in the hospital (with the necessary pain meds if needed) instead of sending you out the door with powerful pain meds that you administer yourself.

I've seen someone end up with an extended hospital stay and I suspect it was because the antibiotics he was given weren't very effective, due to reasons I mentioned earlier. There was also a thread on the main forum in which somebody mentioned they got ill in Japan but the medications they were given didn't work. I've found that headache and cold remedy from Japanese pharmacies doesn't work particularly well either.

I'd say there's plenty of evidence to suggest that medicine is weaker, plus, as I said before, it seems to me that the operations done back home are more efficient, less messy and less time-consuming. For these reasons I wouldn't just rely on the Japanese health system. I'd take out extra private cover, or keep up your National Insurance payments back home, so that you're covered if you run into trouble.

It probably doesn't matter so much if you're younger, don't get sick much and aren't injury prone. Otherwise, it's something that you need to think about. Whether private clinics in Japan can help you out, I really don't know, that's something you'd have to look into.

if you want to get rid of headcahes try Bufferin Plus. Worked like a charm every time for me!

National Health might be OK for regular ailments, but for bigger things like operations or long-term illness, you might find yourself running into problems with regular Japanese doctors who aren't well-versed in the different needs of foreigners.

If this is the case, it really has nothing to do with the insurance provider, but rather the doctor(s) in question. Having private insurance will not mitigate the inexperience of a Japanese doctor with a new or different medical condition he has not encountered before.

In that case, you'd be better seeing a private specialist who knows more about treating foreigners, or maybe even returning home for treatment. And with Shakai or Kokumin Kenko, you won't be covered for those things.

The Kansai region has a free medical help-line where you can call and ask for English-speaking doctors; virtually every time I have used it, they have pointed me towards a doctor that not only speaks English but has either studied and/or practiced abroad as well. And if said operation is a medical emergency that cannot wait, travelling several thousand miles to your home country, seeing a specialist and then booking surgery is not a realistic option.

if you're young and healthy and only in Japan for a short while, but otherwise, Social/National Health Insurance may not cover all your needs.

Just as private insurance in Japan might not cover all your needs either, especially if you have any pre-existing medical conditions at all. You also run the risk of not having the private insurance accepted at whatever medical facility you are at, or it will take one heck of fight to do so.

There are foreigners who are quite satsified with National Health Insurance. I happen to be one of them.

You also run the risk of not having the private insurance accepted at whatever medical facility you are at, or it will take one heck of fight to do so.

This has never been a problem for me using my private insurance in Japanese hospitals and clinics. Show them the colour of your yen, and they are more than happy to accept your business - occasionally they smile too! It's all about the yen, buddy. Heck, Japanese doctors even accept "gift money" for performing operations! (most gaijin rightly don't pay this, though).

If this is the case, it really has nothing to do with the insurance provider, but rather the doctor(s) in question. Having private insurance will not mitigate the inexperience of a Japanese doctor with a new or different medical condition he has not encountered before.

I see your point. It's not a question of whether you're getting public or private health insurance, it's a question of the experience of the doctor, and what facilities, medications etc a particular clinic can offer you.

The Kansai region has a free medical help-line where you can call and ask for English-speaking doctors; virtually every time I have used it, they have pointed me towards a doctor that not only speaks English but has either studied and/or practiced abroad as well.

But that doesn't necessarily mean that, for example, you'd get "Western strength" medication, antibiotics and the like, or that he'd have adequate experience to treat your particular ailment.

Just as private insurance in Japan might not cover all your needs either, especially if you have any pre-existing medical conditions at all. You also run the risk of not having the private insurance accepted at whatever medical facility you are at, or it will take one heck of fight to do so.

I've not heard of anyone having their private health insurance rejected. I wouldn't have thought a clinic would dare do that. I know people at foreign companies who are automatically enrolled on private health schemes by their company, at no cost to them. Reputable, international companies wouldn't put their employees on a private scheme if they thought that a hospital might reject them.

At the end of the day, I think that non-permanent residents should be allowed to choose between private or public insurance. I don't think it's right that someone who isn't living or working permanently in a country should be forced to pay into the public health system.

I personally know a couple people who were outright refused at a hospital because they were on private insurance instead of national. The hospital just didn't want to deal with it. It happens.

Didn't the old NOVA JMA insurance only cover a certain ailment for 6 months? And if someone got really sick or pregnant Nova used to trot them down to the Shakai hoken office and enrol them? (This led to only sick foreigners joining the national health from Nova)

Could you imagine the outcry if this happened in your country?

But that doesn't necessarily mean that, for example, you'd get "Western strength" medication, antibiotics and the like, or that he'd have adequate experience to treat your particular ailment.

"Western strength" medication is hard to come by in Japan because, simply put, it's not the west. There aren't all that many non-Japanese living here, so medication that many of us would find familiar or are back whereever we come from may not be found here. Again, I fail to see how having private medical insurance will mitigate what is clearly a supply issue. As for the experience issue, granted, having an English-speaking Japanese doctor does not guarantee he will have adequate experience in treating your particular ailment, but that also goes for back home (whereever that may be). In addition, the Kansai free health service usually provides you with more than one option (depending on your location; they try and find doctors who are closest to the station of your preference). If you don't like the care you are getting, you have the choice of seeking treatment elsewhere-or getting a second opinion. Just like back home.

I've not heard of anyone having their private health insurance rejected. I wouldn't have thought a clinic would dare to do that.

I have. I used to work with people who had that happen. Just because you haven't heard of anyone having their insurance rejected doesn't mean it doesn't happen.

At the end of the day, I think that non-permanent residents should be allowed to choose between private or public insurance. I don't think it's right that someone who isn't living or working permanently in a country should be forced to pay into the public health system

Well, ultimately it doesn't matter if we think it's right or wrong-it's the law. You are legally required (as far as I know) to pay into one of the two national health care schemes in Japan. Whether we like it or not, it is as much of a legal requirement as it is to pay taxes.

I'm sure there are cases where someone dying in Japan could have been saved in a western country and probably vice versa. It's pretty good here- I've heard people claim the system is "decades behind USA", etc. and that's stupid. People live quite long. But one important reason is people are less fat and get off their asses more often than back west. It's so bad in USA that some teenagers are starting to get type II diabetes. And it was reported that some children today are predicted to have heart ailments when they reach their 40s or even 30s the way they are going with their current Fruit Loops diet. Once I heard a Japanese man returned for stomach cancer treatment in a J. hosp even thought he was insured to be treated in USA- this makes it a two-way street. I've been here long enough to see that personally anyone who was dying here would have died back home too (stage 4 lung cancer, inoperable brain cancer [that particular patient even looked into that experimental brain treatment that the fictional Dr. Green had on the drama e.r. but she was not a suitable candidate], and one person who had a sudden massive massive brain ailment and died even when he was quickly taken to an e.r. that specializes in strokes and such).

Anyway, if you are a gaijin living in Japan that means you are around less fat people so you will be less fat and in the long run will have less health problems so in many cases the J. system will be adequate. Back west if you return to your fat friends (all my friends back west are very fat) and all the other fat people around you like co-workers then you will probably become fat too and need med. care at a more intense caliber. So stay in Japan walk more, eat more fish and less pizza and that should be your best medicine. If you really are afraid of your safety from a bad dr. (and you really don't have to be as there are medical nightmare stories in all countries) then go ahead and do what you think is right with the private care- if you can rely on it. But personally I'm a little more long term and I'm not fat so I'll stick to the normal system of national health care/shakkai hokken.

And if you have some pri. care and in the rare event you are hit by a train and have both legs and arms knocked off and are put in ICU forever, don't worry once your pri. care ends the boring national health care will take care. That is how I have the opinion that they are a bit parasitic- can you really rely on them for the very very intense and long-term care like that?

Eikaiwa Ripper, I wonder if you are cherry picking. What you say sounds more based on emotion rather than hard evidence. I assume you are not a physician but are you claiming you made a valid medical diagnosis on someone who may have not been given enough antibiotics? People stay in Japanese hospitals longer anyway even if patients don't want to. But if you are somehow a dr. then can we assume this "someone" had a bacterial infection? Did he have a staph infection? What really happened? Because this is a big debate in US hospitals as a lot of patients there get nasty staph infections that are resistant to antibiotics anyway. And I'm wondering what a messy operation is.

As our income goes up we pay more with our SH or national health care payments. But even at the highest level here it's still much lower than I can get with the dodgy private policies I would have to try to get back in USA (if I don't have an complicated pre. ex. conditions) so I actually feel lucky after hearing all the nightmare stories of financial problems happening from such a stupid cause as medical bills.

"the government doesn't want a bunch of foreigners joining National Health and then after 1 or 2 years claiming back what they paid in." Umm, what the heck are you talking about? You can't pay into National Health and then claim back your payments ... perhaps you are thinking about the payments to National Pension. Once a health insurance payment is made you can never get it back.

Hoofin and I have discussed this issue at great length before. Article 8 DOES NOT CONTROL no matter what it states. The law in Japan has been for a long time, and continues to be, that if you are living in Japan for more than 1 year you MUST join the Social Insurance System either through your employer or by yourself. Now, this law has hardly ever been strictly enforced with regard to NJ, but it is the law nonetheless.

Yes there are a few exceptions but they are very few indeed. I'm not going to get into them again here, if you want to know more about them then get in touch with me at my site, www.crazygaijin.com

I have. I used to work with people who had that happen. Just because you haven't heard of anyone having their insurance rejected doesn't mean it doesn't happen

Well I haven't heard of anyone being refused private insurance. I know people who work for well-known companies who are put on a private scheme by their company and don't pay SH or KKH, and I haven't heard of any of them being knocked back, although I guess their companies direct them to clinics that they know will accept private insurance.

It may happen, but there's plenty of people who don't have problems with it.

Well, ultimately it doesn't matter if we think it's right or wrong-it's the law. You are legally required (as far as I know) to pay into one of the two national health care schemes in Japan. Whether we like it or not, it is as much of a legal requirement as it is to pay taxes.

But that's like saying that, if you went to Amsterdam, you wouldn't smoke cannabis because the law forbids it. In a situation like that where the authorities turn a blind eye, if you weren't going to smoke it, it'd be for health or moral reasons, i.e. whether you thought it was right or wrong.

Same with SH/KKH - the authorities tolerate people not following the law, therefore it boils down to a matter of individual scruples - do you believe that everyone should pay into a socialized health system, that you should follow the law (even if it's not enforced); or should it be left to individuals to look after themselves?

Do you disagree with the way the govt allows these companies to not follow the law (to increase their power and influence)? Or do you want to save yourself money every month by having a private scheme?

I do pay into KKH, basically because I think that following the law saves you less hassle in the long run, as evidenced by the possibility of people getting stung for 2 years of back-payments if this forced enrollment had taken place. If you don't follow your legal obligations, sooner or later it'll come back to haunt you.

I stayed in Japan and with NOVA in 2007 going into 2008, and had to finally use JMA at about the middle of my stay. JMA would only cover 150,000 yen for what I needed insurance coverage. Therapy and medication from an English-speaking therapist is not cheap. JMA was timely in their reimbursements, but 150,000 yen can only go so far. And when everything went under, needless to say I had to discontinue therapy.

Well I haven't heard of anyone being refused private insurance... It may happen, but there's plenty of people who don't have problems with it.
I do believe I said "you run the risk", which is an entirely different thing than me saying "you definitely will have this happen." Which was precisely my point-having private insurance carries with it this potential liability, which you seem to agree with, so I don't understand what exactly you are disagreeing with here.
But that's like saying that, if you went to Amsterdam, you wouldn't smoke cannabis because the law forbids it. In a situation like that where the authorities turn a blind eye, if you weren't going to smoke it, it'd be for health or moral reasons, i.e. whether you thought it was right or wrong. Same with SH/KKH - the authorities tolerate people not following the law
It doesn't matter if the authorities tolerate or turn a blind eye to the law-it is the law, and no one should at all be surprised if and when the authorities (as they appear to be doing) attempt to enforce a law that has been in existence for a very long time. If the government didn't care about people having private health insurance or not, they would have never passed such a law in the first place. They did, and it doesn't matter if foreigners agree with it or not, it is their obligation to follow it. If people make decisions by banking on the authorities not enforcing existing laws, that frankly is stupidity.

If people make decisions by banking on the authorities not enforcing existing laws, that frankly is stupidity.

I'd better stick to normal cigarettes the next time I'm in Amsterdam then!

Japanese and German medications have made me lose weight, but American medications have made me gain weight in the past. So I would theorize that at least Japanese and German medicinal equivalents are much stronger than American ones because my body wanted to get rid of them and other toxins much faster.

Cheers Shawn-

"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."

This seems so bogus (not you but dmca.com)

I'm surprised you took it down so easily. Were you concerned about possible legal repercussions? The dmca.com seem like a bunch of losers. I checked dmca.com and unless I'm missing something they are NOT affiliated with the Digital Millennium Copyright Act which you can read about at:

http://en.wikipedia.org/wiki/Digital_Millennium_Copyright_Act

It is a law and not a company or firm. To me they seem bogus and are freeloading on that domain name since they simply claimed it. People search "DMCA" on google, they find dmca.com and they feel they are the real authority. No where in that above wiki is the domain dmca.com mentioned. They are simply paid to send intimidating emails to website owners after being paid to do so...with no legal authority. If their "client" really had legal issue they would have contacted you with with a real lawyer, etc.

Look here:
http://www.who.is/whois/dmca.com/

It is registered through godaddy and the reg. info is done by proxy instead of a company. that means it's probably some armature individual who owns the website instead of an actual company.

It's cool, I mean it's your website. But if it were me (if I were in Japan) I would tell them to screw off and see what they do next.

Cheers!

I have a copy of the original letter that that company sent out. Since I am a lawyer back in the States, I don't think dmca.com would have any trouble with me discussing its contents. It's not protected by copyright such that people can't discuss what's in it. And to do this fairly, you have to quote from it.

I think Shawn simply didn't want the headaches. Fair enough.

I am curious why a company that appeared to be so boastful about their bureaucratic successes would turn around and hire paid internet thugs to try and whitewash what they had put out.

It wouldn't make me confident about what the "Free Choicers" are up to. Ne?

Basically, I didn't want to deal with any potential legal hassles. Taking down the letter is not a big deal, as the points that Hoofin has brought up are much more important to focus on. It seems like the health-insurance-company-who-shall-not-be-named was uncomfortable with being seen as advising its clients that there's nothing to worry about.

Shawn
Let's Japan.org::Blog

http://hoofin.wordpress.com/2009/12/12/freechoice-jps-ron-kessler-is-con...

As I've blogged, just doing a domain search on the company shows that the website is licensed to Ron Kessler.

The group of people connected through FreeChoice were not clear up-front that they deal with so-called "private insurance" in the expat community. This should have been put out right at the beginning of their campaign.

To me, your use of the letter was Fair Use. How can you comment about the controversy if you don't show what the one side is saying? Next thing you know, they would be saying that faxes from the government (paid by my tax money) are also copyrightable!

When people start playing it like that, well, yeah, unless you would come back at them with the counterthreats, it's best to grant a "bully pass" on the censorship.

In fact, it's clear from research on the main server, that all the information coming out against Japanese public insurances and FOR HealthOne or other so-called "private insurances" is connected to Ron Kessler, as I show here:

http://hoofin.wordpress.com/2009/12/13/ron-kesslers-freechoice-jp-tied-t...

A very interesting find, Hoofin! Something smells real bad...

Shawn
Let's Japan.org::Blog

When this Kessler fellow and the "Free Choice" group first premiered, it smelled of insurance backing to me. Tactically it took it's work pretty much straight from the insurance company playbook in the US (puppet foundation, pretends to back "the little guy", etc). Part of the reason I am loathe to return in the first place. I actually feel it is quite reasonable for the govt to try to enforce the insurance rules, but only if there were a genuine effort at across-the-board enforcement, as well as confrontation of companies skirting the law.

I think it's reasonable IF something is done about the enforced back-payments. People have come to work in Japan unaware of the law on health insurance, have been "advised" by their companies to get private insurance, and in some cases been discouraged, or even not told about, social insurance. Some companies enrol employees in private schemes, knowing that the SH rule isn't enforced. Because of that, those people will now get stung for 2 years of health insurance back-payments. Something should be done about that - either waive those back-payments, or require companies to shoulder the cost of them.

I think it's reasonable IF something is done about the enforced back-payments. People have come to work in Japan unaware of the law on health insurance, have been "advised" by their companies to get private insurance, and in some cases been discouraged, or even not told about, social insurance. Some companies enrol employees in private schemes, knowing that the SH rule isn't enforced. Because of that, those people will now get stung for 2 years of health insurance back-payments. Something should be done about that - either waive those back-payments, or require companies to shoulder the cost of them.

I know that the back-payments issue is "big". My feeling is that the government should fine the private insurers upon a finding of deceit or other bad behavior.

Equally, companies that have herded their new workers into "private" plans.

Besides the fine, there is also the threat that the companies would no longer be able to write any business in Japan. Maybe criminal sanctions.

The money that people paid obviously went somewhere. And the government is strong enough to track it down. That's what governments do.

A number of companies put their employees on private schemes automatically, at no cost to the employee, the thinking being that they'll get treated and get back to work more quickly than with national insurance. I'm not just talking dodgy eikaiwa here, but prestigious, international companies do this.

Whether they've all duped and deceived people into it, I don't know. Certainly the big eikaiwa and ALT dispatch places do that - Nova used to say nothing about SH to you, and Interac said that it was a very high premium and that private insurance was much cheaper. None of them said that you were legally obliged to enrol in SH or KKH, so as far as I'm concerned, they were deceiving people into taking out private insurance, not to mention getting all their employees to unwittingly break the law.

It's a disgrace, and they should be brought to account for it. I'd advise anyone who was duped like this to resist making the 2-year back-payment, and bring it to the attention of the authorities that your original sponsor did not explain your legal obligations to you, and explain how unfair it is that you now have to cough up back-payments because of that.

If everybody does this, it may have an effect.

The possibility of being on the hook for up to 2 years in insurance back payments is worrisome, but as I've said before, you can plead your case with your ward office. I know people who have successfully negotiated lower payments or better repayment conditions. It's not all gloom and doom, but you do need to be able to make your case in Japanese, though.

Shawn
Let's Japan.org::Blog

I was on private for a while, but I eventually changed to KKH but only AFTER I'd moved cities. A friend of mine changed from private to KKH and got hit with back-payments, discovering in the process that they're retro-active only in the city where you register for the insurance. For that reason, I changed from private to KKH straight after I'd moved cities and sure enough, didn't get hit with any back-payments from before I moved.

This was over 2 years ago but if you're planning on moving, or are willing to relocate, then it's probably a way of avoiding these back-payments (unless they've since concocted some other bloody regulation about that as well).

"I'm not just talking dodgy eikaiwa here, but prestigious, international companies do this." We want names, specifically what companies do you personally know Ripper? Don't generalize this. Be precise and to the point. Expose everyone involved in this fraud.

Yes, this insurance scam is a joke, but only because so many people come here to bitch and moan about life in Japan. The alternative has always been to tell people to go back home if it's so tough here. That doesn't address the issue on insurance. We've all heard that there are too many foreigners living in Japan, but who's to say that this is anyone's problem. While it may be nice to see Edo period Japan, that isn't going to happen.

But this isn't some massive scandal just coming to light, it's common practice. The govt's allowed foreign companies, and companies employing lots of foreigners, to not enrol their foreign staff in national insurance.

I mentioned Nova and Interac for deceiving people on this. As for other companies, if you look into it, you'll find that they probably have a special private medical insurance scheme for their staff and automatically enrol them on it. Lots of companies do that. As for what they do about national insurance, who knows???

This is what the Old Regime should have done. Yes, tell visa holders that they are supposed to be in a legitimate program and hold them to it. BUT then, also, go after the privates who weren't clear they were only selling gap insurance. AND go after any major company that didn't put their company plan into one of the many "kousei nenkin"-related associations.

My own feeling is that if you were sold a gap policy with the implicit understanding that it covered things kokumin kenko hoken was supposed to cover, that's a fraud. Under Japanese law as I've read in English, health insurers aren't supposed to make a profit off health insurance. I think these guys abused the tomin kyousai regulations.

There was too much "looking the other way" by the Old Regime (Liberal Democratic Party). OK, fine, now fix it.

The "gaikokujin who brought peace and quiet" isn't even touching that one. Because it might mean his client has to refund money.

What are they for if not to help with just this sort of thing? Perhaps we should contact our respective consulates and ask them for their position on this whole insurance thing.

Why would you do that when health insurance is run by the government of Japan? The positions of any embassy or consulate are irrelevant in this matter.

Shawn
Let's Japan.org::Blog

There is a lot of mis-information in this section.

First of all, how slow or fast your treatment is doesn't depend at all on what kind of insurance you have. It does depend on what your reason for going to the hospital, and may vary depending on the specific clinic you go to, but the hospital staff won't give you any different treatment just because you're on one type of insurance or the other (they get paid the same either way, so it doesn't matter).

Second, the consulates and embassies (unfortunately) aren't here to help you settle your battles with companies or with Japan's law regarding insurance. They'll tell you the same things that a lot of posts here are saying (especially Hoofin's posts) that the law says you should be signed up for one kind of public insurance. They can't tell you ways to get out of it, because there are no legal ways (at the moment) to get out of it.

Third, the KKH doesn't care if you had a private insurance before signing up (I've been to my local office to ask), and they WON'T charge back-payment if you can show proof that you were enrolled in some kind of health insurance before signing up for KKH. They will charge back-payments for people who have not had any kind of health insurance for more than 2 months (for example, if you canceled your private insurance last September/October and are going in now to sign up for KKH, then you'll get charged for the 2 months you didn't have insurance, but not for any of the time you were with the private insurance company). It also doesn't matter if you've moved cities or anything like that. The city you moved to still can get a record of your previous years income to know how much to charge and all. You may have to ask at your ward, as these kinds of things may vary from city to city, but they really shouldn't. But, like I said, you have to bring proof that you were enrolled in some insurance, and that it has expired or you have cancelled it.

Let's get our facts straight before putting up posts, please.

There's a lot of mis-information in what you've just posted. Your particular office may have told you that they won't back-charge you for the period you've had private insurance, but that doesn't mean that's going to be the case across the board. As I said, a friend of mine was back-charged his KKH. The fact that he'd had private insurance was irrelevant, they still back-charged him, over 2 years of back-payments in fact. This was a few years ago mind, so maybe the rules have changed, or else there's no definitive version of how this works.

You want to check with your particular city office before you know for certain whether they'll back-charge you or not. Get your facts straight before you post please.

It also doesn't matter if you've moved cities or anything like that. The city you moved to still can get a record of your previous years income to know how much to charge and all.

This isn't correct either. As I said, I moved cities and only paid KKH from when I moved to that city. This is what I'd been told by the friend who got stung for back-payments, which I presume is what he was told by his office.

I really don't think there's any across-the-board way of doing this. Check with your local city/ward office first.

That's the first time I've read that a hoken insurance desk would accept coverage by a private insurer in place of the backpayments.

In a way, it makes sense, because the person who took out the private insurance was at least PARTLY covered for claims in the medical system.

However, what should really happen is the government should sit on any gap insurer who is marketing their product in Japan as "replacement" insurance for the kokumin kenko hoken or the one in kousei nenkin. This is the root of the problem. However it comes to be, someone is telling others that gap insurance is an acceptable substitute. Clearly, it's not.

At my site today, I show where one gap insurer is tied to a publicly-traded corporation in Texas, HCC Insurance Holdings. (NYSE symbol: HCC)

Perhaps the discussion about a fair way to bring everyone into the lawful system in Japan should start at levels higher than the ward office or the distributor's 1-800 number . . .

or the one in kousei nenkin.

I meant the one in shakai hoken, the kousei kenko hoken.

HEALTH INSURANCE UPDATE!

Hey guys, I am sure everyone on this board is super relieved that news has come through today that foreigners in Japan will not be required to enrol in the Japanese Government's Health Insurance Plan. To quote the Japan Times 2 Feb:

"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."

The bureau will try to persuade foreigners who don't have the card to enter the social insurance system by giving out brochures, but not having the insurance won't affect the bureau's decision whether to grant a visa, he said.

Ronald Kessler, who founded the Free Choice Foundation to raise awareness of the issue, hailed the bureau's plan to delete item No. 8.

"We peacefully and diplomatically explained to them our predicament," he said. "They listened, they understood, and we applaud them for taking appropriate action."

Look, I understand this Ron Kessler bloke has been a controversial and somewhat divisive figure on these boards, but he fought on the side of good (I understand he had a vested interest however, as Shawn pointed out), so lets all just put these differences aside and celebrate this awesome news today! I am sticking with my private insurance from back home - which I really like - and won't have to shell out all those hundreds of thousands of yen I had thought for years of Insurance backpay. Now I can afford that holiday in China!

This is a victory for commonsense and free choice - and at last a small victory for the gaijin battlers out there!

Hallelujah! Today is a great day!

Dude you"ve misinterpreted the article.
The law still requires that foreigners and Japanese alike be enrolled in either the NHI or Shakai Hoken. The law on this has not changed.
The article merely refers to the production of proof that you are enrolled in either of the Japanese insurance schemes in order to extend your visa. They are seemingly not going to reject your visa extension just because you are not enrolled in a Japanese health insurance scheme. It does not mean the law requiring that foreign workers be enrolled in any of the government insurance schemes has been changed. It is still the law...and hopefully it will remain so.

The talk (and it's just talk) is that Immigration may just pass the names over of those who aren't enrolled to Labor and Health. That department is in a better position to determine the story behind why people aren't enrolled.

This supposed "change" in the guideline is really old news. Immigration said they wouldn't be denying visas late last summer. (If they kick you out, there goes the back premium money too, right?)

It sounds like the issue now is going after some of these internet insurance scams, and "lightly" getting people enrolled where they should be (whether or not they get people to pony up the back payments).

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