Yomiuri: GOJ now requiring hospitals (unlawfully) demand Gaijin Cards from NJ as a precondition for medical treatment

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Hi Blog.  Related to recent discussions about public refusals of service for either not complying with (unlawful) demands for NJ ID, or denial of service anyway when people in charge arbitrarily decide a visa’s length is not long enough, mentioned below is a move by the GOJ to require hospitals demand Gaijin Cards etc. (as opposed to just requiring medical insurance cards (hokenshou), like they would from any Japanese patient) as a precondition for providing treatment to sick NJ.

Granted, the Yomiuri article below notes that for Japanese patients, the government is “considering” requiring a Japanese Driver License etc. as well, because the hokenshou is not a photo ID.  But once again, NJ are clearly less “trustworthy” than the average Japanese patient, so NJ will have more (again, unlawful) rigmarole first.

But there’s a deeper pattern in this policy creep.  Recall the “Gaijin as Guinea Pig” syndrome we’ve discussed on Debito.org for well over a decade now:  Public policies to further infringe upon civil liberties are first tested out on the Gaijin — because foreign residents even Constitutionally have much fewer civil liberties — and then those policies are foisted on the general public once the precedent is set.   So once again, the GOJ is taking advantage of the weakened position of NJ to assume more government control over society.

NB:  There’s also a meaner attitude at work:  Note in the last paragraph of the article below the echoes of 1980‘s “foreigners have AIDS” paranoia creeping into LDP policy justifications once again.  I say “mean” because the point would have been made by just stopping at “the person fraudulently used somebody else’s insurance”.  And I’m sure presenting a Gaijin Card would have fixed the AIDS issue!  (Not to mention that the GOJ apparently WANTS people to get AIDS screening, especially if they’re visibly foreign!)  Such ill-considered policymaking signals!

Meanwhile, don’t expect equal treatment as a patient if you get sick while foreign.  It’s official policy.  Debito Arudou Ph.D.

/////////////////////////////////////////////////

病院で「なりすまし防止」外国人に身分証要求へ
2018/11/18(日)  読売新聞, Courtesy of SendaiBen and MJ
https://headlines.yahoo.co.jp/hl?a=20181118-00050002-yom-pol

(写真:読売新聞)

政府は外国人が日本の医療機関で受診する際、在留カードなど顔写真付き身分証の提示を求める方針を固めた。来年4月開始を目指す外国人労働者の受け入れ拡大で、健康保険証を悪用した「なりすまし受診」が懸念されるためだ。外国人差別につながらないよう、日本人にも運転免許証などの提示を求める方向だ。

来年度にも運用を始める。厚生労働省が在留外国人への周知徹底を図るとともに、身分証の提示要請を各医療機関に促す。

国民皆保険制度を採用する日本では、在留外国人も何らかの公的医療保険に原則として加入することが求められる。保険証を提示すれば、日本人か外国人かを問わず、原則3割の自己負担で受診できる。ただ、保険証には顔写真がついていない。「別人かもしれないと思っても『本人だ』と主張されると、病院側は反論が難しい」(厚労省幹部)という。

自民党の「在留外国人に係る医療ワーキンググループ」が医療関係者や自治体から行ったヒアリングでは、なりすまし受診の実例が報告された。神戸市では不法滞在のベトナム人女性が2014年、日本在住の妹の保険証を悪用してエイズウイルス(HIV)の治療を受けていた。他人の保険証で医療費の自己負担軽減を受けることは、違法行為に当たる可能性がある。

ends

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14 comments on “Yomiuri: GOJ now requiring hospitals (unlawfully) demand Gaijin Cards from NJ as a precondition for medical treatment

  • I read this differently: it says “zairyu ka-do nado kaoshashintsuki mibunsho”, i.e. “a picture id, like the residence card”. According to this we should also be able to use the same kind of id that Japanese use.

    The next sentence is the offensive one: “There is worry about misuse of health insurance cards because of the expected increase of the number of foreign workers”. And Japanese (who would never do that) have to show their id so that Japan doesn’t look racist. I agree with debito that “crimanal foreigners” are again used to justify some policy.

    Reply
  • cynical.nj says:

    FWIW, in the case of us outside people it also says ‘在留カードなど’, so a driving license should be fine too, although I agree: the whole premise and the example at the end are mean…

    Also, a real coincidence, but I just started my stay at a Tokyo hospital last week, so I can tell first hand that as of now, just showing the health insurance ID is still enough.

    Reply
  • Zig Justice says:

    1. I like how in the diagram they just show the zairyu card and leave out equivalents implied by the “nado” in the text.

    2. Does this mean that they’ll also stop taking insurance cards as a form of ID elsewhere?

    3. What about kids?

    4. They mention one case of fraud in the article from 2014. What are the statistics? (I’m sure they don’t know or care, and probably haven’t bothered checking, but I’m curious; I’d also bet that that kind of fraud is much more prevalent among Japanese than foreigners, simply due to relative population numbers and it’s not like there hasn’t been anything stopping Japanese from doing it.)

    5. Is this codified (or planned to be) in actual legislation anywhere? If not, how can they enforce it?

    . o O (Just my initial angry thoughts.)

    Reply
  • > 在留カードなど顔写真付き身分証の提示を求める方針

    Emphasis on 「など顔写真付き」. Unfortunately the 住基カード is over, but you can apply for 個人番号カード, which has a picture on it. If your 住民票 has a 通称 it will appear (unfortunately along with the ALL CAPITAL Latin script version). Japanese driver licenses are also an option, too. Other than immigrations and the 区役所, I don’t think I’ve ever used my 在留[資格]カード . Even the airports won’t look at it.

    Personally I just say that I am Japanese. My identity is my choice, regardless of what some government says.

    > the echoes of 1980‘s “foreigners have AIDS” paranoia

    Still going on. Take a look at this often repeated “Sexual Health Service”. One of these in particular does not seem to fit:
    https://twitter.com/nakasu_safesex/status/1128027531775373312

    Quote: “#Fukuoka, #STD, #Sexual_clamidia, #Sexual_herpes, #Genital_warts, #Gonorrhea, #Syphilis, #Hepatitis_B, #Amoebiasis, #HIV, #AIDS, […] #Fuuzoku, #Sexual_Fuuzoku, #Highclass_Fuuzoku, #Highclass, #Highclass_Soap, #Soap, #Soapland, #Prostitution, #Blowjob, #Instant_Sex, #NS, #Creampie, #Anal_fuck, #Swallowing, #Foreigners”.

    Reply
    • WOW.
      It doesn’t get more prejudiced than this, indeed:

      Nakasu (Fukuoka) “Sexual Health Service
      ‏ @nakasu_safesex”
      “We collect info about HIV and sexually-transmited diseases, rampant in Nakasu’s sex parlors. Please let us know through this account if you have information about [establishments] where STD tests/reporting/condoms are not mandatory, absentism because of an STD is not permitted, antibiotics are mandatory, ——–foreign customers patronize the place——–, infection/transmission of disease is ocurring, etc…”
      (—emphasis mine—)
      Japanese text: “中洲の性風俗店で蔓延しているHIV及び性感染症関連の情報を収集しています。性病検査の(受診・報告)義務がない、コンドームの装着義務がない、病気による欠勤が許されない、抗生物質の常用を強いられている、外国人客が出入りしている、感染者が発生している等の情報をお持ちの方は、当アカウントまでお知らせください。”
      https://twitter.com/nakasu_safesex/status/1128027531775373312

      Now, as Debito says, we don’t really concern ourselves about discrimination in this kind of establishments, because the issue gets easily muddled. But this arguably goes further than “no foreigners allowed”, it baselessly culpabilizes them.

      Reply
  • I would be curious – have no Japanese people ever defrauded the system? Why don’t they provide statistics on that? Oh yeah, it’s easier to blame the foreigners.

    Reply
  • > 在留カードなど顔写真付き身分証の提示を求める方針を固めた。
    > 健康保険証を悪用した「なりすまし受診」が懸念されるためだ。

    Another ill-conceived plan that has not been significantly thought through. My 保険証 naturally only has my Japanese name in kanji. No matter how many how times I’ve asked at immigrations to also add my kanji name to my 在留カード they refuse. (This was not a problem with the older 外国人登録証.) So even with this policy, they will still not be able to verify my identity. Maybe this will give them a reason to add it to the card; I doubt it though.

    Reply
    • AnonymousOG says:

      Exactly.

      My old “Gaikokujin Kaado” had my Roman Letters “real name” PLUS my self-chosen 100%-Kanji Japanese “nickname (tsūshо̄mei)”, but unfortunately: if I were to show that card as I.D. it would totally defeat the whole purpose of the Kanji alias in the first place, namely: compelling businesses to give the same treatment as any Japanese citizen.

      Fortunately, thanks to the fact that I kanjified myself with that 100% Kanji Japanese tsūshо̄mei, the positive result is that I suddenly became able to (even without becoming a Japanese citizen) have my local city hall’s Kokumin-Kenkо̄-Hoken-Shо̄ card-printing-department public workers print my “Kokuho Kaado” (Kokumin-Kenkо̄-Hoken-Shо̄ 国民健康保険証) nicely showing ONLY my 100% Kanji Japanese tsūshо̄mei, and thus my “Roman Letters name” is NOT printed anywhere on the card) for about a decade now.

      By the way, when I first chose that 100% Kanji Japanese tsūshо̄mei and entered it into the Jūminhyо̄ database, automatically the system printed and sent me a new Kokumin-Kenkо̄-Hoken-Shо̄ with “Roman Letters name PLUS Kanji”, but I immediately went in and forced them (using words, camera, and my strong-willed spirit) to print it correctly: Kanji only, nothing else, only Kanji, “because that’s my official ‘doing business as’ name now” (and yes, I even also forced them to print it with my birth year Japanese style (e.g. 昭和51, instead of 1976) and fortunately ever since then the system has been continuously automatically printing and sending my Kokumin-Kenkо̄-Hoken-Shо̄ the way I like it: Kanji only, with my birth year Japanese style.

      So, that 100% Kanji Japanese name printed on my Kokumin-Kenkо̄-Hoken-Shо̄, without anything on the card pointing towards me being “foreign”, has been very useful over the past decade: it has helped me to pretend to be a “Japanese citizen who happens to be white” ever since, for example it allowed me to successfully force staff at banks to treat me as a Japanese citizen (meaning, I got them to create my bank accounts showing only my Kokumin-Kenkо̄-Hoken-Shо̄, nothing else, thus my bank accounts are in my 100% Kanji Japanese name.)

      The problem is the Kokumin-Kenkо̄-Hoken-Shо̄ doesn’t have a photo, and thus logically over the past 5 years the Kokumin-Kenkо̄-Hoken-Shо̄ has become less powerful, since almost all companies are now (logically) demanding I.D. with a photo.

      My Jūki card was I.D. with a photo, but I wasn’t able to get the Jūki card folks to print that the way I wanted. Meaning, my Jūki card unfortunately has the “Roman Letters name PLUS Kanji” (and the western style birth year) so that card marks me as a Gaikokujin. And oh yeah, even if I were willing to use that card as I.D., Japan decided to kill off the Jūki card with a nationwide expiration date a few years ago, so I can’t use my Jūki card as I.D. now even if I wanted to. (By the way, in a logical world, a government-printed form of I.D. should NEVER stop being a valid form of identification. Of course one can’t drive a car on an expired drivers’ license, of course one can’t cross borders on an expired passport, but such expired government-printed forms of I.D. should be accepted by all as a valid proof of who one is.)

      So the situation is:

      I’ve got my valid new Zairyū Card which does NOT have my Kanji on it (boo), and unfortunately it clearly marks me as a foreigner (boo).

      I’ve got my expired old Zairyū Card which has my Kanji on it (yay), yet unfortunately it clearly marks me as a foreigner (boo), and since it’s expired it is no longer accepted as I.D. anymore (boo).

      I’ve got an expired Jūki card with a photo (yay) which has my Kanji on it (yay), yet unfortunately it clearly marks me as a foreigner due to the inclusion of my English Letter name also appearing (boo), and since it’s expired it is no longer accepted as I.D. anymore (boo).

      I could go pick up the My Number Card which is waiting for me somewhere at City Hall, or go earn a Driver’s License, both would have a photo (yay), both would have my Kanji on it (yay), yet unfortunately both would clearly mark me as a foreigner due to the inclusion of my English Letter name also appearing (boo).

      And I’ve got a valid Kokuho card (Kokumin-Kenkо̄-Hoken-Shо̄) which has my Kanji on it (yay), which does NOT mark me as a foreigner at all (yay), yet unfortunately it does NOT have a photo so it’s becoming less and less accepted as sufficient I.D.

      Just as Mumei said: the government of Japan SHOULD simply add a photo to the Kokuho cards and the Shakai Hoken cards yet probably won’t.

      And yeah, just as Mumei says, it is absolutely illogical that the new Zairyuu Cards refuse to print our Kanji on them.

      Reply
      • Anonymous says:

        One of the reasons why I changed my legal name when I naturalized japanese.
        Also, not having to worry about leaving home without an ID feels good too.

        Concerning the hospitals, they never asked me for my 在留カード or even driver’s license, only my 保険証, but I might just be lucky.

        Reply
        • AnonymousOG says:

          Years ago, my wife, who is a Japanese citizen (born in Japan, and having 100% “Wajin” DNA and appearance), presented her Kokuho Card (Kokumin-Kenkо̄-Hoken-Shо̄) to the local hospital at the beginning of the standard birthing procedure.

          The hospital staff looked at my wife’s Kokuho Card (which had her surname in Katakana [due to the naive mistake of having taken my family name when we married] and her first name in Kanji) and suddenly the hospital staff demanded something which cannot legally be demanded of any person with a valid Kokuho Card: “As a gaikokujin You have to pay 300,000 cash upfront, before the standard birthing procedure.”

          My wife (shocked that she would be assumed to be, and treated as, a lowly subclass gaikokujin) replied instantly and strongly “I’m Japanese!” with the amount of disgust as you can imagine any Japanese person feels when being called a gaikokujin. The hospital staff member then without missing a beat quickly said, “Oh, then Kokuho takes care of that, you’re all set.”

          Great, my wife suddenly moved from the “you NEED to pay 300,000” hell category to the “you DON’T need to pay 300,000 – you’re all set” heaven category, just because she was able to honestly say “I’m Japanese!” with enough conviction to convince the illegally-acting hospital-staff that she is indeed a Japanese citizen, suddenly the 300,000 extortion attempt ended, suddenly she was “all set.”

          When she told me about it that night, I told her this is unacceptable and we went the next day to talk to a manager at the hospital about why the staff are fraudulently demanding that “people with Kokuho cards with katakana in their surname (thus, people who appear to be gaikokujin) need to pay 300,000 yen cash upfront before the birthing procedure, which the government will later reimburse after the birth”, when the reality is the Kokuho pays the hospital after the birthing procedure is complete, no patient payment or reimbursement involved.

          The manager lady first tried dishonestly claiming the demand must have been a miscommunication due to language, but my wife instantly and strongly shot that attempt down by explaining she was the only person being spoken to, her American husband was not there, the conversation was strictly between her (my Japanese wife) and the Japanese staff, so absolutely no “miscommunication” about it: the staff claimed gaikokujin with kokuho had to pay 300,000 upfront yet Japanese with kokuho didn’t have to pay 300,000 upfront, this is a simple case of nationality discrimination.

          The manager, frustrated that her attempt at blaming it on language didn’t work, then stupidly admitted the real reason behind their nationality discrimination: “Well, Gaikokujin have a higher chance of leaving Japan right after the birth, while not paying their final kokuho bills, which leads to the government losing money when it pays the hospital 300,000 bill, and/or leads to the government sometimes refusing to pay the hospital 300,000 bill, thus the hospital losing money, so… ”

          So that’s why you are violating the kokuho laws: because you think some races and/or some nationalities are more likely to commit a crime (the crime of not paying kokuho tax) than Japanese notionality/race people, and thus to avoid potential losses you are illegally demanding people who appear to be gaikokujin (based on katakana surnames) to pay 300,000 upfront, and you think the courts won’t penalize your hospital when we present the evidence of this?

          Suddenly, right in front of my wife, the manager lady switched back into non-admittance mode, total denial mode, she claimed that my wife (and I) misunderstood what she had just told us, that her hospital definitely does NOT make any extra requests or demands based on nationality, that everyone is absolutely able to use their kokuho card for birthing without paying 300,000 cash, that my wife misunderstood the conversation with the other staff member, and that my wife misunderstood the conversation right now in which the manager had indeed had tried to make an excuse for their extortion “shift all the monetary risk to the gaikokujin patient” demand.

          My wife of course got rightfully very angry at this manager lady lying to her, trying to gaslight her (I of course have seen this many times, but all this was a huge shock to my wife) but my wife decided to avoid giving more stress to our yet unborn child, and to avoid having to go find a different hospital, and to avoid the hospital giving doing some kind of revenge to her during the birthing, my wife swallowed her pride and simply accepted the manager lady’s dishonest “miscommunication” stance, and my wife asked me to let it go. And I realized that even if I had wanted to take the hospital to court, we had no recordings of the conversations, it would be our word against theirs, and already this manager lady was showing she was willing and able to lie to an absurd extent. And since I’m not a Facebook / Instagram / Twitter social media braggart showing my face and stories for views, I’m going to keep my city private, so I’m not going to mention the hospital name. We simply let it go, since we have no proof about our claim (and even if we did, the hospital could counter-claim and counter-sue us for meiyokison “libel/slander” regardless of the truth, since truth is legally not a defense in Japan. And since their lawyer money would of course outweigh our lawyer money of zero…)

          The lesson learned: always record when dealing with people raised in a culture of lying. Always (secretly) record. Publishing would require mosaic over faces and distorting the voices (of any non-government workers) but recording in public places (without sexual intention) is legal in and highly recommended if one wants to document law-violations, discrimination, and lies about that, in Japan.

          Anyway, as I’ve shared here, a few months ago we finally made the change, to 100% Kanji surnames & names for my wife & kids:

          https://www.debito.org/?p=14096&cpage=1#comment-1762718
          https://www.debito.org/?p=14096&cpage=1#comment-1763014

          How sad that to avoid such discrimination in Japan my family has chosen to, as much as possible, hide any evidence of “non-Japanese” race, nationality, culture, family.

          PS – Probably in part thanks to having officially changed my wife’s and kids’ surname and names to 100% kanji, my eldest son was recently admitted into a top public high school. Congratulations to him for his diligent studying. And congratulations to me for having proactively taken the steps needed to 100% Kanjify our family.

          I still of course wonder if that top public high school would have chosen my son for admittance if his surname and/or name had contained any katakana at the time of application.

          Thank goodness we successfully completed the Family Court “外国人とまぎわらしい = Don’t want to be mistakenly thought of as a foreigner” official Surname+Name change process BEFORE application to high school. 🙂

          Reply
          • Anonymous OG, sounds like a miserable experience you had with the racists at the hospital. It seems your wife was eventually able to safely give birth, which is great.

            I can relate greatly to your story about being given thinly veiled lies as an excuse for racist or inappropriate behavior–I have encountered this same thing many times myself.

            I’ve thought about it a great deal, and I want to make it very clear that I am not advocating for or defending this behavior when I make this suggestion. I’ve come to the conclusion that in interpersonal dealings, Wajin lie like this on purpose, and they do not expect anyone to believe them. On the contrary, I think they tell such obvious lies with the presumed understanding that you will know it is a lie and interpret it is a faux-apology.

            Frequently, the obvious lie comes along with an indirect apology, often an apology not for what they actually did wrong, but for “causing a misunderstanding” or “making trouble” or the sort. (Obviously, not every single time.) I think they do this because they believe that outright admitting to their malicious behavior will never elicit forgiveness and will permanently damage the relationship. On the other hand, by excusing themselves with a blatant, obvious lie, they think they can superficially maintain the relationship without it devolving to transgressor versus transgressed. The cessation of the transgression constitutes capitulation, and the thinly-veiled lie “patches it up.” Thus, “problem solved.” I honestly don’t think anyone expects their obvious lies to be believed as real truth, and in this sense they aren’t lies in the original sense of deliberate attempts to maliciously deceive a person. I have a suspicion that this is what 嘘も方便 means.

            Of course, this behavior carries with it problems. I think the Japanese government tries to apply this same sort of standard to interactions regarding its wartime transgressions and gets butthurt when Koreans and Chinese don’t play along. I have a suspicion that outright admitting to everything would constitute “losing face” in their minds and result in Japan eternally being “inferior” or “beneath” the Koreans and Chinese, because Japan would be the “aggressor,” the “wrong one.” The irony of course is that this very behavior is creating that situation, rather than the reverse.

            On an interpersonal level, this sort of behavior makes it difficult to communicate with people, especially difficult to discuss problems. If you can’t have an open discussion about what you did wrong, it’s difficult to learn why it was wrong or how to fix it. In the hospital case, I can imagine the idiot you talked to admitted to the racist motives behind their behavior, then backpedaled to “patch it up,” knowing that the lie wouldn’t be taken as anything but a superficial gesture. When said idiot further went on to claim “that her hospital definitely does NOT make any extra requests or demands based on nationality, that everyone is absolutely able to use their kokuho card for birthing without paying 300,000 cash,” I think it could be interpreted as meaning “this is what we’re going to do in the future,” or alternatively a concession that that would be the right thing to do (=agreeing with you), even if they don’t actually do it because they’re racist pigs.

            Regardless, by trying to patch things up with an obvious lie, it becomes difficult to have a meaningful interaction about the source of the problem. If I was in your shoes, and I do not say this with any intent to criticize you, I know what it’s like to be in the heat of the moment trying to choose one’s words, instead of asking “you think the courts won’t penalize your hospital when we present the evidence of this?” in reply to the manager’s admission of racist behavior, I would have just started talking down to her. それは人種差別なのでやめてください。This line delivered in a harsh, sharp tone has a nice effect in my estimation. You’re the customer, so address the problem in a top-down fashion. Questions invite responses; orders don’t leave room for them.

            For example, the other day I was at the convenience store just trying to buy a bentou when I was given the gaijin treatment by the clerk. Upon paying and asking the clerk to heat up the bentou, I was subjected to the usual 日本語お上手ですね and the like. I responded by asking the clerk そもそも何故(出身は)日本じゃないと決め付けたんですか。In response, the clerk immediately engaged in the above sort of lying, claiming 決め付けたわけじゃないです。I continued to press him for a reason, and he finally admitted that he had judged me based on my appearance. (I’m white.) In this particular situation, he was just an old guy working as a convenience store clerk trying to make small talk with a stranger, and out of ignorance chose to make my physical appearance the subject of conversation. I don’t think he was actively trying to harm me, but it’s still inappropriate behavior, so I didn’t get angry, but I chastised him by saying 人を見た目で判断するのは違いますね。To this he apologized, and that was the end of the interaction.

            I’m not trying to claim that what I’m saying would absolutely have worked with the hospital manager, but it might be worth considering giving orders and chastising in lieu of asking questions sometimes. From my own personal experience, even a minor chastising or rebuke often prompts a strong reaction from Wajin. That’s why I find it so hard to drink with Wajin strangers at bars–as soon as they start in with the racist behavior, unless you are extremely careful about how you reprove them for it, they will get butthurt extremely easily, and the atmosphere will get sour.

            Anyway, just my two cents. Congratulations on your son’s admission to high school!

            —- I see a lot of insight in this. Cf. “Lose the racism and complete the transaction.” Thanks for writing it up.

  • Glenn L. Boothe says:

    Debito, I don’t know where this is occurring, but I have had medical problems for the last three years and have been seen and/or hospitalized at three different medical centers on a regular basis. I have encountered none of this. I am asked to show my insurance about every third or fourth visit which is normal. Maybe I’m just lucky, but the hospitals are Ome Sogo, St. Luke’s and Nikkei. I am seen at a minimum of twice a month to as many as eight times a month!

    Reply

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