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  • Japan Times: NJ visas now contingent on enrollment in Japan’s health insurance program starting April 2010

    Posted by Dr. ARUDOU, Debito on August 3rd, 2009

    Handbook for Newcomers, Migrants, and Immigrants to Japan\Foreign Residents and Naturalized Citizens Association forming NGO\「ジャパニーズ・オンリー 小樽入浴拒否問題と人種差別」(明石書店)JAPANESE ONLY:  The Otaru Hot Springs Case and Racial Discrimination in JapansourstrawberriesavatarUPDATES ON TWITTER: arudoudebito

    Hi Blog.  Here’s a good article describing issues of health insurance and pensions, and how recent revisions clarifying that every resident in Japan (including NJ) must be enrolled may expose the graft that employers have been indulging in (“opting out” of paying mandatory social security fees, encouraging NJ not to pay them, or just preying on their ignorance by not telling them at all) to save money.  The problem is, instead of granting an amnesty for those employees who unwittingly did not pay into the system, they’re requiring back payments (for however many years) to enroll or else they get no visa renewal!  Once again, it’s the NJ employee who gets punished for the vices of the employer.  Arudou Debito in Sapporo


    New law: no dues, no visa (excerpt)
    Enrollment in Japan’s health insurance program tied to visa renewal from 2010
    The Japan Times, Tuesday, July 28, 2009


    In your wallet or somewhere at home, do you have a blue or pink card showing that you are enrolled in one of Japan’s national health and pension programs? If not, and if you are thinking of extending your stay here, you may want to think about a recent revision to visa requirements for foreign residents. The changes, which the Justice Ministry says were made in order to “smooth out the administrative process,” may have major consequences for foreign residents and their future in Japan.

    On a drab, rainy Sunday in June, a group of foreign workers gathered at the office of the National Union of General Workers Tokyo Nambu in Shimbashi to discuss an equally drab topic: social insurance. According to a new immigration law passed by the Diet earlier this month, foreign residents will be required to show proof of enrollment in Japan’s health insurance program in order to renew or apply for a visa after April 1, 2010…

    The bottom line is that all residents of Japan … 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.  However, the reality is that most foreigners in Japan do not have either form of insurance…

    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 thekokumin 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….

    Rest of the article at:

    102 Responses to “Japan Times: NJ visas now contingent on enrollment in Japan’s health insurance program starting April 2010”

    1. level3 Says:

      I find it quite naive that the labor union reps think that this new regulation will magically make employers start following the law regarding shakai hoken.

      Without enforcement (which there hasn’t been, and I don’t see any signs there will be more) laws don’t really mean anything. And it seems the only new enforcement that will be happening is against the individual gaijin who tries to renew his visa without insurance.
      Immigration will deny the visa, but Immigration has no relationship with the Ministry of Labor or enforcing labor laws.

      The only result will be the dodgy employers telling their workers to enroll in kokumin kenko hoken at their own expense, while continuing their polcies of denying that their gaijin employees are actually full-time workers.

      For the employers who want to jsut keep a steady stream of short term (under 1 year) contract workers, this rule will actually HELP the shifty employer.
      Immigration will helpfully deny visa extensions, thus making any claims to contract extensions and employment rights moot.

      The only hope for the hapless gaijin is that whoever is at the health insurance desk on the day you walk in to enrll yourself will decide not to make you pay 2 years’ back dues. Each civil servant can interpret the law differently. A total crap shoot as anyone who has butted heads against the Japanese bureaucracy knows.

      Perhaps it’s time to start practicing to bow to your knees and cry real tears (not so hard if you’re asked to cough up 1,000,000 yen in back dues or effectively be deported)

      Though perhaps being informed about the law which requires employers to pay back dues if they willingly avoided enrolling you would help as well.

      Is there any Japanese printout of the applicable regulations? It could save a lot of people a lot of money, or at elast increase their odds at the ward office crap shoot.

    2. Justin Says:

      Would getting Permanent Resident status before April 2010 mean that you will not be forced to join the hoken scheme since you will never need to renew your visa? If so, sounds like now is the time to go for PR…

    3. Hotbertaa Says:

      it’s a step in the right direction.

    4. James N Says:

      This could be a double edged sword for those people who plan to live and work in this country through retirement.

      The good news: Finally being recognized as a real full time employee with all the benefits that shakai hoken entails. Not to mention being on equal par with their Japanese counterparts. (I used the term “equal” here, but individual cases may vary).

      The bad news: Getting fired or “let go” because the company does not have the funds set aside or intends to pay the back fees due to prior negligence.

      Mark my words here on this blog today….People will get let go for innumerable excuses once it becomes evident that the companies in question will have to pay years upon years of unremmited dues.

      My advice: If you really want to stay here in Japan and NOT get fired, you must do the following: Join the Union, and in my OWN OPINION, sign up for Kokumin Nenkin (Pension) and Kokumin Kenko Hoken (Health Insurance). By doing this, you become a lot more retainable and easier to roll over to the Shakai Hoken system in the companies eyes since they won’t have to pay hand over fist just to keep you employed.

    5. Ken Says:

      I find it quite naive that the labor union reps think that this new regulation will magically make employers start following the law regarding shakai hoken.

      I agree 100% with Level3. This will not necessarily force companies to begin obeying the law. Foreigners will have to register as self-employed in the kokumin plans.

    6. Tom Says:

      I hope they offer some sort of amnesty for those not yet enrolled (although I am).

      I came here originally as an English teacher and was told explicitly by the company not to enroll (but to get the private health insurance conveniently offered by the company)

      Then when I went to work at a JP firm, the only reason I was eventually enrolled is because my wife works in a law firm and made them.

      But I think this is a good move in general. It will hopefully make employers more accountable and NJs more knowledgeable about their rights and responsibilities.

      BTW, companies that use short term (1 yr) contracts have to enroll the contracted employee in their insurance scheme by law if the employee is there for longer than 3 years

    7. matt at anarchyjapan Says:

      Just for the record, only about 60% of Japanese citizens who are required to have kokumin nenkin are actually paying their dues. The number has been going down each year, and given the current economic situation will likely continue to go down.

      What to do, what to do? I know, let’s make the foreigners pay. Sigh.

      The DPJ say they will reform the system, but no one had better hold their breaths.

    8. Curzon Says:

      This will likely cause major problems. Many foreign nationals have private health insurance and don’t go near the national program.

      The nenkin issue is also a big one — what about those of us who pay US social security instead of nenkin, as permitted by the Japan-US tax treaty?

    9. Asterisk Says:

      @ Curzon –

      If you have an exemption under the U.S.-Japan social security treaty, you can prove it by the form J/USA-6

      From the website:

      “To establish an exemption from compulsory coverage and taxes under the Japanese system, your employer must request a certificate of coverage (form USA/J 6) from the United States at this address:

      Social Security Administration
      Office of International Programs
      P.O. Box 17741
      Baltimore, Maryland 21235-7741
      U.S.A. ”

      Hopefully someone along the way gives a heads up to the bureaucracy about this issue.

    10. Mark Says:

      So, if self-employed, “one-yen” business, one-man operation (all me), is exempt? I have private health insurance and spouse VISA.

    11. Nick Says:

      The rule booklet they gave me a couple of weeks ago says there’s a maximum of two years backdated fees they can ask for. Is that changing or is the article misleading?

    12. Deepspacebeans Says:


      Exempt from having to provide Shakai Hoken for yourself? Yes. However, you would still need to enroll in the Kokumin Kenko Hoken.

    13. Ken Aston Says:

      How do I make sure I have this insurance? Do all seishain have it automatically? It that the health insurance card I was given?

    14. Mumei Says:

      I have read the article twice now, but to be honest, I am still confused. What counts as a valid health insurance? Is kokumin kenkou the only valid system? Is it trying to say that no private system will be valid? Stated another way, is there a way to verify that one is properly covered? I suppose that I could take a day off and head down to immigrations, but would rather avoid that…

      — Immigration is not the office to inquire at. Go down to your local town or city office and ask where the appropriate section is for your question (local Tax Office). See also HANDBOOK Ch 2 from pg 90.

    15. Johnny Says:

      I work for a company that pays 100% of my health insurance.

      Given how little I use it, and how much they pay because of what my income is, it’s very poor value indeed.

    16. let`s talk Says:

      Work visa can be sponsored only for full-timers.Full-timers must be enrolled in shakai hoken.Immigration should be logical.If they approve a work visa for a full-timer, why later they renew a visa with NHI when shakai hoken must be in apply? They must follow themselves and renew a work visa, which is for full-timers, with shakai hoken as for full-timers.In this case employers will not be able to cheat with 29.5 working hours and will have to enroll in shakai hoken sponsored by them foreign workers with work visa.But J-law makers as always did it in the wrong, at least in the current idea of future new rule.As the result, I am afraid foreign workers will have to pay 100% for NHI.

    17. Hoofin Says:

      This is the Japanese finally getting smart about things. See my blog post today, if you want the whole 1,000 words.

      National pension and national health insurance are required of all residents, regardless of work status. The Employer health and pension programs are of course, better. And we get left out of them.

      But realistically, the people setting up their own rules are just cheating us. And probably the folks back in their home countries, too, if they have a social insurance treaty with Japan.

    18. Doug Says:

      Hello folks

      I do not work as a teacher so I guess I can offer a different point of view for consideration. Please bear with me and consider the following. I would welcome feedback as maybe there is something I am missing or have not considered.

      This is a bad deal for alot of people, including expats at large foreign corporations, teachers at international schools (and the international schools themselves), and small business people like me.

      Most of us in the category above have private insurance that is much cheaper and provides better coverage then the Japanese system. We also have no use for the pension.

      As for me I have a small business and employ foreigners. I sponsor their visa and pay 100% of their private health insurance (I am not one of the bad Eikawa’s that tries to skirt the system). I have friends that teach at international schools that have school sponsored private health insurance that exceeds what the Japanese system provides. I have many friends working for large multi national corporations that have company provided plans that exceed the Japanese plan.

      If this is 100 percent true with no exceptions this is a disaster for alot of people.

      My take on this is as follows

      The Japanese system is going broke and is headed for a meltdown due to the aging Japanese population. If you combine the 50% employee contribution and 50% company (institution) contribution (payroll taxes) for all expats/foreigners in Japan this will be a gigantic subsidy on the backs of foreigners, international companies, and certain institutions to help subsidize the Japanese program.

      For alot of us in Japan this is a disaster and I believe this will severely impact Foreign Direct Investment into Japan.

    19. Behan Says:

      My ALT dispatch company plays a smoke and mirrors game to keep us off of shakai hoken. On paper they have us working 29.5 hours a week, but in reality we are often at the schools for far more than that. We are only supposed to work 5.9 hours a day, but a lot of schools will have us there for eight hours. The ALTs are supposed to be free to use the difference of two hours as they please but I suspect a lot of schools will expect work in this time.
      And if you are at work, I think you are working.

    20. Jake Says:

      Sadly I see this as yet another reason for employers to avoid providing proper visas for their workers: doing so means they have to pay more money. I expect this will cause the number of illegal foreigner workers in Japan to rise, not fall.

      “What to do, what to do? I know, let’s make the foreigners pay.”

      Yep. The system is going broke so they’re trying to get money out of everyone they possibly can. Unfortunately that overrides what is otherwise a completely bone-headed move.

    21. KyushuJoe Says:

      Johnny:Given how little I use it, and how much they pay because of what my income is, it’s very poor value indeed.

      Yes, but if (God forbid) you were hit by a bus tomorrow and ended up in hospital for a year (which happened to my Japanese teacher) then it would suddenly look like very good value. That’s the point of medical insurance; it’s there when you need it.

    22. Doug Says:

      Dear Hoofin

      With a qualification (below), I have to take issue with your post….also can you let me know how I can find your blog? Would be interested in your full perspective.

      My qualification is that I believe it is the responsibility for all employers to provide insurance for their employees. (I think that companies working employees 29.5 hours a week just to avoid shakai hoken is criminal as stated in by Let’s Talk and Behan is criminal).

      On the other hand, I do not think anyone is being cheated by those that are not in the system (with the above qualification). In most cases where foreign capitilized firms or entities exist(at least in industry, multi-national corporations, and small businesses) a very large majority of employees are Japanese nationals (in my small company it is a 8~1 ratio). Legitimate businesses (corporations, small business like mine, etc) are heavily scrutinized and provide full benefits to employees. All of my Japanese employees (every single one) are fully enrolled at a significant cost to my employees and my business. I was specifically asked to prove I am providing insurance for my Japanese employees during a recent tax audit.

      I do not plan to retire in Japan and neither do most expats, so enrolling in this program (health and pension) provides absolutely no value to us. I personally do not think I (or anyone in my situation) is cheating anyone by doing this as we are paying in for all of our Japanese employees and ensure that foreign employees are fully covered so as not to be a burden to Japan.

      Japan cannot have it both ways – treat us as “guests” while we are paying corporate and personal income taxes and emplying Japanese nationals and then on top of that adding on additional tax burdens which are unnecessary and we will never use (in the case a pension).

      I understand your point, and would like to read your blog (how do I find it?) but I do not believe it applies in all cases.

      I also do not understand the “we get left out of them” statement (regarding Employer benefit packages). Can you please elaborate more on that? Or is the implication that companies should not be free to offer differing levels of benefits to employees. I just want to understand the rationale. Some of my friends working at large multi national corporations have great Employer packages..far exceeding what I am doing for my private insurance….I do not resent that or feel left out or feel I am deserving something from another comoany.

      One can always argue “That is the way it is – follow the rules or get out” but in my case this could result in me (or someone in my situation) saying “OK – I am closing down” which would result in several high paying engineering jobs held by Japanese Nationals being lost and their (and my company’s) associated contributions into the system.

      I believe there needs to be some level of flexibility as long as the person holding the visa will not be a burden on society.

      I think Jake has a very good point. The unintended consequence (in addition to some loss of FDI) may also be an increase in illegal workers.

      Anyway probably could be a good topic for debate. I would also be curious if anyone knows of other countries having the same requirements.


    23. chuckers Says:

      >If you combine the 50% employee contribution and 50% company (institution) contribution (payroll taxes) for all expats/foreigners in Japan this will be a gigantic subsidy on the backs of foreigners, international companies, and certain institutions to help subsidize the Japanese program.

      Umm…I call BS.

      At the end of 2008, the foreign population of Japan was 1.74% of the
      total population in Japan.

      Let’s say, for sake of argument, that ALL of those foreigners are expats
      (obviously not true as that number includes Special PRs etc.) that will
      never see Japanese pension etc (also not strictly true.)

      Further, for the sake of argument, that ALL of those foreigners are salary
      men (and women) paying Kousei Nenkin (obviously not true.) Average salary
      in 2008 for employees in Japan was JPY 461 MAN.

      Let’s further take this thought experiment and say, because ALL of the
      foreigners are expats, that they are making 3 times the average or
      JPY 1,383 MAN or JPY 115 MAN per month. That works out to a monthly
      payment to Kousei Nenkin of JPY JPY 95,170 per month (half paid for by
      the company, half by the employee.)

      While JPY 95,170 per month per person is a fair amount, we are still only
      talking about 1.74% of the population here. The ENTIRE foreign population
      would be contributing JPY 21 Million per month. The goverment probably
      wastes that much in toilet paper.

      Anyone that claims that this is discrimination against foreigners or blaming
      the government for trying to fill the deficient holes by making foreigners
      foot the bills (bills that are owed by ALL Japanese citizens, btw) is promoting
      paranoia and rabble rousing!

      There are a LOT of shady employers out there. Go after them for exploiting
      foreign workers! Blaming the government for implementing these checks to
      ensure that everyone is carrying their weight is misdirected. Blame the
      government for not cracking down on shady employers!

    24. Doug Says:


      I do not think I claimed discrimination….just claiming that the government is looking for ALL sources of income to increase revenue (as most governments in the world are doing) – perhaps my point was lost or misdirected…Also I do think FORCING foreign residents into the program is subsidizing the Japanese system. Why else would they make this a condition of obtaining a visa other than trying to increase revenue.

      I do not think ALL foreigners should be FORCED into the program. Do you?

      If you do not think the J Govt is aggressively trying to obtain all possible revenue (as all governments are doing) join me for a tax audit. Also my accountant (Japanese) was pretty straight up in telling me that I am a foreign owned business and thus will be more heavily scrutinized.

      Not trying to promote paranoia or rabble rousing….trying to argue against being forced into this system

    25. HO Says:

      Doug, “Most of us in the category above have private insurance that is much cheaper and provides better coverage then the Japanese system.”

      If an employer fails to insure his/her employee with kenko hoken, s/he shall be punished by 6 month in prison and a fine of 500,000 yen.

      I doubt a private insurance can be better.
      Kenko hoken covers;
      (1) 70% of medical fees,
      (2) if medical payments go beyond 80,000 yen a month, a refund of 99% of the amount beyond 80,000 yen.
      (3) if an insured cannot work more than 3 days due to illness or injury, 60% of salary, tax free, during the absence.
      (4) if an insured has dependent family, 70% of their medical fees with no additional premium.
      (5) if an insured or his/her dependent family die, 50,000 yen
      (6) 350,000 yen, if an insured or his/her dependent family have a new baby, (or if pregnancy ends with death of a fetus.)
      (Kokumin kenko hoken does not cover (3) or dependent family.)
      Is your private insurance that good?

    26. chuckers Says:

      You claimed that this would be a gigantic subsidy on the backs of foreigners
      implying that foreigners were going to be supporting a good chunk of the old folk
      in Japan with their pensions payments/health care fees. I was pointing
      out that 1.74% of the total populations wasn’t going to make much of a dent
      even supposing that small sliver of population was making 3 times the average

      >I do not think ALL foreigners should be FORCED into the program. Do you?

      Why not? It is the law of the land, is it not?

      [nastily preachy citation of “Do as Romans” axiom deleted]

      Most countries would require payments of taxes and pension/social security

      Those who think they are getting the short end of the pension stick should
      either lobby their home countries for an equalisation treaty or make other
      arrangements. Those unhappy with health care insurance should find ways
      to supplement it or get a government approved replacement.

      Please provide a valid reason why one group of people should be allowed to
      avoid paying what everyone else is required to pay.

    27. O.T. Says:

      “While JPY 95,170 per month per person is a fair amount, we are still only
      talking about 1.74% of the population here. The ENTIRE foreign population
      would be contributing JPY 21 Million per month”

      Er… you math is off.

      The population of Japan is about 128 million. 1.74% of that is about 2.2 million
      If this amount of people were paying 95 000 yen per month, that would make about 21 000 000 000.
      Ah, I see now. You lost a factor 1000 somewhere.

    28. john Says:

      I have a question.maybe someone can answer this.
      Do we also have to join the STATE PENSION SCHEME? If so why would a 50 (for example) year old person who lives in japan untill retirement want to pay until they reach 65,then retire but be unable to claim as they haven’t achieved the full 25 years contributions?

    29. chuckers Says:


      Those over the age of 20 and below 60 are required to join Komin Nenkin,
      regardless of whether they have Japanese citizenship or not.

      However, those that will obviously not be able to make the required
      payments in order to receive an old age pension may, with the approval
      of the Social Insurance Agency, be able to exempt themselves. Contact
      your local SIA office at your local City/Ward office.

    30. O.T. Says:

      > If this amount of people were paying 95 000 yen per month, that would make about 21 000 000 000.
      > Ah, I see now. You lost a factor 1000 somewhere.

      Ha, my math is off too, missing one zero here.

      That would be actually 210 000 000 000 yen per month.
      But of course, as you mentioned, the assumptions were not realistic to begin with.

    31. Hoofin Says:


      I blog on WordPress under the name Hoofin (so I am not here to promote my own site, but I give my whole explanation over there.

      If I understand how Debito has it set up, when you see someone’s name that’s clickable (colorized), it takes you to their site.

      I realize any number of people disagree, but that’s what debate is about.

      Two things:

      1) It isn’t clear if the private insurers operating for foreigners pay into the fixed costs to provide the health system. They only cover the bill the hospital or clinic hands you.

      That bill may already be well subsidized as it is by the overall program. Who is paying the fixed costs to set up the system?

      What if it was decided by the Japanese that these fixed costs are subsidized by the progressive nature of the contribution “tax”? Higher earners pay more and maybe they are footing the fixed costs. A puzzle inside a puzzle. I went to the hospital for $300 USD (list price) last year. Insurance covered, but I can’t believe for all the service I got, it just cost $300.

      2) Social insurance programs, like national pensions, work only if every who should be paying in does so.

      It involves what is called the time value of money. If a person is allowed to skip years by working in a treaty partner that lets them skip, then the people back home are going to be the ones usually to have to make up the difference if the expat here does not have enough dough at the end of their career. By paying in, the expat is making the same money sacrifice as everyone in the cohort, and assuring the viability of the system longer term.

      I respect what you are saying, but I don’t like the idea that non-enforcement by the Japanese somehow opens up a debate on libertarian philosophies of government. Yes, great, if everyone or a majority decides they don’t want the National Pension scheme anymore. But voting with their feet, so to speak, is not a real vote. It’s cheating.

    32. AIB Says:

      HO, you have shot yourself in the foot.

      The problem is that, as you state..

      If an employer fails to insure his/her employee with kenko hoken, s/he shall be punished by 6 month in prison and a fine of 500,000 yen.

      This is routinely ignored, or circumvented by employers of foreign workers in Japan – and the authorities routinely ignore it.

      Just claiming “but the rule is” is just out of touch with reality.

    33. chuckers Says:

      >Er… you math is off.

      Sorry about that. I must have meant JPY 21 Million MAN. Either I left it off
      or it got edited out.

      Either way, the point remains. JPY 210 OKU is a drop in the bucket compared to
      what the Japanese government should be collecting from Tarou Q Kokumin.

    34. Level3 Says:

      Chuckers, your math IS way off, unless you’re using a different definition of “million”

      You have some good points and seem to be trying to take a balanced look, HOWEVER, you neglect a major point that supports the “gaijin are getting soaked by the government” case.

      Yes, gaijin are 1.74% of the poulation, I get that, but how many are pension-drawing retirees?
      Not many. I bet I wouldn’t be going out a limb that the proportion of gaijin retirees is FAR below 1.74% of retirees, I’d bet it isn’t even 0.0174%. (unless we’re counting Special residents)
      Additionally, recent pension treaty agreements mean that the J government is going to have to start paying out and honoring international pension obligations in the next 10-20 years, whereas they could previously just keep all pension payments beyond 3 years with zero obligation to people who left Japan, those payments now count toward a pension in another country (Britain, the USA, etc.) They are motivated to make sure the system is getting as much money as possible. Though not motivated enough to piss off voters. So, target non-voters, namely, gaijin.

      I’d assume that the proportion of gaijin who are in the labor force is higher than the proportion of population which is gaijin(1.74%). And since gaijin (unlike native Japanese) are easy to target/control/threaten with laws, can’t vote, aren’t allowed to live on the dole, and must be employed or eventually lose their visa status, gaijin are a good target for getting funds because they are (usually) employed, while those that aren’t employed can be deported (before they start presenting a burden to the system they’ve been paying taxes into for years, but that’s another issue) What is the gaijin unemployment rate, anyway? Or do they even keep track of anything except the alleged “gaijin crime rate”?
      Add in there is no real punishment for Japanese who don’t pay in. You can’t deport a citizen. And it bceomes clear how gaijin are a tempting target for all kinds of new government efforts to “improve efficiency” or “fight terrorism” or whatever, as long as you don’t call it “justify our xenophobia”.

    35. Doug Says:



      Thanks for your information. I am well aware of the Japanese system and I would consider my coverage equal to the Japanese one and for me personally (because of my personal situation) better. A few years back one of my children had an operation in Japan and our insurance covered 100% including full coverage for the private room. Also I have friends on the Japanese system (that are American) and they have had issues using the coverage overseas. The coverage I have is less expensive and provides equivalent or better coverage for me. If the Japanese system was a better deal overall I would enroll but it is not. I am not saying whether your system is good or bad – just relating to my (and several other foreigners I know) situation. Also I am not married to a Japanese so that is a factor as well.

      H.O. – can you please site me the specific law? This would be good information – thank you

      Chuckers – if you took what I said literally you are right – so perhaps different wording would be in order, however I agree with O.T. I think you underestimated the revenue – perhaps you intend to stay in Japan for life. If you do you should join and it might be a good deal for you….I do not so it is not a good deal for me.

      Also Chuckers I am not avoiding paying anything – My business is paying for all of my Japanese employees and I am paying for my own insurance (I am still paying) which is easier to use overseas, gives me a bit of a cost savings which helps my business survive in tough economic times. I would rather find a way to save costs for my self and other foreign employees, which prevents me from laying someone off, which keeps the person I do not lay off paying taxes and paying into the system, which helps everyone else in the system. I guess I would have to turn it around and say give me a good reason to force me into this system.

      Chuckers – I do have health insurance – can you please let me know what a “government approved replacement” is? I have not been able to find one. There are alot of us that would be grateful for that kind of information and some pretty “connected” folks have been looking for that. Presently supplemental insurance that works well overseas is pretty much equivalent to paying twice – have looked into that – but that is a good idea.

      John – this is one of the main issues – being forced to join also requires enrollment in the pension (from what I know).

      On a side note there is a large organization in Japan looking into this issue and estimating costs and even considering a legal challenge to this issue (I say considering because it sounds like they will not take that step). The financial impacts are pretty big.

      I do not disagree that insurance is a good thing, nor do I think companies should not insure employees however I do believe in choice – especially for people in my situation who do not intend to stay in Japan permanently.

    36. Hoofin Says:


      I don’t mean to sound like I am baiting you. But this has left me confused.

      1) If you are doing well as a proprietor here in Japan, then why would the 14,660 yen a month pension payment break you? That’s 175,920 yen a year. And you get to deduct it from both national tax and residents tax. So if you are in the combined 30% bracket, the national government is picking back up 30% of the cost to you anyway. You pay 123,144 yen net.

      2) Likewise, National Health insurance premiums are deductible. But a private company insurance that really isn’t licensed to operate in Japan isn’t charging deductible premiums. “Private” in the sense it is not a Japanese health insurer. Are the premiums really that much lower than the public program with the tax write-off? That’s hard to believe.

      I know that many employer cooperatives here make like they are separate from the national program. But the national government highly regulates these. And all health services must be not-for-profit as a rule. So what is the program you are using doing? How do they do it?

      3) All your employees (the high paid Japanese engineers) are required to be in both the pension and health insurance. Since they are high paid, they would rather be in the employer system, right? It would net to less taxes for both you and them. Unless they don’t care because they’re skirting payments or made other arrangements, too. Then that’s a situation, right?

      If they have to pay, say 50,000 yen premiums out of pocket themselves, aren’t they just as well off taking a 25,000 yen salary cut and having you pay half and they pay half? They pay 25,000 back to you (don’t get taxed on it), and only have to pay 25,000 (tax deductible) for the premium.

      What am I missing?

    37. AWK Says:

      Got PR in 2004, since then f…ck NHI which is nothing, covers almost nothing either and Japanese themselves have thousands of insurance to cover them up in case of hospitality, cancer, etc. Japanese cannot afford to pay and many do not have so the best is to force again gaijins to cover old and not paying Japanese. Someone wrote above about paying back 1mln yen. I would prefer leave (1 year rent in Europe for 100m2) than pay for nothing to someone who treats you already like a criminal

    38. Hoofin Says:


      There is a special exemption of 1/3 or 2/3 of the nenkin payments for low-income individuals. I don’t know if there’s a full waiver but I imagine in some situations there is. When I have had to pay it by coupon, I notice you are given two years from the due date to get it in. So there is a lot of flexibility.


      I am still trying to figure out how a totally private insurer gets away with it in Japan unless the regulators look the other way. All medical care is provided on a nonprofit basis. Even when companies began to set up nurse dispatch services in the 1990’s, the dispatch companies themselves had to be owned by nurses (so no profit maker outside of medicine was being let in).

      It really sounds like the company you use is cherry picking. Essentially, you are uninsured by Japanese rules, even though you are supposed to be. But you have a side agreement with someone else to pay your bill if you use the medical system.

      If the prices in the system are fixed, regulated, and quotes only meant for those who are already members of government recognized insurance programs, then it sounds like the company is free riding as well. Cherry picking, and free riding.

      How is that libertarian taking care of oneself?

      The prices are really meant for people who are paying the other cost through the arrangements in the Medical Care Law (fixed premiums based on income).

      Frankly, I am surprised the Japanese haven’t shut down that insurer long ago. It sounds like something illegal.

    39. Doug Says:

      Hoofin – no worries about your post – it does not seem to be baiting to me but seems to be legitimate questions. Also I have learned a few things I did not know before during this debate and tend to learn more when challenged

      That said

      1. My pension payment would far exceed 14,660 Yen per month based on present salary

      2. Even with the deductable insurance premium it is still less expensive and also there is the issue of using coverage overseas – I would be at the top level of what I need to pay for insurance which would be over 113,000/month (company + personal contribution)

      3. The program I personally use is a private insurance company that is geared to providing insurance to expats – I use a broker in Tokyo – I am not using the biggest one that most of us are familiar with (the one that begins with “I”). The insurance I use is widely known and accepted in the U.S. without up front payment.

      4. My Japanese employees (actually driving force is their wives) all WANT to be in the Japanese system. I actually asked them if they would be interested in other options. My accountant advised against it and my employees are not at all interested (all are married with at least 2 children). Financially there are some of them would come out ahead in the short term, however it is not a good long term option for them

      a) I am not sure it is legal for me not to put them into the National system (see post by H.O.)

      b) If we interrupt their coverage it is a bad deal (I actually had to help out and pay “back” taxes for 2 of them as 2 of them worked for an unscrupulous company that was not paying into the system (unknown to the 2 employees – yes this happens to Japanese too – not only foreigners).

      It is a very bad deal to interrupt the program once you get on.

      Because of the timing of this, this happens to be a very important issue for me at this time so thanks for the questions and comments.

    40. chuckers Says:


      >aren’t allowed to live on the dole

      Foreigners are “allowed to live on the dole” provided they have been paying
      into unemployment insurance. A few years ago, foreigners were “allowed” to
      opt out of Kouyou Hoken but that legal “loophole” has been closed and now
      non-shady businesses are required to enroll ALL staff in it (there might be
      some exceptions due to company size. Not that up on the finer legal points
      of it.)

      As you point out, this is contigent on having a valid visa. But that applies
      to probably just about any country in the world that has such a system.

      >which keeps the person I do not lay off paying taxes and paying into the system,

      Your employees maybe paying into the tax system but you have also claimed that
      your foreign staff are NOT paying into the health insurance system. It may look
      like it goes to the same place (government) but they are (mis)manageged

      And come to that, you claim that you are paying the insurance for your Japanese
      staff but not your foreign staff. Why are you discriminating against the
      Japanese by making them pay higher insurance rates? Wouldn’t you have a greater
      cost inscentive to place ALL of your staff under the same program?

      I am not trying to flame you on this matter but I see this as an equality issue.
      I have met numerous Japanese that have told me they envy me because they are
      convinced that because of my foreignness, I am exempt from taxes/health insurance
      payments/nenkin payments. I always have to correct them and tell them I am
      paying into the same systems they are. That mind set won’t change unless there
      is education and actual work towards worker equity.

      As for goverment approved options, have you looked into some of the kumi-ai?
      Many of them have fallen on hard times but there are still a few out there.
      Do I understand that you manage an IT firm (sort of implied by a previous post
      but I may have mis-read it.) Have you looked into the following:

      It is based in the Kanto region and is for IT related companies. They provide
      cheaper premiums than straight out of the ward office government insurance
      program as well as slightly better benefits.

      I do understand the point of people saying “why should I pay into a pension
      scheme when I won’t see any benefit?” But I hear that in my home country as

      I have a friend that paid 3 years into the Japanese system but hasn’t continued
      it for the last 10 years. He has maybe 30 years to go before retirement
      but I worry for his future, especially when he isn’t sure what he is going to
      do going forward. Inertia has set in and for the moment, he is stuck in
      Japan. If he makes it to retirement, he won’t have a pension here. If he
      is going to go home, he had better do it quick and find a job that would
      allow him to make up his “lost” time in Japan (in this global economy?)
      If he had paid into the Japanese system for the past 10 years, he wouldn’t
      have as much to make up and would still be able to collect some of it.
      Japan does make pension payments to foreign addresses (as does the US as
      well as many other countries.)

    41. Josh Says:

      Hello all,
      As far as private insurance goes, I use it because I can go to the foreign clinics here in Tokyo that don’t accept NHI. I’m sure there are a lot of people that feel the same way I do about this. Any thoughts?

    42. Hoofin Says:


      The National Pension (so-called “Kokumin Nenkin”) is 14,660 yen a month. It is the same price for everyone, and the ward or prefecture sends you the coupon book.

      The payment is a deduction to taxes. At least as what the English translations from the tax office say.

      The National Health Insurance (“Kokumin Kenko Hoken”) is based on prior year’s wages. It looks also like the schedule is based on resident’s tax. So Starting June 2009, the premium is based on reported income for 2008.

      The premium (tax, really!) is figured on the same sliding scale as taxes, so people who make more pay more. The added money is obviously going to cover people who are making less. But there is a cap to that payment. I think in Shibuya Ward it’s 69,000 yen a month in 2009.

      I know for the government health program, it is regardless if you have a company or not. So if you walk in and enroll, they aren’t going to ask about your employer’s system. They are going to go over to that computer where they have the names of all the registered foreigners in the ward, then somewhere along the line get the tax information from Otemachi. Later, send you the coupon book.

      A lot of first-year [NJ]– kids mostly — don’t realize that the Japanese will base the first year on their prior year’s income in Japan (which would be zero of course). So the first year premium is next to nothing (maybe 4000 yen a month). Even the second year would probably still be low, unless they show up in the first few months of the year.

      Your employees’ wives know the score: the Employer plans are much better, because they can go into the government-regulated cooperatives. But the prices at the payment desk are the same. It’s just that the premiums get to be calculated differently, and in a way that usually costs less.

      If private companies are coming in and offering even lower premiums, but they don’t sell to Japanese because what they’re doing is really illegal, then I don’t know what to say.

      I guess there are these scams that go on all the time in life, and they grow and die based what people get away with. I think the vaunted NOVA English school was running a non-government private insurer for its employees before it went bankrupt in 2007. When the foreign workers went to collect social insurances in their local offices, they found they were liable for 2 years’ of back insurance premiums—even though they had had deductions out of their NOVA pay packet.

      To me, it’s funny here that almost everyone (NJ) gets word of the “ways around the system”. But when the government goes to lower the boom about a rule, everyone pretends they were never told and what an outrage it all is.

    43. chuckers Says:


      Not sure why I was being responded to in your last response
      but you are correct that it is possible to get a reduction in
      the amount you have to pay into Kokumin Nenkin if you are in
      the low income bracket. The law was recently changed to break
      it down in to 1/4, 1/2, 3/4, and full exemption, based on income.

      Details here:

      You have to be pretty much living hand to mouth in order to get
      the full exemption. A 3/4 exemption is fairly possible for a family
      of 4 making just under the average salary.

    44. Steve Says:

      I have been working in Japan for about 10 years now,
      and I’ve always been enrolled in Kouyou Hoken ONLY.

      Well, 2 years ago I joined the Kenkou Hoken as well,
      so that fact will satisfy the new April 2010 regulation.

      My Kenjou Hoken card admits I am the householder,
      supporting 3 dependents (Japanese wife + 2 children)
      but the main point here is – I’ve never paid into Nenkin.

      The Kouyou Hoken only costs me about 1200 yen a month.
      Why do people think Kouyou Hoken and Nenkin are a set?

      OK, here’s my problem, I hope you have some good advice:

      My current employer has 20 employees, yet he refuses to
      process the Kouyou Hoken card which I gave when I joined.

      He mistakenly assumes Kouyou Hoken and Nenkin are a set,
      and because he wants to continue to refuse the Nenkin system,
      he thinks turning in my Kouyou Hoken card will cause him trouble.

      * Kouyou Hoken has saved me before, so I demand to be enrolled.
      Once, when I needed it, Kouyou Hoken kindly gave me 36man yen.

      So, do you have any links in Japanese which will help him realize
      1) one can be enrolled in Kouyou Hoken WITHOUT paying Nenkin
      evidenced by my 10 years’ experience at many Japanese firms
      2) he is legally required to turn in my Kouyou Hoken card, which
      means 1200 yen will be subtracted from my salary, as always.

      I don’t want to complain directly to the Kousei Roudousho, since
      that might cause him to decide to fire me, I wouldn’t want that. (!)

      I simply want him to turn in my Kouyou Hoken card, as every other
      company I have worked for in the past has, so that I am protected.

    45. AWK Says:


      Somewhere was written here that J officials said that if foreign clinics accepted NHI they would have to take J people and shorten their visits, so now I know why in J clinics you have 3min visit, get some pills and go home. I only use foreign clinic, first of all Tokyo British in Ebisu where I often spend 30min or longer with doctor. This is great service where someone try to help you and really investigate. What they cannot do there they will recommend “real” hospital and doctors to go. My J wigfe have expat insurance too and go to foreign clinics. At least nobody refuse her due to overbooking as yesterday one of my family pregnant member was refused in J Hospital during the day and asked to go elsewhere. Well…overbooked and she was bleeding. Still wants to pay to dying system? Better leave

    46. Mumei Says:


      Forgive me for being pedantic, but surely mean “koyou hoken” (雇用保険 employment insurance).

    47. Steve Says:

      Hi Mumei,

      Thanks for the correction, you’re right, I meant to write Koyou Hoken.

      So – does anyone have any thoughts on the subject of Koyou Hoken?

      Has anyone else been enrolled in Koyou without ever joining Nenkin?

      Thanks in advance for any related advice you might be able to share.



    48. chuckers Says:

      He may have got the spelling from me. I hate romaji because I always misspell words.

      Steve, here are a few links:

      It basically says that it is required. The second URL contains the pertinent law.
      Section 8 covers penalties for failure to submit information to the authorities
      which includes jail time up to 6 months and fines up to JPY 300 000.

      N.B. I didn’t read the law all the way through nor am I a lawyer. Also, I don’t
      think the site is a government sponsored site but I don’t really have any reason
      to doubt that the information is accurate.

    49. Josh Says:


      So, what will happen to the clinics like the British Clinic, and the American Clinic once everyone has to be on NHI? I suppose that some people will put buy expat health insurance on top of NHI, but that seems very expensive to me.

      I imagine with the loss of so many expats over the last year, and everyone having to have NHI in April 2010, the expat doctors are quite worried.

      On a side note, I have been very dissapointed in Interglobal’s understanding of this situation. Basically, they are refusing to tell customers that they will need to change to NHI from next year. I understand they are going to lose a lot of business, but people could be in a lot of trouble if they just blindly sign up for another year of their health care.

    50. JP Says:

      Um Hoofin,

      Maybe you missed this above. There is a link to the SIA homepage.

      Kosei nenkin (kokumin nenkin) is paid based on a sliding scale with the top monthly payment of 47,585 JPY. Payable by the employee. If the amount you are paying is 14,000 JPY then either your employer is under-reporting your income or you are earning in the neighborhood of 190,000 a month.

      The average annual household in come in Tokyo was in the 7 million range. Can’t find the link right now. Assuming that is being earned by a single breadwinner, the average person pays in excess of 40,000 a month, while the employer is on the hook for a similar amount. At least there is a cap.

      I think the whole reason people/businesses try to avoid paying this is because it is substantial.

      I look forward to reading your blog.

    51. James N Says:

      Just thinking out loud…..

      If the DPJ wins the election at the end of this month, what are the chances of this new law being delayed or altered in some way?

      I also find it disconcerting that my employer’s silence on this issue is quite deafening. Are a lot of these companies attempting to make backroom deals with the government? I called my head office yesterday, and I got the run-around.

      They “didn’t know” what I was talking about.

      Per my previous post on this topic, and if the law stands AS IS, then I feel strongly that many long term NJs will be canned in the name of “a bad economy” in order to avoid the additional costs that could and would be inflicted on these companies. Either this scenario will play out, or it will be mixed with a dose of corporate bankruptcies.

    52. Hoofin Says:


      You have two situations confused.

      Kousei Nenkin (employee plan) is slightly different from Kokumin Nenkin. Kousei has two parts: one of them is the same as the national pension. The other part is a sliding scale pension like U.S. social security.

      Everyone in kousei gets their kokumin nenkin automatically credited based on their withholdings.

      You are right that the top scale is 47,585 yen or so, at least until September when it will go up again. The employer is usually chipping in at least half. Even when you are in the lowest bracket of the program, which is about 7,500 yen a month, you see how your share and the employers share make 15,000 yen and that would cover the kokumin nenkin amount.

      BUT, if you are NOT enrolled in a kousei nenkin type program, then you MUST pay kokumin nenkin if you are resident here and between ages 20 and 60. So that was my point to Doug I believe. He said he wasn’t in the national pension because it was a burden on an otherwise profitable company employing many Japanese. But I asked if 14,660 yen a month (tax deductible by the way) was going to break him?

      You are right: Kousei nenkin has payment bands higher than 14,660 yen. But only if your company has this kind of plan. Otherwise you are supposed to be in the kokumin nenkin regardless.
      The kousei nenkin schedule, combining both health insurance and pension insurance withholdings looks like the one on the link. You see your 47,585 there, starting at Line 34. The health insurance bands in that company keep going up to a higher point—I think each company program is different. But here, I was just talking about KOKUMIN nenkin.

      As you see, if you are even a mid wage eikaiwa worker in Japan, it is much better for an employee to be in a kousei nenkin plan than have to foot the 14,660 yen him- or herself.

    53. Hoofin Says:

      @ JP:

      PS – on the Pasona chart, even though the bands quickly rise about 14,660 yen, the formula for the benefit is different (and much more favorable) than the basic national pension. It’s complicated, and if I have time to blog about that in the future, I will.

    54. Steve Says:

      Hi Chuckers –

      Thanks for the info and the link, I appreciate your kind help.

      That certainly is a big stick potential punishment: Employers who refuse to process the
      Koyou Hoken card can be fined 30man yen and can be emprisoned for 6 months, wow.

      OK, now how about the “carrot” to positively motivate him: Does anyone have a link that
      explains that one can legally enroll in Koyou Hoken WITHOUT having to enroll in Nenkin?

    55. chuckers Says:


      Because Koyou Hoken and Nenkin are run by 2 seperate government
      offices, there *shouldn’t* be any need to be in one without the
      other. I have been in Kousei Nenkin without being in Koyou Hoken
      before they closed the loop hole. If I hadn’t changed jobs, I
      would still be in that situation.

      Your employer *does* have to tell Hello Work your Visa status as a foreigner
      (unless you are a Special Permanent Resident visa holder.) That
      law went into effect 2007-10-1.

      The *might* be some financial inscentives for enrolling certain
      types of employees (just being foreign probably doesn’t count.)

      Can’t seem to find any thing that would indicate what the employer needs
      to present to Hello Work beyond your Visa Status which would be found in
      your Passport or on you Gaijin card. I haven’t seen the forms that
      an employer has to fill out, though. Those *might* have a Nenkin number
      requirement but I doubt it.

    56. JP Says:


      I did my homework and yes I was able to confirm everything you wrote in post #52. Actually, there was one thing that I was unable to verify. Kousei nenkin includes health insurance (kenkou hoken)? As per your Pasona example and my own experience, health insurance is separated from kousei nenkin. My question would be, why would a company choose to get additional health insurance if it is already part of the benefits received for being part of the kousei system? It seems that that would just cost an employer more money that could be considered an unnecessary expense. And I just remembered, I quit a company after 3 months when they refused to enroll me in health insurance but were deducting kousei nenkin fees. Or is something else happening here?

    57. chuckers Says:


      Kousei nenki and kenkou hoken are indeed seperate. I am not sure where you got
      the idea that one was included in the other.

      As such, going with another carrier for kenkou hoken isn’t a waste for
      the company and can actually save money for the company and employee by
      NOT using the government supplied kenkou hoken.

    58. Hoofin Says:


      The catchall phrase is “Shakai Hoken” (social insurance, or “SH).

      If I had said that Kousei Nenkin included the health portion, then I misspoke. I wrote a ton about the issue between here and my personal site, so I might have made the mistake somewhere.

      “Shakai Hoken” consists of the employer pension (Kousei Nenkin), and the employer health insurance (which might be called Kousei Kenko Hoken). The national pension is within the employer pension as “Part A” according to the Social Insurance Agency website.


      By the way, it’s my understanding that Koyou Hoken (unemployment insurance) is entirely separate from the catch-all Shakai Hoken. SH includes the parts mentioned above, but NOT the koyou hoken.

      So to the earlier poster, arguably you can try to enroll in koyou hoken without setting off any fireworks about SH.

    59. HO Says:

      Doug, re #35,
      The law is 健康保険法.
      You can read the law (in Japanese) from here.
      In general, if you employ 5 people or more, you have to provide your employees with kenko hoken coverage, but there are exceptions. See article 3.
      I would recommend the following page than reading the law.

    60. Steve Says:

      Hi Chuckers –

      Thanks again for helping me collect the proper motivational tools.
      I will let him know about that 6-month prison term (God forbid).
      And I will simply remind him that Koyou and Nenkin are seperate.
      I’ve always been enrolled in Koyou without Nenkin, it must be so.
      I’m glad to get confirmation that my experience matches reality.
      I already gave him my Koyou “card”, he simply needs to submit it.
      After he submits my card to Hello Work, they’ll print up a new one.
      (I will post an update later – about whether he actually submits it.)
      OK, thanks again for having spent time/energy helping a stranger.

      Hi Everyone – a more relevant question, which we all need to know:

      Does the new law state Kenkou Hoken is enough for visa renewal?
      Or does the new law require Health PLUS Pension for visa renewal?

    61. AWK Says:


      You`re right. I was thinking about the same thing. Foreign Clinics may have two choices IMO
      1. [accept] NHI
      2. rely only on short term expat and embassy employees

      my private insurance is full coverage (in-/out-patient). From next year as additional insurance one can take the one which covers you 100% in case you are admitted to hospital (cheaper in-patient only).

    62. Shane Says:

      It goes both ways. Cheap ass eikaiwa companies such as Peppy Kids Club, iTTTi Japan, Geos… should stop taking advantage of foreign workers on stupid one year contracts and provide more stable employment with national health insurance, shakai hoken.. and the cheap ass teachers ahould’ve enrolled into NHI which costs a little more than the cheap health insurance advertised in the Metropolis magazine. The Eikaiwas didn’t tell us workers about enrolling into the NHI when we first started for their crappy companies. Hard working teachers put in more than 29.5 hours per week. The Labor Law Office should investigate some of these illegal companies…

    63. James N Says:


      The law stipulates that all full time employees must be enrolled in Shakai Hoken. Shakai Hoken includes Health and Pension. THEY CANNOT BE LEGALLY SEPARATED. That said, in order to work at an eikaiwa LEGALLY, one must be hired on a full time basis. This is the law, and the very law that the eikaiwas have been flouting for all these years. If any eikaiwa teacher looks at their Gaikokujin Torokushomeisho (Gaijin Card), it will say 英語教師 (Eigo Kyoshi) on it. This is important, because the term “教師” identifies in no uncertain terms that the job the card carrier was hired for was indeed for a full time position as a teacher. A part time teacher would be referred to as a 嘱託講師 (Shokutaku Koushi).

      If the law stays as is, subscribing only to private insurance will not be sufficient enough to renew your visa. No one knows how the enforcement of this up until now ignored yet long standing law will affect Spousal and PR visa holders.

    64. chuckers Says:

      Refer to:

      While the guidelines listed above do apparently state you
      need to be enrolled in Shakai Hoken (both Nenkin and Kenkou
      Hoken) WHERE required (that last bit is a bit vauge.
      Probably means if you are employeed, you need to be in Nenkin
      but if you are a student etc, Kenkou Hoken is sufficient) it
      also states they will only require you to show your health
      insurance card.

      Hopefully, they won’t require you to show your pension book
      as well. While I always have my health card with me, my pension
      book is in a lock box at home.

      It is also unclear whether or not re-entry permits will require
      you to show your health card or not.

    65. Behan Says:

      With Kokumin Kenko Hoken, I believe you do not receive any salary compensation if you are off sick from work. But with shakai hoken, is it true that you can receive some salary compensation? If so, this is another reason I wish my company would put its employees on shakai hoken.

    66. Steve Says:

      Hi James N –

      Thank you for explaining about Shakai Hoken so clearly for me and everyone.

      I understand that old Shakai Hoken law states all full time employees must be enrolled in Shakai Hoken, and how many companies refuse to comply.

      The VITAL question remains unanswered, about this NEW visa renewal law that goes into effect from April 2010, for those whose companies refuse to obey that old Shakai Hoken law:

      Does this new visa renewal law state that from April 2010 to avoid deportation we merely need to show proof of enrollment in Kokumin Kenkou Hoken?

      Or does this new visa renewal law state that from April 2010 to avoid deportation we must show proof of enrollment in BOTH Kokumin Kenkou Hoken AND Kokumin Nenkin Hoken?

      The article by Jenny Uechi posted above doesn’t answer this question, because it describes the new requirement in 2 differing ways:

      “…enrolled in one of Japan’s national health AND pension programs?”
      “…show proof of enrollment in (just) Japan’s health insurance program.”

      So, which is it?

      Before we all get deported next April, we should find out the answer to this vital question.

    67. Steve Says:

      Hi Everyone –

      OK, I found the official Ministry of Japan page with this new visa renewal law:

      It seems that proof of Japan’s HOKEN enrollment is all that is needed (whether it be Shakai Hoken through your employer, or Kokumin Kenkou Hoken paid for by yourself.)

      It seems that if we choose the Kokumin Kenkou Hoken option, this new visa renewal law DOES NOT require us to also join Kokumin Nenkin.

    68. chuckers Says:


      Refer here with regards to Health Insurance:

      Here for Japanese:,271,25.html

      Health insurance can cover some of your salary in the event
      of hospitilisation due to illness/injury. Nenkin can provide
      you with disability payments if you are unable to work:

      Here for self employed persons:

      Here for people working for a copmany:

      Those documents are about 2 years old and may NOT reflect current
      laws. English translations are probably low on the list of priorities.

      This is a really convoluted issue and it is being made more
      complex by similar terms being bandied about that are often NOT

      I am, by know means an expert on this and even most Japanese find the
      whole thing a bit convoluted based on the number of tv variety shows
      explaining how things are meant to be when the Nenkin Problems exploded
      a few Prime Ministers ago.

      Let’s try to recap.

      Shakai Hoken (社会保険)
      – Catch all phrase that refers to the Social Insuarance (Security) system.
      It includes Kenkou Hoken (健康保険i.e. Health Insurance) and
      Nenkin(年金,i.e. Pension)
      Everyone is REQUIRED to be enrolled in Shakai Hoken in some form or other.
      That means Kenkou Hoken (Health Inusurance) AND Nenkin (Pension.)
      This is the law. Many people are skirting around this and not paying one
      or the other (or either.) Pension is probably the easiest one that goes
      missing as there are fewer checks. Lack of Health Insurance would quickly
      get noticed unless you never ever get sick.

      Kenkou Hoken (健康保険)
      – Health Insurance. Again, required to have. This is especially
      important for foreigners now because from April 2010, you will be required
      to show you health insurance card for visa renewals (thus, this article.)
      It provides 70% of the costs of doctor visits as well as 70% of
      the cost for prescription medication for you and your family. It also
      provides a meal allowance for hospital stays as well as some salary
      coverage if you are unable to work. There is the generic, government
      provided one that anyone can join and can be applied for at your
      ward/city office. There are often company provided plans though various
      groups that provide cheaper premiums and better benefits (e.g. ability to
      stay at various hotels at a discount, discounts on gym club memberships etc.)
      The level of health care doesn’t change as you are still going to the same
      hospitals. You usually have one or the other. Some companies don’t
      have a seperate plan and just use the generic government supplied one for
      their employees. Premiums are based on salary.

      Nenkin (年金)
      – Pension. There are 2 types for this: Kokumin Nenkin (国民年金)
      and Kousei Nenki (厚生年金). Part of Shakai Hoken.

      Kokumin Nenkin is required for everyone. It is mostly used to refer
      to the pension plan for Self Employed (or unemployed) persons between
      the ages of 20 and 65. Costs JPY 14 660 per month (will continue to
      increase.) Allows for disability as well as a widows benefit (although
      not a widowers benefit) for the wife and any children under the age
      of 18 (20 if the child has a level of disability.)

      Kousei Nenkin is the Employee Pension which only company employees
      can join. It is required for all companies to provide that have
      5 or more employees (you can join it if you want if your company
      has less than 5.) It sits on top of Kokumin Nenkin as an additional
      benefit for company works and provides a much better retirement benefit
      but, naturally, has a higher premium. That higher premium is offset
      by the employer paying half and the worker paying half. The premium
      is based on your income (and will increase as the years go by.)

      There are also other types of pension schemes that don’t really need
      to be worried about: goverment worker pensions (naturally, this
      doesn’t apply to NJ) as well as Kikin(基金pension funds) which
      are added bonuses to the pension benefit for a small additional
      premium. Available in Kokumin and Kousei Nenkin varieties.

      Not seeing a benefit to the pension scheme is not an excuse for
      skirting the law. If one doesn’t think one will be going to
      collect a Japanese pension due to a minimal stay in the country,
      perhaps one should be lobbying one’s home country for a totalisation
      agreement if it doesn’t have one in place already (US, UK, Germany
      have them with other countries due at some point with varying degrees
      of “totalisation.”) You are allowed to claim up to 3 years refund if
      you leave Japan and decide not to remain in the pension scheme (less
      taxes and payable to a certain maximum amount. Must be claimed within
      2 years(?) of leaving Japan.)

      In summation: Legally, you are required to have both health insurance
      and be part of a pension plan. Either join both on your own or encourage
      your employer to sign you up for the equivalent of each. That keeps
      both you and your employer legal. It also helps those of us that have
      been paying into the system for so long already. Some of us intend to
      collect a Japanese pension even if we don’t necessarily intend to retire

    69. Steve Says:

      Hi Chuckers

      Good summary.

      Yes, legally, we should join pension.

      I’m just releived to know this new visa renewal law doesn’t require that.

      I now notice someone at mutantfrog also thought about this, and came to the same conclusion.

      “…these regulations refer only to the health system, and it does not seem that non-registration in the pension scheme will have any effect on visa renewals.”

      I think I would rather to continue not paying into pension, but I will take into consideration what you said about helping others, as well as the legal ramifications.

      By the way, if you do pay into pension, it seems you might want to take a little holiday every 3 years if you want to receive that (capped) Lump Sum Withdrawal Payment “Datai Ichijikin”.

    70. chuckers Says:

      >By the way, if you do pay into pension, it seems you might want to take a little holiday every 3 years if you want to receive that (capped) Lump Sum Withdrawal Payment “Datai Ichijikin”.

      I am a bit beyond the 3 years so doing that would end up costing me
      quite a lot.

      Add to that, you would need to “find a new job” every 3 years. In an
      economy like this, that might not be easy. Even if you think you can
      “find a new job” with your current company, they would have to be pretty
      understanding to let you pull out and then re-apply for a new work
      visa. Re-apply for a spousal visa every 3 years after a confirmed
      break would be a real pain, as well (if that applies.) I’d considered
      the “vacationing” option previously but decided it was too much
      work to make it worthwhile.

      Plus, pulling out every 3 years means you still aren’t making points
      with getting a pension in anywhere (Japan or home country if there
      is an equalisation treaty in place.) If you are independently wealthy
      and don’t need to worry about your golden years, more power to you.
      I intend to use the pension to help supplement mine. It won’t likely be
      enough to live on but at least it should provide food for the table.

    71. Steve Says:

      4 things I learned from this thread:

      Kokumin Kenkou is separate from Nenkin.
      Koyou Hoken is separate from Nenkin.
      Nenkin is not required for visa renewal.
      I am relieved I’m in Kokumin Kenkou.


    72. Steve Says:

      I belatedly notice that Chuckers was the first to post the visa renewal law MOJ link.

      The sentence to remember about the new visa renewal law is:


      We are only required to show our proof of enrollment in Kenkou Hoken.

      So you have 2 choices:

      A.) Push your employers to enroll you in Shakai Hoken (without getting fired, good luck.)

      B.) Simply enroll yourself in Kokumin Kenkou Hoken (which from now on we can jokingly refer to as “VISA RENEWAL INSURANCE”.)


    73. chuckers Says:

      One other thing I forgot to mention to Steve.

      Hello Work will allow you to verify that you are indeed enrolled in
      Koyou Hoken. This is to make sure that some shady businesses don’t
      screw their employees.

      You have to fill out some paperwork (naturally) and provide some
      ID and address verification (driver’s license, health insurance card,
      likely Gaijin card) and they will send you your status via registered mail.

      Section 4 of this page:

    74. Hoofin Says:

      I believe your interpretations may be off a bit. Or subject to another reading

      The above website mentions the valid insurance card as a requirement. But in both cases where its mentioned, they focus on “Number Eight” (social insurance requirement).

      First, it says: なお,8の社会保険制度の加入については,平成22(2010)年4月1日以降申請時に窓口において保険証の提示を求めることとしています。

      I read that first long clause to mean “concerning the (requirement) in Number 8 about becoming a member of the social insurance system(s). . .” The website is listing eight requirements about visa renewals.

      Number 8 itself says:

      8  社会保険に加入していること

      That first line under the caption reads: “When there is duty to participate in social insurance, it is necessary to carry out the duty concerned.” Then it goes on to say about how starting next April you are going to be asked for an insurance card.

      There is nothing in that website page to suggest that it’s “OK” not be enrolled in the pension program of Kokumin nenkin. In fact, the strong indication is that if it is a duty, then you are supposed to be in. The Ministry is only emphasizing that they will be asking for proof of health insurance.

      That’s just my reading, and I don’t really read Japanese well.

      You should also know that starting January 2010, the Social Insurance Agency will disband and another agency will be responsible for social insurance administration.

    75. Hoofin Says:

      You see, the Social Insurance Agency is going away:

      There is no saying how the new “Japan Pension Agency” will handle things. And there is an election between now and next January, which could change things even more.

    76. Shane Says:

      Thanks Steve abd Chuckers for providing that useful info. Luckily I’m enrolled in both and I don’t see cheap and stingy Eikaiwa/ALT employers enrolling everyone onto Shakai hoken. They’ve always found a way around the law.

    77. Steve Says:

      I see they have included that reminder
      about “if you have a duty to participate
      then it is necessary to carry out the duty.”
      Yeah, I agree, we should carry out duties,
      especially if we happen to have that duty,
      but, they are only demanding health cards.

      Example, driving 5 kph over the limit is illegal,
      but if a new law only punishes 10 over the limit,
      many folks will continue to drive 5 over the limit.

      If they were gonna require pension proof as well,
      then they would have written something like this:
      健康保険証 と年金険証 の提示を求めること

      So, I see pension as analogous to paying NHK,
      you should pay, of course, but many folks refuse,
      since the current reality is: no enforcement – yet.
      If someday they begin enforcement, then we pay.

      Since most governments have proven themselves to be totally
      incapable of refraining from spending the initial pension funds,
      (then creating guilt for each next generation to replace that loss)
      many citizens and residents choose to handle their own savings.

    78. Hoofin Says:


      No, it’s a little different. The Ministry is specifically saying it will look for proof of enrollment in a Japanese health plan.

      They are silent as to the other part of social insurance (the pension). But they do say the social insurances you have a duty to pay are considered factors (Number Eight). NHK fees are not social insurance.

      It depends on the new Japan Pension Agency (January 2010). And what the new government does whoever takes office next month.

      What happens when people get asked for proof of nenkin enrollment under Number Eight? Are they going to say “sorry, you can’t ask me about that. Just the insurance card?”

      Good luck.

      Sure, there are things you can get away with. But that always involves some risk.

    79. chuckers Says:

      >What happens when people get asked for proof of nenkin enrollment under Number Eight? Are they going to say “sorry, you can’t ask me about that. Just the insurance card?”

      Which is why I am hoping they aren’t going to make us carry our Nenkin books
      around as well.

      The next time I have to go out to Immigration, though, I will be sure to
      take my Nenkin book, just in case.

      I am also hoping that they don’t want to see these things when you apply for
      a re-entry permit. That would be even MORE tedious.

    80. Steve Says:

      If immigration were to start demanding proof of nenkin enrollment (which this new law does NOT state must be shown) then at that stage one would answer “OK, I’ll go get that,” and you immediately go to your local city hall and give some of your hard-earned-money to the government for proof of nenkin enrollment (best case just one month, worst case 2 years worth of back pay – all depending on the mood of the bureaucrat you’re dealing with that day factored by your ability to come back later and try again with a different bureaucrat.)

      Look, this new law says “We’re gonna start asking for proof of Hoken enrollment 保険証.” Sorry, that’s not going to scare strong intelligent people into purchasing proof of Nenkin enrollment in advance yet.

      Maybe someday they will actually write a strong intelligent new law that will state a new requirement of showing proof of pension.

      Like, 平成22(2022)年4月1日以降は,健康保険証 と年金険証 の提示を求めることとなります。

      Until then, in my opinion, pension is still analogous to paying NHK.


    81. Mumei Says:

      Even though it is not specified, I too will probably bring my nenkin techō the next time that I go to immigrations. However, as nenkin records are entirely computerized now and no longer kept in the booklet, it will be mostly blank for most people. What you can do is go to your local tax office and request a 被保険者記録照会回答票 (hihokensha kiroku shōkai kaitō-hyō). It is free and contains a summary of your pension details, such as how many months you have payed for. Again not necessary, but going the extra way with immigrations really can’t hurt.

    82. chuckers Says:

      Yes, the Nenkin booklet is pretty much blank. It looks like they
      should update it with all of your changes of status (from student
      to salaryman or self-employed to married to whatever) but I don’t
      think they bother any more. It is basically just a way of recording
      your number and wasting paper.

      I have been meaning to write down in it my various enrollments as
      indicated by the Neknin Tokubetsu-bin mail that came a few months
      ago but haven’t got around to it yet.

      Since it doesn’t seem to be updated, one would think it would be
      really easy for them to replace it with an ID card to go along with
      the Kenkou Hoken card (which also used to be a 3-fold slip of cardboard.)
      That might be one of the things on the agenda when the SIA goes away
      next year and is replaced by something else.

      All those not paying Nenkin now had better be prepared for that
      eventuality and either start paying up or start packing up.

    83. Hoofin Says:


      I appreciate that this thing might be going around in circles, based off two differing opinions.

      I just want to point out that simply because they don’t specifically ask for something, doesn’t mean immigration won’t look for it.

      It’s well known, they can check tax arrearages. What makes you think they won’t be able to check pension arrearages? All you point to is that they want to see an insurance card. Maybe immigration doesn’t have access to insurance enrollment?

      I appreciate that many people want to get away with whatever they got away with before. And maybe they will.

      I’m just saying it will be one lonely yell the day that someone’s renewal gets turned down because the new Japan Pension Agency (January 2010) has no record that they ever paid anything in.

      I think people who want a very narrow reading of what the Ministry said are kidding themselves if they think that’s the only reading out of it. Especially with this new agency appearing in January.

      Like I say, good luck to those that try and wing it.

    84. Doug Says:


      Just want to thank some of the posters here for some very good information. Sorry I could not reply sooner as I was away on a fishing/camping trip

      This has been one of the most constructive and informative debates/sharing of information I have seen on this board

      I am still of the opinion the Japanese system is not for me (or other foreign employees) but is best for Japanese or those that have naturalized or for other reasons will remain in Japan for a very long time. I also believe my Japanese employees are not interested (perhaps are skeptical of) private plans. Seens that generally their wives drive this decision and tend to stick with what has been traditionally accepted as the path with least risk (real or perceived).

      Anyway depending on what immigration decides to do with this law I have some information I did not have before.

      Thanks again!

    85. Steve Says:

      “…either start paying up or start packing up.”

      Or, just choose the relatively cheaper third option:
      wait and see if immigration asks for nenkin proof,
      and THEN, only then, go pay as little as possible.


    86. Steve Says:

      @Hoofin (as well as everyone else who shared good advice)

      I changed my mind, you are correct, thank you for your advice.

      From April, people not paying pension will not receive new visas.

      If my company refuses to pay half, I will simply pay 100% myself.

      I will begin paying the new agency from January 2010, absolutely.

      Sure would be great if we didn’t have to – but – the law is the law.

      Hoofin posted 13 good posts on this page, and then I read further:

      Thanks for your altruistic advice – to help us avoid deportation.

      PS – I also want to thank you for sharing this other link as well:

      I suddenly have become a strong supporter of the DPJ “Manifesto”.

      I never trust rulers, but I sure hope they implement those ideas.

    87. Dave Says:

      To Steve (and all others)

      First time commenter long time reader. I’ve been following this issue on both and on hoofin and I need to point out one thing. In your comment you stated that you would start paying as of January 2010. I would suggest that you start paying now.

      I recently joined the national health insurance and was forced to make back payments to July of 2008 which is when I left my full-time job in Tokyo. When I recently joined the national health I did not also join the pension, that was a mistake which i am promptly going to fix. I have also learned of a woman who was told she would have to make up to a maximum of 2 years of back payments if she were to now join the Pension system.

      It seems that no matter what the local ward offices are sticking to the policy of making people pay back payments of up to 2 years. Doesn’t matter if it’s Health or Pension. The back payments for the Health hurt more becauser they make us think of all that medical treatment we could have had but didn’t. The pension hurts less because we didn’t lose anything by not making the payments. However, since you will be forced to make 2 years of back payments it doesn’t matter if you start paying in January or now – you’ll still have to pay 2 years back. I’d suggest going to the ward office now and POSSIBLY slipping through the cracks. That’s what I’m going to do. Seems much less likely that you’d be able to slip through the cracks in January after the ward officials have dealt with this issue hundreds of times.

      Hopefully in both of our cases we will slip through the cracks and only have to pay the Pension going forward. Worst case scenario for you … you’ll have to pay 2 years back. Worst case scenario for me I’ll have to pay back to July of 2008 when I left my full time job and got dumped from the Shakai Hoken system (and should have subsequently joined the National Health and Pension).

    88. chuckers Says:

      Keep in mind that payments due for Nenkin will be increasing every year
      by JPY 280 until it peaks at JPY 16 900 per month in the year 2017
      (Heisei 29.)

      Low income persons can look into a Pension exemption of 1/4, 1/2, 3/4 or
      even full exemption. The size of the exemption will depend on your income
      and the number of mouths you have to feed at home.

      There are also (small) discounts for paying 6-months or 1-year in advance
      rather than paying every month.

    89. Dave Says:

      Update on my last comment. Got a letter from the City of Yokohama today demanding that I make all back payments due on my pension to July of 2008. For those of you who are thinking that this isn’t really happening or that you won’t really have to join the H. Insurance and Pension to get your visa renewed I have just 2 words … wake up.

    90. Anecdotal evidence that Japan is finally enforcing social insurance enrollments « Hoofin to You! Says:

      […] month, there was a lot of discussion over on Debito’s blog about social insurance enrollment becoming mandatory for the visa in Japan. Probably not on the […]

    91. Hoofin Says:


      I just wonder that, the government usually gives everyone 2 years to make an individual coupon payment. It looks like it says so right on the coupon.

      Are they asking for the post July 2008 payments right away, or before July 2010 (Aug. 2010), etc.?

    92. Glenski Says:

      I seem to recall that the law itself may pass in 2010, but that it really won’t take effect until 3 years later. This might have something to do with people having a 3-year visa, and giving them time to get on NHI. Has anyone else heard this schedule?

      As for the original article, I am a bit disappointed in at least one statement, the one citing that so many foreigners do not have the insurance plan in question. Shoddy research or poorly documented research. Let me quote:
      “However, the reality is that most foreigners in Japan do not have either form of insurance. For example, a 2004 survey by Hiroshi Kojima of the National Institute of Population and Social Security Research found that only 28.3 percent of Japanese Brazilians in Iwata City, Shizuoka Pref., had any kind of health insurance, and that of these only a third were enrolled in shakai hoken. Another survey in 2009 found that just one out of 27 manufacturing companies had enrolled its foreign employees in workers’ compensation, leaving thousands of foreigners ineligible for any form of assistance when the economic downturn hit Japan last year, leading to mass layoffs.”
      So, the author cites a 5-year-old survey on Brazilians in one city. Hmm. And, as for the 2009 survey, where are the details or a link?

      The article also mentioned that part-timers are obligated to be on NHI if they are there more than 2 months:
      “companies legally have to enroll part-timers if they have been working for the firm more than two months”
      Can anyone verify this? It only seems to apply if you work more than the illustrious 29.5 hours/week, but the article sure didn’t write it that way.

      HO wrote:
      “If an employer fails to insure his/her employee with kenko hoken, s/he shall be punished by 6 month in prison and a fine of 500,000 yen.”
      Where did you get that, please?

      Just a couple of comments here to close.

      1. Immigration wants to be the ones to handle all matters concerning visas now. Perhaps that will actually be a good thing ONLY in terms of the following: I would think that when a foreigner signs up for an alien registration card, the ward office should take responsibility to determine what kind of insurance plan they are on. I signed up for my ARC and NHI simultaneously ages ago without any advice from the office, only from the coworker who brought me to the ward office. If immigration will be in charge of things from now on, perhaps that will be enforced more strictly. Since many foreigners were clueless about needing to sign up, it only makes fair sense to allow some sort of amnesty, as mentioned earlier.

      2. Since many foreigners were clueless about needing to sign up, it only makes fair sense to allow some sort of amnesty, as mentioned earlier. The truth is, very little information has been released on this whole topic of visa renewal, and lots of public speculation has been generated. Be careful about spreading rumors.

      3. In trying to read up more on the kokumin plan, I just noticed that the site is down, citing “under maintenance”. Coincidence?

    93. Doug Says:

      I know this is an old post, however this web link, petitioning for eliminating the requirement that foreigners join the NHI, was forwarded to me by a friend. Please take a look at this link and if you agree with the points presented consider signing the petition. Also please forward this link to as many people as you can.

      This group is not trying to change anything about the existing NHI in Japan. This group also advocates requiring foreigners in Japan to have insurance (so as not to be a burden on society). This group only wishes that foreigners in Japan, because of many of our unique situations, be allowed to use private health insurance.

      The newly elected Democratic Party of Japan is very open to reversing this decision and allowing foreigners to use private insurance.

      The potential costs to foreign companies in Japan, including international schools, is huge, especially if foreigners renewing their visas are required to pay 2 or 3 years “back payments” on insurance premiums. A friend of mine at a large international company in Japan also told me that this new law was one of the reasons (not the only) that their East Asian headquarters and much of their R&D was moved out of Japan. This resulting in a very large loss of tax revenue and of course a loss of jobs for Japanese nationals. The net benefit to Japan in this case was a huge negative. One of the international schools in Japan indicated that the costs of this law could be “devastating”.

      If you agree with the contents, please consider signing this petition and forwarding this on to others.


    94. Jon Says:


      The solution is relatively simple and I just completed it myself. The answer is MOVE CITIES. Well, not in reality, just on paper.

      My city wanted two years back payment (a substantial sum)for the health plan. I argued against payment until I was read in the face. Having private insurance (with proof) the entire time I resided in Japan was not convincing enough to municipal employees that I had NOT been milking the system. Frustrated, I obtained the paperwork needed to change address to a neighboring city. I “moved” to my friends address in a neighboring town, registered for insurance in that town with NO PENALTY (since I was viewed as a NEW resident). Once the paperwork was through and I had card in hand, I reversed the procedure and “moved” back to my house.

      No raised eyebrows, no questions, no back payments. It seems municipalities do not communicate with each other very well on this issue, a lucky break.

    95. Mumei Says:

      I am confused. Back in early August when this first broke, I went down to my local city hall to verify that I was fine. I have pension (kousen nenkin) and health insurance through my company. City hall thought that it was fine, but they really could not comment authoritatively on upcoming immigration policies. (The person that I spoke with was not even aware of the policy change.)

      Jon, if you have (had?) private (=company?) insurance, then why do you need to transition to the national system? In what way was your private insurance incompatible with immigration requirements?

      I am under the impression that valid company-provided health insurance should be sufficient. Am I mistaken? Many companies provide health insurance, and it seems wasteful to pay into two systems at the same time.

    96. Jon Says:


      I changed from private (Global Health Care) to national at the request of my spouse. She seems to think this will make our lives in Japan easier. I do have PR and to my understanding the visa connection would not have effected me.
      I have never had to use the private insurance so I cannot comment on its performance. I had a 5000 yen deductable on any claim and in my years in Japan have never needed medical attention exceeding that (with the exception of routine medical examinations which are paid through our company).

      Anyhow, I changed because keeping my wife happy seemed more important than retaining the private insurance.

    97. Hoofin Says:

      The last few posts are arguing around what the Japanese have clearly stated.

      You are all making an assumption, and it is the fatal flaw.

      The Japanese kokumin kenko hoken (National Health Insurance) is priced based on a SLIDING SCALE. This means, that the more you earn, the more you contribute to the health insurance system.

      So in this sense, kokumin kenko hoken is PART premium and PART progressive tax.

      (You get a tax deduction for the premium. But it is still a progressive tax.)

      What you are doing by your online petitions and “hey who are we hurting?” arguments is to suggest that as long as you cover a PREMIUM part of your costs, the Japanese government should simply ignore the fact that you are EVADING (not AVOIDING, but actually cheating) on the progressive tax aspect of both, or either, shakai hoken and/or kokumin kenko hoken.

      You want to free ride, basically. The system is set up to provide a health system where the users (the residents of Japan) pay based on a sliding-income scale to support the system. And then, there is a user fee that is 30% of the visit, prescription, etc.

      If you’ve ever gotten a Japanese health system bill, it’s clear that the 30%—-and even the 100%—-doesn’t even really cover the cost to serve the patient.

      I had a dental exam and cleaning that was $18. Full cost was $60. For the number of workers at the dental clinic, the rent of the location, the equipment, and to pay the dentist (who went to Penn in America), I doubt the full cost of the visit was $60. The other money was coming out of the overall shakai hoken and kokumin kenko hoken systems.

      If you are going to make these presentations to the government, please be honest about how Japan is actually funding the health care system.

      Let’s noe pretend it is the same as America’s current debate about Public Option versus private insurers. It clearly is not!

    98. Hoofin Says:


      The confusion arises because people confuse the “gap” insurers with the company insurance under Shakai Hoken. They say that Shakai Hoken is “private” because it is being provided via an employment relationship. But it is not private as in “for profit”—it is a highly-regulated nonprofit cooperative that is permitted in place of National Health Insurance.

      When people are running a financial scam of any time, confusion is their best friend.

      As I explain link here, the bottom line is that anything other than Shakai Hoken or Kokumin Kenko Hoken enrollment for residents in Japan is illegal. And the matter has only been how hard the Japanese government has pressed on its own laws . . .

      Good luck to the protesters. Hope the government doesn’t make a list . . .

    99. Dave Says:

      @Hoofin To answer your question, I did not intend to imply that I was required to make payment for everything all at once. I was permitted to have a “payment plan” as it were for the back-payments. However, this option was only extended when I politely pointed out to the prefectural employee that the payment coupon itself allowed for payment up to 2 years later. Interestingly, when I initially requested the payment plan option it was denied and I was told that I would have to pay everything at once.

      Hope that clears things up.

      –[Sorry, I think your comment got thrown out with the spam. Getting a lot lately. Apologies.]

    100. rod Says:

      You dont have to pay back payments just change your address to different city and enroll health
      insurance there. Borrow address from your friends.

    101. Health care cheaters in Japan’s expat community out in force | Hoofin to You! Says:

      […] is, as I explain at, is that the gap insurers have been conspiring (not sure if it’s criminal in Japan or not, […]

    102. Japan making expats live up to the letter of a rule | Hoofin to You! Says:

      […] buddy at suggests that he agrees with the new policy. Share […]

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