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.
A handful of attendees were young, but most were middle-aged or approaching retirement age. Many had been working in Japan for years and had never been told anything about insurance, while others were aware of the program but had been dissuaded by their employers from joining it.
Louis Carlet, deputy secretary of Nambu, laid it down for everyone in the room to understand. There are a few basic things that all foreigners in Japan have to know, he explained: first, that everyone over the age of 20 in Japan is required to enroll in an approved Japanese government health insurance scheme and pension fund. If you are under 75 and working at a company that employs more than five people, this most likely means the shakai hoken (social insurance) program; if you are unemployed, self-employed or retired, the equivalent system is the kokumin kenko hoken and kokumin nenkin (national health insurance and pension). The only people exempt are sailors, day laborers, and those working for companies employing less than five people, or for firms without a permanent address (e.g. a film set).
The two systems cover different ground, all of which is explained in detail at www.sia.go.jp/e/ehi.html. Roughly, shakai hoken consists of two parts: kenko hoken (health insurance), which covers 70 percent of your medical costs and 60 percent of lost wages due to illness, and kosei nenkin (pension insurance), which provides a pension after age 65 for those who have paid into the system. The two are inseparable, and anyone enrolled in shakai hoken through their employer automatically pays into both. The kokumin kenko hoken (national health insurance) and kokumin nenkin (national pension) package offers similar coverage but is not provided through an employer.
The bottom line is that all residents of Japan (except those mentioned above) have to be enrolled in one or other of the two systems. The revised visa laws, therefore, should pose no threat to anyone’s visa renewal, because every foreigner in Japan should already be enrolled.
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.
Foreign workers often hear a litany of reasons why they should not be enrolled in shakai hoken, or are simply not told about it at all. Employers would have a much tougher time leaving their Japanese staff off the system, argues Carlet, as many associate shakai hoken with a certain social status — those left out of the system tend to be in insecure employment such as day labor and very short-term contract work. For many Japanese workers, nonenrollment implies that their company either doesn’t value them as a long-term employee or simply doesn’t have the funds to cover the cost of insurance.