List of Issues:

1. Health Insurance -- Discrimination by Visa Status
   
   

   The Health Insurance Law provides that health insurance is part of the social insurance system and that it covers foreign laborers who are in a position of regular employment at a fixed place of business. But foreign laborers who have over-stayed their visas, or who are doing work which is not allowed under the conditions of their visas, do not receive health insurance coverage, even if they are under regular employment. Is there any thought of correcting this condition which has been imposed but is not clearly defined in the Health Insurance Law, and which constitutes discriminatory treatment towards foreigners?
   
   

2. Health Insurance -- Distorted Condition
   
   

   National Health Insurance applies by law to those who have a specific address in a town, city or village in Japan. But towards foreigners the application of insurance is administratively limited to those who are expected to be in Japan for over one year. Can this be thought of as a legal condition that has been unfairly distorted at the administrative level and that causes discrimination against foreigners? Also, what kinds of corrective measures are being considered?
   
   

3. Public Assistance for Living
   
   

   Public Assistance for Living is the final measure to provide relief from poverty, but in Japan it only applies to those who have Japanese citizenship. Permanent resident foreigners are deemed not having a right to the assistance, but in practice it has been provided mutatis muntadis. The assistance had been applied likewise to foreigners without permanent residency status, including those who have overstayed their visas, or who are working outside of the conditions imposed by their visas. However, after October 1990, they were excluded from being able to receive public assistance for living. Is there any thought of changing this policy, which can be thought of as unfairly discriminating against foreigners by depriving them of this final measure against the loss of their ability to support themselves?

Background:

1. Health Insurance is an insurance system that is applicable by the categories of occupation, and has the largest number of members (roughly 70 million) in Japan's insurance system. Health Insurance applies to employees who are regularly employed, and has no citizenship requirements. Consequently, not only should there be no distinction made between foreigners and Japanese, insurance should apply to foreigners who are regularly employed even if they have over-stayed their visas or are working outside of the conditions imposed by their visas. Regarding this point, the roundtable established by the Ministry of Health and Welfare to discuss health issues related to foreigners expressed the same opinion in its May 26, 1995, report. But the Ministry of Health and Welfare has denied application of insurance to foreigners who are not qualified to stay or work in Japan. This is a mistaken interpretation of the law, and the policy should be changed as soon as possible.
   
   
2. National Health Insurance is a medical insurance system into which people enter who are self-employed or who are not part of an employee health insurance program. Approximately 42 million people are entered into the system, and by requiring all those who do not have any other health insurance to enter, it is a system that fundamentally provides insurance to all citizens.
   
   National Health Insurance applies by law to all those within Japan who have an address in a town, city, or village, and there is no distinction between the entry of Japanese or foreigners into the system. But on March 31, 1992, the Ministry of Health and Welfare, in a directive, as a general rule limited application of National Health Insurance to those foreigners who "have had registered themselves, and who will be in the country for over one year from the time of arrival." This is a legal condition that has been unfairly distorted at the administrative level and that causes unfair discrimination against foreigners.
   
   In Japan one's "address" is the same as the place at which one supports oneself. As long as one has a place at which one supports oneself, one has an address regardless of the types or existence of residential qualification. It can only be said that, while the legal criterion is placed on an "address", the administration arbitrarily employs the law by bringing up the concept of the types and existence of residential qualifications.
   
   
3. When it is not possible to be a part of the medical insurance system referred to above, the final remaining means is medical relief under the Livelihood Protection Law. This, differing from the insurance system, is not premised on premiums, and is the last stronghold for life, health, and the right to exist. Public assistance for living is only applicable to Japanese citizens living in Japan. The system has been applied, though not as their right, to foreigners mutatis muntadis, for over 40 years. This not only includes foreigners who have the formal resident status, but also foreigners who do not have proper resident status.
   
   According to the oral instructions made by a lower-ranking official of the Ministry of Health and Welfare in October of 1990, the application of the Livelihood Protection Law should be limited only to foreigners who are permanent residents. Consequently, foreigners who are not permanent residents or who have over-stayed their visas or who do not have the correct resident status are excluded from application of the law. It can only be said that this deprives foreigners of their final means to ensure their right to exist, and that it is an unfair discrimination against foreigners. Moreover, various local authorities have requested that the Ministry of Health and Welfare apply livelihood protection to emergency medical services, but there has been no change in policy.