Foreign workers have become increasingly common at convenience stores and construction sites throughout Tokyo in the past several years, with the number of immigrant workers climbing to a record high 2019. But aid agencies say those foreign workers are struggling to secure access to adequate medical care in a country which prides itself on providing equal availability for health services.
Despite a fall in visitor numbers this year due to the coronavirus pandemic, the trend for more foreign workers is expected to continue in the long term as Japan’s population keeps shrinking: The Japanese government 2019 created a new visa category of “Specified Skilled Worker”, a move towards accepting more foreign labour.
For Medical Information Center Aichi (MICA), a non-profit
organization providing free medical support for foreign residents in Aichi
prefecture, these new workers will face major issues experienced by their
predecessors – some are not enrolled in health insurance plans, they’re
reluctant to go in for annual medical check-ups, and the language barrier
remains a formidable hurdle.
MICA says that about 80% of those who seek its help are enrolled in health insurance, either through an employee scheme or through Japan’s public health insurance plan. But the remaining 20% belong to neither.
While most employers enroll their workers in an insurance scheme, shouldering half of the fees, some smaller companies skirt this responsibility, MICA says, asking staff to join the public scheme which is available for unemployed people. Some workers find this too burdensome, or too complicated, and end up outside the system. This leaves them with few options when they become seriously ill, requiring costly medical care.
“If they do not have any insurance, we will introduce a low-priced clinic. But when they have serious illnesses, medical institutions will be troubled by the deficit so it is really difficult to deal with the problem,” Norimi Fujita, MICA, told Mita Campus in an interview.
MICA also helps foreign workers who have lost their jobs and visas, as well as asylum seekers.
“They have neither visas nor money but still require medical treatment. Unfortunately, the cost of care is unaffordable for them,” Fujita said.
MICA says a public insurance scheme accessible to all foreigners, regardless of status of residence, is necessary to ensure all foreign workers can seek adequate care without worrying about costs.
Another major issue has been language barriers, with many workers unable to communicate in Japanese with their doctors.
Around 95% of all medical institutions in Japan do not assign medical interpreters, according to government data. Moreover, public health insurance does not cover fees for interpreters. Often, it is up to the doctor and foreign patient to agree on how to cover the additional cost of interpreters.
MICA says medical interpreters’ fees should be covered by insurance, lifting the burden off hospitals and patients. This would also help encourage foreign workers to enroll in insurance schemes and visit doctors as needed.
According to MICA, another challenge has been in ensuring healthier habits among workers who are working in physically demanding conditions and living far from home. One key activity for MICA volunteers has been in encouraging workers to go for regular medical check-ups in which they can discuss issues, including work stress, instead of avoiding doctors until they face serious health issues.
“Those who come from overseas and work
in Japan pay taxes as we do. First of all, we hope Japan treats them as fellow
people, not just as a workforce. They are contributing to our country,” Fujita said.
Written by Manae Otsuka Edited by Mita Cam crew
 令和元年度「医療機関における外国人患者の受入に係る実態調査」の結果、調査結果（全体版23頁） 厚生労働省実施 全国の病院５６７３件の内。