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Japan to refuse entry to foreign travelers with unpaid medical bills

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35% were unable to collect payment.

That is a massive number. Payment should be discussed before the procedure especially with foreigners who may not understand the system here or do not have insurance.

How would 35% get away with not paying? Sounds like a systems flaw.

3 ( +11 / -8 )

this is good news. Air fare tickets are probably a lot cheaper than medical treatment costs. it would be interesting to see a breakdown of the country's that are most unlikely to pay

13 ( +15 / -2 )

This is moronic. Denying entry over medical bills? Some pay how they can and when they can.

The government could set up a (--scheme--key word here.) modeled after that of other countries. In Britain, for example, travelers with unpaid medical bills of over 500 pounds ($670) are denied their entry into the country.- So glad know all those Islamic terrorist over they let in, nice to know they do not owe any medical costs.

The measures also --encompass promotions--Translation we have partnered with travel insurance companies to make money of tourists- through diplomatic--under the guise of missions to encourage foreign visitors to enroll in travel insurance prior to traveling to Japan.

The number of foreign visitors to the country jumped to a record 28.69 million in 2017 from 8.61 million in 2010.

We are not making enough off these gaijin's. Lets really rake em' over the coals in Japan now with travel insurance and high hotel costs. Be careful Japan. There are not that many tourists going to Britain much.

You can't come in and see Tokyo tower cause you didn't pat Dr. So and So. get on plane go home. We don't want you here. Nice real nice.

-29 ( +1 / -30 )

Make all incoming visitors have compulsory healthcare cover including having it available at the major points of entry.

How will they know if someone has previous unpaid medical bills.

The hospitals should have insurance against non payments.

14 ( +18 / -4 )

It would be easier to have customs check travellers on entry to confirm they have travel insurance if not give them the option to purchase insurance to cover their stay or leave on the next flight.

10 ( +14 / -4 )

The Japanese government says foreign travelers with unpaid medical bills will be denied entry to the country in the future, 

How about writing this better please? On the surface it sounds like, "You haven't paid your bills" so you can't enter the country?

This is purely for reentry tourists I'll bet! Probably which only a fraction if any would return anyway!

6 ( +8 / -2 )

Agree with Zichi & Crisp. UK should do the same, unpaid tourist and medical tourist bills cost the NHS many millions a year.

7 ( +8 / -1 )

This is another lack of human empathy policy. So only wealthy people are welcome to travel here. People who don't have health care and paying medical bills in installments have no rights to visit their relatives living in Japan? Why not make compromises. Charge the medical bills through credit cards.

-14 ( +1 / -15 )

Maybe treatment should be limited to medical emergencies. Otherwise, people will come to Japan for medical treatment just to escape paying by returning to their home country. The cost of the plane ticket may be far less than the medical treatment at home (especially in the US).

9 ( +11 / -2 )

@englisc aspyrgend

But the article says:

In Britain, for example, travelers with unpaid medical bills of over 500 pounds ($670) are denied their entry into the country.

6 ( +6 / -0 )

The problem is not wether a tourist has upaid medical bills or not, what they really need to focus on is how to make an efficient way to reimburse the medical bills to their health insurance back home.Because a traveler may not have unpaid medical bills before entering Japan ,  but has no means to pay if suddenly they got hospitalized here. Why not just strictly require for travel insurance, Higher amount of pocket money for expenses during their stay in Japan or Credit Cards?

-1 ( +1 / -2 )

This is another lack of human empathy policy.

noypikantoku - I don't think it is. For example, it cost my wife about 10,000 yen for health insurance when she went to Britain for 2 weeks compared with a plane ticket of 120,000 yen. Any tourist who has the funds to go to Japan on holiday should have the funds to pay for health insurance. I'm entirely with the Japanese ministry on this one.

On the other hand, as Yubaru says, I wonder how many people actually revisit Japan, so what effect this policy of refusing re-entry will have. It would be interesting to see how many of these nonpayers are from neighbouring countries, who are relatively likely to revisit, and how many are from more distant western countries on a trip of a lifetime.

10 ( +11 / -1 )

Normal lack of clear information from the Japanese government (or at least little info reported in English). They only say that 35% of institutions that have treated foreigners have been unable to collect bills. How many unpaid bills per institution? Could be just one? Could be lots? No info on whether the patients are long term residents of Japan (who are more likely to run up large bills) or tourists. If they're just trying to make residents pay their bills, fair enough. For tourists, how about accepting credit card payments? Poorer people from less developed countries can't get a tourist visa anyway, so pretty much all tourists here are likely to have credit cards.

3 ( +7 / -4 )

Agree with Zichi & Crisp. UK should do the same, unpaid tourist and medical tourist bills cost the NHS many millions a year.

Agree...make it a visa like procedure...travellers can purchase insurance before flying to Japan or at point of entry ..if they refuse, entry denied. Fair enough.

5 ( +6 / -1 )

This really doesn't make sense to me! First, there's no way for Japan to know what medical bills people have in OTHER countries. So it's not a case of "You didn't pay your bills while you were in X country, so if you run up a bill here you're unlikely to pay it". Rather they already have unpaid medical bills in Japan and are coming back here?

How many tourists come to Japan, run up a medical bill, leave Japan, and then come back again?? It's got to be a small number!! Besides, how can they pay them off if they're not allowed in!? Japan's not exactly advanced in online/overseas payments is it?

Sounds to me like it's only a matter of time before Japan denies re-entry to foreign residents for not being in the Health System? That can soon be extended to those behind on pension payments, taxes etc. I don't like it one bit.

-8 ( +3 / -11 )

This really doesn't make sense to me! First, there's no way for Japan to know what medical bills people have in OTHER countries. So it's not a case of "You didn't pay your bills while you were in X country, so if you run up a bill here you're unlikely to pay it". Rather they already have unpaid medical bills in Japan and are coming back here?

That's what the article says:

Authorities will screen foreign visitors based on information provided by the Health, Labor and Welfare Ministry to the Justice Ministry and foreigners with a record of unpaid bills will in principle be denied entry.

1 ( +1 / -0 )

If the Hospital only accepts Cash or Furikomi transfer then the only way to pay your bill is to return to the country, but as you haven't paid it... you wont be allowed back in... some things in Japan are a bit backward still.

2 ( +7 / -5 )

That's what the article says:

*Authorities will screen foreign visitors based on information provided by the Health, Labor and Welfare Ministry to the Justice Ministry and foreigners with a record of unpaid bills will in principle be denied entry.*

Exactly. So it's the Japanese searching the Japanese Ministry's info for foreigners that have racked up an unpaid bill here in Japan before. Just seems really weird to me! 1) How will people pay them if they're not allowed in?? 2) The number of such people must be so small that it's hardly worth bothering. How much will this system cost to run and how much do they expect to recover?

Wouldn't they be better to find a way of preventing foreigners from LEAVING until their bills are paid?

-2 ( +4 / -6 )

build debtors' prisons to house incarcerate these miscreants until they pony up the funds

-4 ( +2 / -6 )

1) How will people pay them if they're not allowed in??

Maybe they can pay, then be let in. Or maybe Japan doesn't want them even if they can pay.

2) The number of such people must be so small that it's hardly worth bothering.

That they are doing it indicates that the numbers may be bigger than you suspect.

3 ( +3 / -0 )

How will people pay them if they're not allowed in?*

That is the point. They won't be allowed into Japan. Effectively, they are ban from Japan, It is quite simple. If someone at a restaurant leaves without paying the bill, the restaurant won't let him back into the restaurant.

Japan is going to impose a 1000 yen levy for people leaving Japan. The hospitals should ask to get some of that money.

-7 ( +0 / -7 )

The best way to solve this problem is for Japan to require the purchase of insurance for obtaining visas.

4 ( +7 / -3 )

At first I thought that they meant travelers with *any unpaid medical bills (i.e. even in their own country). Now I see they mean people who have unpaid medical bills from a previous visit to Japan ...

8 ( +8 / -0 )

Many chinese come and abuse this system. They come here to give birth, have operations, cancer treatment, and then just leave without paying.

2 ( +8 / -6 )

The few times I've helped foreigners with their medical issues in Nagano, the hospitals (big ones!) didn't even seem to know what travel insurance was. The foreigners were ready to be discharged, had contacted their travel insurance companies, but the Japanese hospital had no idea what they were doing. It's their own fault - the whole system is just so behind.

2) The number of such people must be so small that it's hardly worth bothering.

That they are doing it indicates that the numbers may be bigger than you suspect.

Japan too often does random things for random reasons. I have no trust that they're doing it out of necessity at all. Easier to look proactive by chasing some non-issue foreigner problem than fix the real and broken systems at home.

9 ( +11 / -2 )

Part of the problem is the way the system works even with travellers healthcare insurance.

Not all Japanese hospitals recognise or accept the insurance and the traveller must pay first and then claim back from the insurance. The hospitals don't accept credit cards and is cash or bank transfer only. So the traveller may not have enough means to pay, even though they have insurance. Even with insurance remember, it does not cover pre-existing conditions.

Japan need to sort out how it deals with this especially before the 2020 Tokyo Olympics.

10 ( +11 / -1 )

a friend of mine who had travel insurance from a UK company, which covered medical costs, ended up in hospital here. After the operation the hospital refused to accept his medical insurance and wanted 3000 dollars in cash, he explained he had no such money and the health insurance should cover it, they then refused extra treatment.

He was in a bad way and had to get the UK embassy on the case. Finally the embassy sorted it. The Japanese healthcare system is very backward (as is most systems in Japan) they need to change their healthcare system rather than the easy route of blaming the 'mendokusai gaijin' ...it's a form of selfishness and hard-headedness from the Japanese.

7 ( +9 / -2 )

According to a survey conducted by the health ministry, 80 percent of medical institutions in Japan treated foreign patients in fiscal 2015, of which 35 percent were unable to collect bills.

80 percent. It must include foreign residents who have for most of them I guess the National Insurance or an other one. But is is possible in some places to delay the paiement of the bill. I have been exceptionally taken outside the visiting hours, and came back an other day to pay.

I would suppose the 35 percent includes mostly visitors which is a huge number unless for residents, they do not respect the delay to pay.

By the way I used a Japanese travel insurance in France for an emergency hospital stay. At first I was told the insurance won’t be recognized and should pay but the Japanese staff in France could deal with the hospital I did not pay anything

I guess foreign travel insurance companies must have representatives here to be able to deal directly to the hospital. If the insurance staff can negotiate there is no reason it does not work

Aniway Japan is right to take such a measure

2 ( +4 / -2 )

I have both city hokken and private insurance. Not worth doing without here. My private insurance covers 100% of costs, so I never lose money if I have to go to hospital.

0 ( +1 / -1 )

This was a struggle for me to grasp too. Foreigners with unpaid medical bills abroad, denied entry(?), I thought.

If the article had said 'denied reentry', then most the confusion among the posters above could have been avoided.

The problem itself though is real, and unfortunately some hospitals now refuse to start treatment without a prior clear indication of method of payment.

2 ( +2 / -0 )

35% sounds like a lot, but each of those institutions only need to have had a single case of non-payment to be counted, and on what timeframe? Within the last month, or within the last 10 years? How many cases of foreigners not paying compared to the number of total payments being made? How much money will it cost to set up and implement this reporting system and how much will they recoup? How would that cost compare to say, creating a national support line to help hospitals deal with travel insurance? Or a system allowing foreigners to pay online via credit card to a middleman agency when local hospitals can't take c-card payments but it's the only option a foreigner has?

Chances are, anyone regularly frequenting Japan aren't the people skipping payment! The whole thing just seems like a waste of money, time and resources which could be spend elsewhere to achieve a much better result dealing with the same problem.

3 ( +4 / -1 )

A: So Steve how was your trip to Japan?

B: Man, I got so sick!!! Had to go to the hospital. Can't wait to go back again.

0 ( +2 / -2 )

After the operation the hospital refused to accept his medical insurance and wanted 3000 dollars in cash

That doesn't make sense. In that situation the insurance company should be in direct contact with the hospital. Why would the hospital not accept reimbursement? Sounds more like an insurance company problem.

-2 ( +2 / -4 )

Are you getting afraid of tourists? Did hear about aids checks before entering in the 90ths, otherwise without better infos this sounds ridiculous islandish.

-1 ( +0 / -1 )

It is true that Medical Tourism is on the rise, and that there has been an increase in non-payment, but this is symptomatic of the current backward state of the Japanese Payments system. I wonder how they're going to handle the influx of Tourists for the forthcoming Olympics ?

4 ( +5 / -1 )

That doesn't make sense. In that situation the insurance company should be in direct contact with the hospital. Why would the hospital not accept reimbursement? Sounds more like an insurance company problem.

You've clearly not been to a Japanese hospital where travel insurance payments were made. Unless they're very used to them (like large hospitals in Nagano/Hokkaido the past few years) Japanese hospitals have zero idea what to do.

Foreign travel insurance companies are usually affiliated with Japanese-based insurance companies. When a patient calls their travel insurance it takes time for them to contact the Japanese one, and the Japanese one to contact the hospital.

The Japanese hospitals are very confused and reluctant to let you go until they've had confirmation of payment. But no insurance companies work that fast. Even if they're paying the hospital directly (which they usually do if it's over 1000USD or equivalent, though it depends on the company) it takes time for payments to go through.

In most cases the bill wouldn't be that high. I helped someone with a broken ankle in Nagano once. 22yo guy on a Working Holiday. The hospital wanted 70,000yen. Insurance said pay first and claim later. He only had a credit card which they didn't take. No SevenElevens nearby so unable to get cash out. And they didn't want us to leave without paying. What exactly were we supposed to do? In the end they trusted us to leave and pay later - which he did.

4 ( +6 / -2 )

Is that a tourism promotion before new law starts ? (2019)

0 ( +0 / -0 )

Medical costs are so expensive in most countries. Can't expect governments to cover the costs of foreign nationals that probably haven't paid taxes, apart from a little sales tax.

Compulsory medical insurance will be the norm for international travelers in future.

3 ( +3 / -0 )

Good for Japan! Persons who did not pay medical fees or skip over bills may commit kinda crimes if they entered Japan again and again. That seems Japan's worry about. J Goverment are gathering names from hospitals would make black list on network systems.

3 ( +4 / -1 )

Should at least be able to buy Japanese health insurance at the point of entry which is also accepted by all the hospitals.

4 ( +4 / -0 )

An interesting thread!

Couple things, first 35% of hospitals having some non-payments DOES NOT = 35% of foreigners Doctor & Dash!

As for denying entry for those that haven't purchased insurance before they take off....that is going to be a hard one to deal with, I always buy travel insurance or as I refer to it as the Mrs lottery  ticket if I croak overseas SHE gets the big payment LOL! So far she is outta luck. That said a couple times I have realized oh crap I have landed in a country I am non-resident & FORGOT to buy insurance, bet that has happened to a LOT of JTer's!

And to J-hospitals & using foreign traveler insurance, man oh MAN I remember the HORROR stories from the early 90s & reading some posts it seems that J-hospitals are still in the dark ages wrt to traveler insurance, some things NEVER change!

I also remember lots of sellers of insurance to foreigners living in Japan that was MUCH cheaper than the local insurance if they figured out how NOT to pay into he local one, I always warned them that they risk SAID insurance being rejected, ah those wild west days!

2 ( +2 / -0 )

Oh and I wonder what the govt is going to do with all the Japanese who are NOT paying their bills, those numbers will make the foreign ones seem utterly INS!GNIFICANT!

So will Japanese returning home with hospital debt be denied entry me wonders....interesting question don't you think!

-3 ( +0 / -3 )

About time.

I don't see how any rational individual could think this policy to be bad at all.

If you owned a store and some customer with unpaid bills tried to use your business, would you deny that person entry? Of course you would.

If you can afford to travel to Japan, you can afford the 20 U.S. dollars travel insurance.

Only when the Japanese government does it do some here then think it to be some 'draconian' and 'xenophobic' policy.

3 ( +3 / -0 )

The problem even with people with medical insurance is that that they are probably not aware that in a medical emergency they'll have to pay for the treatment first and then make a claim against the insurance when they return home. Also their credit cards are not acceptable. So what are these people suppose to do?

6 ( +7 / -1 )

Agree with Zichi & Crisp. UK should do the same, unpaid tourist and medical tourist bills cost the NHS many millions a year.

It does, it's in the article.

2 ( +2 / -0 )

I agree with this in principle, but there need to be conditions, as well as humanitarian considerations. While it's unlikely someone is travelling to Japan if they are in need, there could be cases where paying the medical bills is not a possibility. They should be allowed back in if they agree and are somehow held to paying them back, at least in part. Also, Japan needs to open its system to third-party insurance and allow people to pay then and there with other insurance, rather than pay 100% and try to claim it back through their companies later. And honestly, if they want tourists to come here in droves, some things should just be counted as a loss and covered. Certain things, like maybe some stitches or a quick consultation, really shouldn't be held as a black record forever and grounds for banning people.

I have to be honest, this sounds like a bit of a scam to get them to buy into travel insurance.

-2 ( +2 / -4 )

In the UK there are no payments made at the point of source. In Japan people with National Insurance pay 30% and pay in full without it.

In the UK no one is required to produce the passport but are suppose to supply their National Health Number. But yo can still get treatment without giving it.

1 ( +2 / -1 )

You hear stories about how you can pay with credit cards at certain places and how it's so great, but that should be the bare minimum.

Travel insurance procedures, the same.

The j govt does random things got random reasons but it speaks volumes about how people feel about foreigners. Surely the majority of people would pay immediately if they could.

Again I think there is a parallel to the random rules some local govts added to the new Airbnb law.

0 ( +1 / -1 )

The University of Tokyo Hospital

Medical Billing and Payment.

http://www.h.u-tokyo.ac.jp/english/international-patients/medical-payment/

1 ( +1 / -0 )

It pays to do your research on which travel insurance policies require upfront payments and which don't. Contact the insurance company to find out specifics.

Or you can do what some people do, use social media to gain sympathy and money from strangers. Almost every month I read of someone getting into a motorcycle accident in Thailand, and these people either have no travel insurance or didn't read the fine print. They are stuck in the hospital and can't even get treatment, hence they use GoFundMe and get tens of thousands of dollars.

-1 ( +0 / -1 )

This is a good strategy by the Government to penalize those ‘ free riders ‘ who seem to abuse the health care system. Some foreign people really try to take advantage of the medical system here and leave without paying their bills! These types of foreigners give a bad impression! It’s not fair on some of the foreigners who follow the rules and clear up their medical bills before leaving the country. If you want to visit a country as a tourist or short term resident then you need to follow basic rules of the country such as paying your bills... no exceptions!

-2 ( +0 / -2 )

@oldman_13...spot on mate! You’ve highlighted a very good example !

-2 ( +0 / -2 )

Canadian doctors have no problems getting credit card details from American skiers with broken legs before treatment. How hard can it be for the Japanese to do the same ...

2 ( +2 / -0 )

I'm sure Japan will get top people to address this right away.... Top.. People..

If patients are in Japan and have no record of previous non payment then there won't be much of a reduction. Are there a lot of repeat patients?

This would also mean that hospitals would need to share information in a standard format across the country. There would also need to be a mechanism of being removed from such a list and making that a legal requirement too.

Put it in the inbox with stickers of unicorns and rainbows

2 ( +2 / -0 )

When I was in Malaysia last year I was near death, literally. I needed an emergency heart surgery due to heart defect, and UMSC an excellent hospital with excellent doctors required payment always upfront. This is fair, I’m not a citizen and so why should tax payers of that country pay for me.

I do not trust doctors here, with that said as a tax payer I do not wish to see my money going to dead beat travelers.

-1 ( +1 / -2 )

Rather than talking about this and that country. Let's work for proper solution. And here it is.

If visitors from UK are travelling Japan, they need to register Health Insurance Company of Japan, Not UK. When they don't need treatments, they can be able to claim the money back from Health Insurance Company (even after they return back to UK)

(In UK, foreigners out of Europe pay health surcharge, some don't even have to go GP medical service but then they don't get paid back)

0 ( +0 / -0 )

Ask all foreign visitors to buy health insurance at Airport if they don't have one.

0 ( +0 / -0 )

Chop Chop

Ask all foreign visitors to buy health insurance at Airport if they don't have one.

The problem isn't the lack of health insurance. The hospitals won't accept them so you paid the hospital for your treatment and when you return home you claim that back. Not a system that works and helps create the problem highlighted by the post.

If you have to pay a $1000 then you are stuck with a problem if you don't have the cash. Also the hospitals don't accept many of the foreign credit cards. You need to check that before leaving.

At least visitors should be able to buy healthcare at the port of entry which is accepted. In all policies, any preconditions are not covered as is pregnancies.

Some countries have reciprocal health arrangements with Japan.

0 ( +0 / -0 )

cucashopboy

noypikantoku - I don't think it is. For example, it cost my wife about 10,000 yen for health insurance when she went to Britain for 2 weeks compared with a plane ticket of 120,000 yen. Any tourist who has the funds to go to Japan on holiday should have the funds to pay for health insurance. I'm entirely with the Japanese ministry on this one.

On the other hand, as Yubaru says, I wonder how many people actually revisit Japan, so what effect this policy of refusing re-entry will have. It would be interesting to see how many of these nonpayers are from neighbouring countries, who are relatively likely to revisit, and how many are from more distant western countries on a trip of a lifetime.

Your wife's hospital bill is obviously cheap but how about the people who are having on going therapies with tens and thousands of hospital bills? Just an example. Let's say a senior citizen is having an on going lifetime therapy and hospital bills are already a part of his/her monthly bills and his son or daughter is getting married in Japan, will you not allow this person to attend a once in a lifetime event just because he cannot settle his 20,000 hospital bill on time which he didn't asked for? Yup they can be in debt but who isn't? A relative can sponsor his plane tickets and accomodation but not a 20,000 USD on going hospital bill.  I am not suggesting that the patients will leave their hospital bills in Japan unpaid but if people can make applications to make on-line shopping efficient why can't we make hospital billing easy as well? Or let's admit it we human beings have that attitude of If you have no money then suffer without compromise and considerations.

0 ( +0 / -0 )

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