For many years, the General Union has campaigned for the rights of ALL workers to be enrolled in shakai hoken, and – as a union – are generally happy with this change.
However, even we can see why some people are now concerned – especially after being kept out of the system for so many years.
So, for those still on the fence, here are a few points that you might want to think about while considering your options:
1. PUBLIC HEALTH AND PENSION INSURANCE IS MANDATORY
Other than a few minor exceptions, if you work here in Japan, you MUST be enrolled in either the kokumin system (National Health and Pension Insurance) or one of the two employer/employee funded insurance systems (shakai hoken/shigaku kyosai).
However, just what does “MUST” mean?
Well, we’ve dealt with a lot of cases where MUST is rather clear: if you’re not in an employer/employee funded plan and the city office finds this out, they will demand back payment for two years and will even seize your bank account or have your wages garnished.
Does it happen a lot? Yep! Enough for us to write about it.
The government can also demand back payment of the kokumin pension portion, although this seems to happen less often.
2. KOKUMIN HEALTH INSURANCE IS EXPENSIVE
Kokumin health insurance (NHI) is run by your local government (so the rates are different); but, in our experience, it’s expensive – especially for what you get (more on that below).
This begs the question: just how expensive is “expensive”?
In many of the cases we’ve seen (and we’ve seen a lot of them), members are paying MORE for Kokumin health insurance ALONE than they are for BOTH the health and pension insurance of shakai hoken / shigaku kyosai – or at least substantially higher than the health insurance portion alone.
In fact, the union once supported a court case where it was worth enough to sue the employer (who didn’t enroll in shakai hoken) over the difference!
Kokumin health insurance is also calculated on your full earnings. This means that if you work multiple part time jobs, your premiums are based on ALL of your jobs.
On the other hand, if you have a few parts time jobs and at least one job is twenty-hours plus, you can get health insurance based on your income from ONLY that one job.
Furthermore, Kokumin health is paid per-member of the household.
In contrast, shakai hoken and shigaku kyosai are based solely on income, meaning that you can cover ALL your dependents at no extra cost.
3. KOKUMIN HEALTH INSURANCE IS A POOR SUBSTITUTE FOR WORKING PEOPLE
Kokumin health insurance pays for your medical costs just like the shakai hoken system… but how do you pay the rent AND other expenses if you’re in the hospital or too sick to work?
Shakai hoken and shigaku kyosai offers a short-term disability allowance which pays about 60% of your wages when you can’t work due to sickness of illness.
It starts from your fourth day off and can last up to eighteen months!
(Not bad for insurance which is comparable in cost to kokumin health insurance.)
4. THE PENSION IN SHAKAI HOKEN/SHIGAKU KYOSAI IS NOT A WASTE FOR MOST.
Actually, if you’re not enrolled in shakai hoken, you are supposed to be on the much inferior Kokumin pension system – but that’s not the main point here.
For those in Japan for three years or less, you can get a refund on almost ALL of your pension premiums. This means you pay nothing in pension while enjoying relatively cheap health insurance.
While it used to take twenty-five years to qualify for a pension, it has since been lowered to ten years.
If you don’t apply for a pension in Japan, you can (in many cases) use your time to help qualify for a pension in your own country if there is a social security treaty with Japan.
You can even do this while enjoying the benefits and costs of the shakai hoken health insurance.
In addition, just in case you end up with some kind of permanent disability, you are also eligible for a pension regardless of your length of enrollment.
5. PRIVATE INSURANCE SCHEMES DO NOT OFFER THE SAME PROTECTION AS SHAKAI HOKEN/SHIGAKU KYOSAI
As stated above, a private insurance scheme does NOT cover your enrollment obligation in Japan – and you can be hit with a lot of back payments if you’re caught!
Private insurance is NOT an alternative to public health insurance.
However, that’s not the only thing to consider:
In a country where public insurance is the mandated norm, there is no guarantee that your private insurance will even be recognized. In fact, we’ve heard of many people who have been forced to wait for care while their private insurance was being checked. And, government hospitals are prohibited from accepting private insurance.
While private insurance MAY cover some extra things (like a repatriation allowance to get you back to your home country’s public system, if it exists), it isn’t appropriate for residents in Japan.
For one thing, your private insurance will have a time and monetary limit on the treatment of any single illness; so, unless you’re going home (or even able to go home) to your native country’s public system, your insurance might just run out!
Ultimately, we know that there are problems with the shakai hoken system.
The General Union believes that health coverage should take care of all your costs, and that pension payments shouldn’t suffer the cuts that are being forced upon it these days.
However, in terms of costs, benefits, and security, it should be clear that you’re always better off in the shakai hoken system REGARDLESS of how long you’re in Japan.