Japan is poised to implement tighter regulations aimed at addressing the growing issue of unpaid medical bills in Japan by foreign visitors. The government is reportedly planning to introduce new immigration checks and mandate private medical insurance for incoming tourists, according to sources cited in Japanese media.
The move is part of a broader effort to ensure that visitors cover healthcare expenses, following rising concerns from hospitals and clinics across the country.
Unpaid bills spark policy shift
Recent data from the Ministry of Health, Labour and Welfare revealed a worrying trend. A national survey across 5,500 medical institutions found that in September 2024 alone, 11,372 foreign visitors received treatment, with 0.8% failing to pay.
This resulted in unpaid medical bills in Japan totalling around ¥61.35 million (approximately £336,000).
- One of Tokyo’s top hospitals, St Luke’s International, reported that around 30 out of 2,000 foreign emergency patients annually leave without paying.
- The Japan Tourism Agency found that nearly 30% of tourists lacked any form of insurance during their visit between October 2023 and February 2024.
Such figures have prompted authorities to rethink how they handle medical cost accountability for tourists.
Japan’s soaring inbound tourism, driven partly by the weakening yen, has seen hospitals increasingly burdened by international visitors. These tourists often access top-tier medical services, placing financial strain on facilities when bills go unpaid.
“It’s becoming a serious issue,” said a health official involved in the policy discussions. “We need a system where everyone who enters is medically accountable.”
As part of the plan, the Immigration Services Agency may soon have access to data on foreigners with outstanding medical bills, supplied by the Ministry of Health. This would enable stricter entry screening, especially for repeat offenders.
Immigration authorities could be allowed to verify whether tourists have a record of unpaid medical bills in Japan or if they possess valid medical insurance before granting entry.
The government’s 2025 annual economic and fiscal policy review is expected to formally address these concerns. One key proposal includes requiring all short-term visitors to have private health insurance before arrival.
This would mark a significant shift. Currently, only foreigners staying over three months must enrol in Japan’s National Health Insurance system – unless they’re already covered under a public or employer scheme.
The ministry is also eyeing measures to prevent long-term foreign residents from defaulting on national insurance premiums, which may be addressed in the same upcoming policy paper.
This isn’t the first time the issue has surfaced. Back in 2022, nearly 30% of medical institutions surveyed said they had experienced problems with non-Japanese patients failing to pay bills. The pattern has only grown more pronounced since, spurring calls for action from across Japan’s medical community.
With unpaid medical bills in Japan climbing and international tourism rebounding post-pandemic, lawmakers appear more determined than ever to tighten oversight.
Key Takeaways
- Japan may soon require private medical insurance for all tourists.
- Authorities could screen visitors for a history of unpaid medical bills.
- Healthcare institutions continue to bear the brunt of uninsured medical costs.
- The proposal is expected to be part of the 2025 fiscal policy agenda.
