TOKYO, Feb. 24, 2019—At its regular cabinet meeting Feb. 15, the prime minister Shinzo Abe cabinet approved the on-line use of the national ID card, called the MyNumber card, by hospitals and other medical service establishments empowering such entities to check whether patients are covered by the National Health Insurance program and to discourage non-NHI patients from receiving treatments unless they are covered by other types of medical insurance policies. The cabinet decision coincided with reports that the government is poised to repeal the MyNumber notification paper card issued right after the system and instead require all taxpayers to obtain the IC chip wedged photo-ID plastic card. The bottomline: more privacy data collection and consolidation by the Abe government, probably in violation of privacy protection.
The bill to amend the National Health Insurance Law for Appropriate and Effective Management of the Medical Insurance System (known as Kempo-ho) was submitted by the cabinet to the House of Representatives of the 198th Parliament (25th bill to the parliament). It is expected to be enacted during the current session that runs through mid-June.
It has been the prime minister’s stated policy to enable the government to collect and consolidate as much personal information as possible of the Japanese people and foreign residents in Japan, the center of it being the introduction of the MyNumber card system in October 2015. MyNumber card is supposedly used for social security services, such as healthcare and pension, as well as taxes. The government mailed paper MyNumber notification card right after October 2015, while urging the public to obtain the plastic IC chip wedged, personal mug shot bearing plastic card. But as of October 2018, the third anniversary of the system, the Cabinet Office reported that as many as 53.0 percent of the public did not have it for concerns about security breach and other reasons. The Cabinet Office report was based on physical personal interviews of 3,000 people over 18 years old.
The bill provides that the government would establish an ‘on-line qualification verification’ system that would double-check the MyNumber holder’s identification and qualifications for receiving NHI treatments to rout out patients who have been in arrears in NHI premium payments and therefore do not qualify for NHI treatments. This means that medical establishments such as hospitals and small clinics would have to install the MyNumber card reader to obtain patient information stored on-line as well as in IC chips. It also would allow patients to use the MyNumber photo-ID plastic card in place of the NHI card that each individual currently must hold for visiting medical establishments. For its part, the government can collect patient data – e.g., types of illnesses, diseases, legions, payments for treatment, etc. – into the national medical data base (which the government calls as NDB). And data on recipients of the elderly nursing care as nursing care data base (called the nursing care (kaigo) DB. Based on NDB and nursing care DB, the government can write programs for the elderly’s healthy life and reduce national healthcare spending, which was at about 43 trillion yen ($390 billion) and growing to the tune of population aging.
The bill also is aimed to discouraging non-resident foreign nationals to receive treatments at Japanese medical establishments and sneak out without paying, the practice which is known to be popular in Asian countries as medical tourism to Japan, it said. Another, which is intended for consolidating data and administrative authority to the national government is to reduce the role and the number of regional NHI reimbursement analysis committees.
Abolishing the paper ID card. On-line publications of the Nihon Keizai newspaper and Nikkei Computer magazine Feb. 20 reported that the Abe government is gearing to submit in March 2019 legislation, an ‘administrative procedure on-line promotion law, to the parliament to abolish the current paper MyNumber card and make it almost impossible for taxpayers not to obtain a plastic IC-chip wedged photo-ID card. As of December 2018, the number of MyNumber plastic cards issued was only 12.2 percent of all taxpayers, according to government statistics.
Toshio Aritake