Chinese Woman Sues National Cerebral and Cardiovascular Center Over 'Discriminatory' Triple Medical Fees During Short-Term Stay

A Chinese woman who received emergency treatment during a short-term stay in Japan has sued the National Cerebral and Cardiovascular Center in the Osaka District Court, seeking exemption from paying the difference in medical fees. She claims it was unjust to be charged three times the amount an uninsured Japanese person would pay. Her legal team asserts that this constitutes "discrimination based on nationality."

According to the complaint and other documents, the Chinese woman arrived in Japan in November 2019 with a 90-day short-term visa to visit her daughter. However, due to the COVID-19 pandemic, her return became difficult, and she repeatedly renewed her 90-day residency status under a special government measure. In January 2022, she was rushed to the hospital after complaining of discomfort on her left side and was diagnosed with a brain tumor and colon cancer, receiving inpatient treatment until early March of the same year. The total medical expenses reportedly amounted to 6.75 million yen.

Regarding the calculation of these medical fees, the plaintiff points out that the hospital applied a significantly higher "uninsured patient" rate of 30 yen per medical point for foreigners, as opposed to the 10 yen per point applied to Japanese patients without health insurance. This, she argues, resulted in a difference of approximately 4.5 million yen compared to uninsured Japanese patients.

The issue has sparked various discussions on social media. Many users emphasize that it is an individual's responsibility to purchase private medical insurance or credit card-affiliated insurance when traveling abroad. Comments include: "When we go overseas, we take out private insurance for unforeseen circumstances. This is to avoid the risk of high medical expenses during a short-term stay," and "It's a personal decision not to subscribe to travel insurance services." There are also numerous suggestions that foreign visitors to Japan should be mandated to purchase private injury insurance as an entry requirement, which could alleviate the burden of foreign language support and reduce the risk of unpaid medical bills.

On the other hand, regarding the claim that the medical bill was "three times that of an uninsured Japanese person," some voices criticize it as discriminatory, exclaiming, "That's outright racism!!" or stating, "Charging 'three times the price of uninsured Japanese' solely for being a short-term foreign visitor is undeniably unjustly high." However, some opinions also view it as an acceptable distinction, arguing, "Isn't it a difference between Japanese and foreigners? Then it's a distinction, not discrimination."

This lawsuit has the potential to significantly impact future foreign healthcare policy, considering the increasing number of foreign visitors and residents in Japan, the sustainability of the Japanese healthcare system, and considerations of international fairness. The judicial decision is highly anticipated.

The Context

Japan operates a universal healthcare system, primarily through National Health Insurance and Employee Health Insurance. Medical fees are calculated based on a standardized point system (診療報酬点数, *shinryō hōshū tensū*), where typically 1 point equals 10 yen. For insured individuals, typically 10-30% of these costs are paid by the patient, with the rest covered by insurance. For uninsured Japanese citizens, they are generally charged 100% of the standard 10 yen per point.

However, foreign visitors on short-term stays, like the plaintiff in this case, are generally not eligible to enroll in Japan's public health insurance system. In such cases, hospitals may apply what is known as "free medical care" (自由診療, *jiyū shinryō*), where prices are not bound by the standard point system and can be set at the hospital's discretion. The core of this lawsuit is the hospital's decision to apply a rate of 30 yen per point for foreign patients in this category, creating a significant disparity compared to the 10 yen per point charged to uninsured Japanese citizens.

The plaintiff's extended stay was due to special measures implemented during the COVID-19 pandemic, which allowed repeated renewals of short-term residency status when international travel was restricted.