The number of foreign workers in Japan has rapidly increased during the last several years, because of the nation's insufficient work force. The influx of laborers into Japan has brought various issues to the forefront of society, one of the most serious being their medical care.
To clarify the present status of their medical care, we sent a questionnaire to 1, 004 clinics and hospitals in Tochigi Prefecture. The response rate was 55.6%, and the results are summarized as follows:
1. Clinics were rather reluctant to accept foreign patients because of the language barrier and the consequent time-consuming medical care.
2. Two-thirds of foreign patients did not enroll in any health insurance system. Most clinics and hospitals requested foreign patients with no health insurance to pay 100% of the medical cost set by the national insurance system of Japan. Some hospitals required more than 200% of the set cost, while some clinics reduced the cost.
3. Only a few doctors can communicate with patients in English. It is very difficult for doctors to communicate with foreign patients, who speak only their own native language, but not English. Most doctors felt it necessary to have the assistance of translators or booklets for translation.
4. Foreign patients endured illness, that is, ignored illness, delayed or stopped medical care at clinics and hospitals, because of communication problems and high medical costs. Labor injury cases among foreign workers were more frequent than among Japanese workers.
5. The medical cost for foreign workers per year has been estimated to be 44 billion yen (370 million dollars). It corresponds to 0.2% of the total Japanese medical costs of 1989, while the ratio of foreigners to Japanese is around 1.1%.
