Opinion

The Osaka District Court has overturned a ruling by the Osaka prefectural government in which three South Korean A-bomb survivors’ applications for relief were rejected. The ruling stated that South Korean victims were also entitled to reimbursement of all of their medical expenses as are survivors who live in Japan.

This is a step toward eliminating the discrimination that has been suffered by atomic bomb survivors who reside outside Japan.

For many years survivors living abroad have been excluded from receiving aid. The situation has gradually improved since the 1970s as a result of judicial rulings by courts in Japan, but unfairness with regard to the payment of medical expenses has long been an issue. Thus this latest ruling is highly significant.

Ichiro Matsui, governor of Osaka Prefecture, has indicated that he will not appeal the court’s ruling. Similar suits have been filed in courts in the district courts in Hiroshima and Nagasaki, and they are likely to be affected.

The A-bomb survivors are growing old. There is no time to lose in resolving this issue.

The biggest point of contention in this latest ruling was whether Japan’s Atomic Bomb Survivors Relief Law applies when A-bomb survivors outside Japan receive medical care in their own countries.

Under the Atomic Bomb Survivors Relief Law, the central government pays the entire portion of A-bomb survivors’ medical expenses not covered by their health insurance. But this system does not apply to survivors living outside Japan. Instead they receive a maximum of approximately 180,000 yen in government assistance per year under a separate program.

As for the reason for this discrimination, the government cited the differences in the health insurance systems of various countries. Unlike Japan, which offers generous public health insurance, in many other countries and regions patients’ out-of-pocket costs are high, and the government said “the appropriateness of payments could not be guaranteed.”

But A-bomb survivors residing in Japan are entitled to be reimbursed for medical expenses incurred when they travel abroad, so it was only natural that people complained about the unfairness of the system.

Although overseas survivors are entitled to be reimbursed for the full amount of their care if they come to Japan for treatment, it is difficult for many of them to make the trip on account of their advanced age. The central government is under pressure to take prompt action.

But there are practical problems with making major changes to the operation of the system in line with the recent ruling.

There are approximately 4,500 A-bomb survivors living overseas in 38 countries and territories. Cumbersome procedures will be required to overcome the differences in their health care systems and provide reimbursements.

And how can survivors residing in North Korea, with which Japan has no diplomatic relations, be reimbursed? It is difficult to determine the state of medical care there. Political clout will have to be exerted.

This latest ruling once again raised the question of the basic concept behind the Survivors Relief Law.

The central government has lost numerous lawsuits regarding A-bomb survivors living overseas and has continued to address the issue simply by making partial changes to the system.

At the root of the problem is the fact that the notion of “state compensation” is not part of the government’s philosophy on the Atomic Bomb Survivors Relief Law. The government regards assistance to A-bomb survivors as a form of social security and has taken the basic stance that it applies to those in Japan only.

On the other hand, there is a growing trend in the courts to regard the relief law as a form of state compensation. In this latest ruling as well, the court noted that the law has “the character of state compensation.”

The inhumane A-bombings took place during a war that was initiated by the Japanese government. Many survivors would like the central government to take responsibility for the destruction that resulted from the A-bombings and to compensate them for it.

It is time to debate extensive revisions to the Atomic Bomb Survivors Relief Law and to clearly stipulate its spirit of state compensation.

This will lead to a government pledge that there will be no more A-bomb victims.

(Originally published on October 27, 2013)