My Number Cards for Health Insurance: Sluggish Usage Rate Shows Lack of User-friendliness

There have been a spate of problems surrounding the use of My Number identification cards that function as health insurance certificates. The government should strengthen measures to ensure that patients can visit medical institutions with peace of mind.

When the Japanese Medical and Dental Practitioners for the Improvement of Medical Care (Hodanren) surveyed nearly 10,000 medical institutions in 33 prefectures, it was found that 90% of them had experienced problems related to My Number insurance cards since December last year, when the government stopped issuing new paper health insurance certificates.

Sixty percent of the respondents that reported problems said that “some kanji characters are not displayed correctly,” and 40% said they experienced “poor card reader connection and authentication errors.” More than 10% reported that they had patients pay the full amount of their medical fees because they could not use their My Number insurance cards.

The introduction of My Number insurance cards was supposed to make procedures more convenient. If it causes inconvenience to patients, it defeats the purpose. The fact that the usage rate is still in the 20% range is probably due to the public’s deep-rooted distrust of the system.

An expiration date problem was also reported at 30% of the medical institutions. A My Number card, the physical embodiment of a My Number insurance card, contains an electronic certificate with a validity period of five years, which is used to identify the holder, among other purposes. About 28 million people are due for renewal of the electronic certificates this fiscal year.

But it is believed that many people will continue to try to receive medical care without being aware of the expiration date.

It seems that the system of My Number insurance cards is complicated, and the government also has not sufficiently informed the public about the renewal. The government must identify the issues and take immediate action to solve them.

For people who do not have My Number insurance cards, a “certificate of eligibility,” which serves as a substitute for a health insurance certificate, is issued by entities such as health insurance associations to which the individuals belong. However, this system is also extremely difficult to understand.

The government intends to issue certificates of eligibility to everyone aged 75 or older as a provisional operational step until July 2026. This is because many elderly people find it difficult to use My Number insurance cards, and some welfare facilities are concerned about managing the cards.

In contrast, the Shibuya and Setagaya ward governments in Tokyo plan to soon send certificates of eligibility to all national health insurance subscribers in the wards, regardless of whether they have My Number insurance cards. This is an unusual measure that allows people other than the elderly to have both a My Number insurance card and a certificate of eligibility.

Although this measure may seem to go against the central government’s policy of aiming to promote the use of My Number insurance cards, the decision by the two wards appears reasonable, considering the current situation of a spate of problems at medical institutions and convenience for users.

The digitalization of administrative and medical services is an important issue. However, if the government is in such a rush to spread digital technology that it pushes ahead too aggressively, it will not be able to win the trust of the public.

(From The Yomiuri Shimbun, May 23, 2025)