Second meeting of the Expert Working Group on the Integration of My Number Card and health insurance card

Overview

Date and Time: Thursday, December 22, 2022 (2022) from 17:00 to 18:30
Location: Online
1. Opening
2. Proceedings
  1. Review Meeting
    - Review Meeting
    - Expert Working Group
  2. Matters to be discussed at the Review Meeting
  3. How to proceed in the future
  4. Hearings from various organizations
3. Adjournment

Materials

Summary of proceedings

Date

Thursday, December 22, 2022 (2022) from 5:00 p.m. to 6:30 p.m.

Location

Held online

Participants

Keisuke Murakami (Digital Agency For the public Group Director-General)
Hirotami KIKKAWA (Ministry of Internal Affairs and Communications Director-General of Local Administration Bureau)
Kazuhito Ihara (Director-General of the Ministry of Health, Labor and Welfare Insurance Bureau)
NAGASHIMA Kimiyuki (Executive Director of the Japan Medical Association)
Hideki Endo (Vice President, Japan Dental Association)
Shohei Mori (Vice President of the Japan Pharmaceutical Association)
Etsuro Ito (Managing Director of the Federation of Health Insurance Societies)
Seiya Okazaki (Chairman of the Central Association of National Health Insurance)

Observer

Nobuki Ando (President of Japan Health Insurance Association)
Yasuhiro Senda (Director of the Second Investigation Department of the National Governors' Association)
Shigehito Kimura (Director of the Department of Social and Educational Affairs, Japan Association of City Mayors
Taro Koide (Executive Director of the National Association of Towns and Villages)
Toshihiko Yokoo (Chairman of the National Council of medical care Area Association for the Elderly People)
Hiroshi Shimonaka (Director of the Personal Identification Number Center, local governments Information Systems Institute)

Hearing

*Abbreviation of the category of public interest corporations
"Public property" refers to "public interest incorporated foundation," "public corporation" refers to "public interest incorporated association," and "one company" refers to "general incorporated association."

Masato Kanai (Managing Director of the National Social welfare Council)
Hiroshi Miyata (Chairman of the Systems and Policies Committee of the National Social welfare Corporation Management Council)
Masatoshi Itoh (Co-Representative of the National Federation of Hikikomori Family Associations of KHJ, a specified non-profit corporation)
Kyoko Hayashi (Representative Director of (Issha) Hikikomori UX Conference)
Risshi KOIZUMI (Vice President of the National Council of welfare Facilities for the Elderly)
Masuda Heiwa (Councilor of the National Council of welfare Facilities for the Elderly)
Motoji Hisagi (Chairman of the Policy Committee of the welfare Association for the Mentally Challenged)
Hideki Nanakusa (Vice President of the Japan Association of Long-Term Care Support Specialists)
Keiichi Kikumoto (Representative Director of the Japan Consultation Support Specialist Association, a specified non-profit corporation)
Tadashi Hashizume (Director of the Japan Consultation Support Specialists Association, a specified non-profit corporation)
Hiroaki Yoshida (Executive Director of the Japan Consultation Support Specialists Association, a specified non-profit corporation)
Aoi Matamura (Managing Director and Secretary-General of the National Federation of Hand-Holding Training Associations)

Proceedings (opinions from members, etc., questions and answers)

Masato Kanai (Managing Director of the National Social welfare Council)

As long as it is promoted as a national policy, it is necessary to clarify what measures have been taken so far for people who are difficult to acquire.
In a newspaper article, it was stated that the director of the facility would be able to assist elderly people entering the facility in applying for a card or receive it on behalf of them, but it is difficult to respond to the director of the facility, and it is considered that an administrative official should handle the matter.
Social welfare commissioners may provide assistance for the appropriate use of welfare services and cooperate with the public authorities to a certain extent, but it is difficult to treat application assistance for various public service, proxy application, etc., which are voluntary, as normal activities of social welfare commissioners. It is extremely difficult for social welfare commissioners to apply for public service, etc., which are voluntary, due to aging and vacancies. It is considered that the services that can be performed by social welfare commissioners are the distribution of administrative leaflets, the dissemination of systems, and the provision of information on application methods, etc., if there is consultation.
In the Daily Life Self-Support Promotion Program conducted by the Social welfare Council, the basic information about the system is disseminated. However, even if the person is disseminated, it is not known whether the person can understand it, so it is considered that the information is disseminated to the family or guardian. It is necessary to confirm whether the person has already obtained the card and whether the person has an intention to apply, but it is unknown whether the person understands or wants to apply. The requirements for state subsidies do not include an application agent for the card, and basically, it is considered that the person cannot apply on behalf of the person. I think it is possible to accompany the administrative window and support it, but naturally, a usage fee is required.
Who controls the My Number Card is also very problematic. Who controls the personal identification number is also very questionable.
It is necessary to increase the number of support staff, and therefore, it is necessary to increase subsidies.

Hiroshi Miyata (Chairman of the Systems and Policies Committee of the National Social welfare Corporation Management Council)

It is necessary to specify support measures by the administration for the acquisition of My Number Card. In addition, it is necessary to organize specific measures such as the scope of support and confirmation of intention by welfare related parties. In particular, since I am worried about confirmation of intention, I would like you to clearly indicate the procedures.
Issue is the storage of the My Number Card after acquisition. Until now, there have been many cases in which the insurance card was kept at the facility, but if possible, the My Number Card should be kept by the family, and if possible, it would be good if a subcard with only health insurance card information could be created.
At present, complicated procedures are required for publicly funded medical care systems for severely disabled people and publicly funded medical care for designated intractable disease patients, but if centralized management can be made in My Number Card, it may be an incentive to acquire the card.

Masatoshi Itoh (Co-Representative of the National Federation of Hikikomori Family Associations of KHJ, a specified non-profit corporation)

In many cases, it is difficult for the Hikikomori to go to public office, and the system in which the Hikikomori themselves must show up at the public office to confirm their identity when receiving the Hikikomori is a hurdle.
When obtaining a card, it is necessary to take and register a face photo, and to confirm the face photo at the time of identity confirmation, but it is considered that many of the Hikikomori parties have a sense of resistance and fear toward the face photo.
There are many people who are reluctant to have someone see their personal data, not just their photos. There may be insufficient explanation from the viewpoint of the personal data, such as understanding their medical history and health condition.
Many people who are Hikikomori and their families have refused to acquire My Number due to their distrust of the government and the risk of personal data leakage. I think people who are Hikikomori in the first place may not feel the benefit of wanting to acquire My Number Card that much.
We would like to see an increase in the number of options that can be used without visiting the public office counter, such as online meetings and online chats, in order to confirm the identity of the person who acquires the card.
In light of the fact that there are many people who do not go out to the counter due to the condition of Hikikomori, etc., even if they do not have a disability or a recognized disability, it is requested that the category of Hikikomori who have difficulty going out be specified in the scope of the card that can be received by the proxy.
We would like to see a wider selection of identification documents, such as insurance cards and financial institution passbooks, other than those with a photo.
We would like you to consider a system in which the personal data registered in the card can be selected by individuals except for essential items. We would like you to make the posting of a photo on the My Number Card optional.
For the Hikikomori who have interpersonal anxiety, the interaction with people itself is a burden, and there are many cases in which the staff at the reception desk and the response over the phone are hurt. It may be good to consider installing an unmanned reception desk using an AI robot. If the person is treated in an arrogant manner at the reception desk or over the phone, or if he or she acts as if he or she is a troublesome person, he or she will be hurt considerably, so we would like to ask you not to do so.
We would like you to consider a system in which even if you have not obtained a My Number Card, you can issuing on the same day when you need it.

Kyoko Hayashi (Representative Director of (Issha) Hikikomori UX Conference)

I feel that there are very many people who think negatively about My Number Card among the people who are hikikomori. There is a background that many people do not want their existence to be known or do not want anyone to know about them, and therefore they are hiding themselves in their homes so as not to be seen.
There are many people in My Number Card who feel that the problem of security has not been eliminated, and it is considered that the fear of linking personal data is quite strong for those who do not want themselves to be known. The most important thing is to communicate about safety until the people themselves are convinced.
Hikikomori do not want to go to a hospital even if they get sick, and there are almost no cases in which personal identification is required, so it is thought that there is little awareness that an insurance card or My Number Card is necessary in the first place.
If you decide to acquire it, it is necessary to have a method that allows you to complete the procedure without meeting with a person. I think it will be necessary to apply online or by mail. It is highly unlikely that you will be asked to complete the procedure on behalf of your family. You will either use some means to do it yourself or not acquire it.
If the person who is a Hikikomori wants to obtain a card, it is good to have a detailed explanation of the procedure, assistance in filling out the application form, and attendance at the counter. It is important to have support from a person who understands Hikikomori and can accompany the person with peace of mind.
For those who are Hikikomori, a sense of crisis over the safety of cards is a high hurdle to acquisition, so I think that communicating a sense of security as accurate information is the first and important thing to be addressed.

Risshi KOIZUMI (Vice President of the National Council of welfare Facilities for the Elderly)

For those who are unable to create a My Number Card by themselves or their families, it is considered necessary to expand the scope of proxy applications. However, considering the current administrative processing capacity of the Intensive Care Home for the Elderly, even if the creation of the card is entrusted to the facility, it will be a considerable challenge due to the wishes of their families. Therefore, we would like to ask the administration to act as an agent or assist in the application. We would like to ask you to take a form that is easy to support after considering the current situation regarding how to proceed with the creation of the card, how far the facility staff will be involved, and how they can be involved.
The management method of the My Number Card itself is a problem, and how should the management system be arranged?
How do you handle personal identification numbers? Can't we use them if we don't know everyone's personal identification numbers? I would like you to think of a better way.
With regard to problems such as the misuse of cards, there may be risks such as loss or removal, and we would like to receive explanations and guidance in advance on the risks, such as what kind of handling is inappropriate.
It is said that prescriptions will also be available at the My Number Card, but at the facility, it is currently the case that a large number of prescriptions are brought to the pharmacy and the medicine is taken home, so it is worrying that the My Number Card will have to be brought home in the future.
It is not good to have too many expectations from people in welfare, but I guess it is just an agency to make cards.
It would be nice if you could see the new benefits of having a card. We would like to support them properly.

Masuhei Tawa (Councilor of the National Council of welfare Facilities for the Elderly)

The first Issue is to confirm the intention to create. It is assumed that most people cannot confirm their intention.
There is a Issue where it is very difficult to confirm whether a person is the person himself or herself even if he / she goes through the procedure of having a staff member come from local government to meet him / her in person and take a photo.
Facilities manage a variety of things, including money management, and in most cases they keep their insurance cards at the facility in preparation for medical examinations in emergencies. However, even if a My Number Card is issued, it may be difficult to think of leaving it at the facility. It may be possible for a family to leave a health insurance card at the facility, but it may be impossible to leave a multifunctional My Number Card at the facility.
Isn't it impossible to keep and use the health insurance card at the facility unless only the My Number Card function can be used with a separate card for the facility?
We would like to ask you to make a design after fully considering how to respond to people who are difficult to identify or communicate with.

Motoji Hisagi (Chairman of the Policy Committee of the welfare Association for the Mentally Challenged)

When people with severe disabilities get a card, I think there may be a Issue of whether or not they can confirm their intention. It is fine to select a guardian on a adult guardianship system basis, but it is difficult if there is no guardian. We believe that this may be a Issue because we value the decision making of the person very much.
How to manage cards when they are acquired is also a big Issue. When it comes to management by the facility side, there is very sensitive information, so the responsibility is very heavy. I think Issue around here will come out.
We asked several facilities within the Association, and in one case, the facility carried out the application procedures for all the users whose intentions had been confirmed. In this case, it was reported that a judicial scrivener was involved, but if it was through a third party, there would be a problem of cost burden, so how to respond would be Issue.
The center of gravity medical care is handled differently in each local government. In some local government, it is handled by refund for overpayment, but the procedure is extremely complicated in the case of refund for overpayment. If the convenience of these things is enhanced by the card, the usefulness of the card will spread. I think it is necessary to consider the convenience of this point.

Hideki Nanakusa (Vice President of the Japan Association of Long-Term Care Support Specialists)

My Number Card is expected to be used in the long-term care insurance field. We believe that it can be a tool for medical care in which information on both information linkages and long-term care is shared, and support for people requiring long-term care at home is developed in a speedy and timely manner. It is also profitable for users who receive support, and we would like to cooperate in its spread.
However, since the support for the procedures for applying for and receiving the card by the long-term care support specialist is different from the long-term care insurance service, it is requested that consideration be given to the labor and effort for that. Even at present, long-term care support specialists are developing various supports as entrusted long-term care support in order to support the lives of users at home. If the procedures are performed on behalf of the users, not only for a new Issue, but also in the case of home, since the insurance card may be lost, it is considered that the procedures for re-appointment of Issue will be included. Since the risk of loss is higher in the case of home than in the case of facilities, it is necessary to consider the procedures for re-appointment of Issue, etc., while taking such matters into consideration.
There are also problems of storage and management. If support is provided, it will put pressure on the original business and increase the burden, and naturally, it will affect the support for users.
It is also necessary to create an environment for obtaining consent for acquisition. Since it can be easily assumed that confirmation of consent is necessary for procedural support, it is requested that consideration be given to the form of consent so that both the user and the long-term care support specialist can respond with peace of mind.
It is requested that the application and acquisition by the long-term care support specialist not be positioned as an obligation to perform the procedures on behalf of the long-term care support specialist. If it becomes mandatory to respond to requests without fail, it is expected that people who can apply and acquire by themselves will be asked to do so. Since it is difficult to determine whether or not a long-term care support specialist can do so based on the criteria of the long-term care support specialist alone, it is requested that consideration be made so that a unified standard can be shown and necessary support can be provided to users in need. We would like to cooperate as much as possible, but the role of the long-term care insurance should be prioritized to perform the original business.
As a realistic method for a long-term care support specialist to effectively provide procedural support, it is considered appropriate to connect to a municipality, etc. based on the needs that require support such as procedures of users and the area they are in, with the function of connecting to the Issue society, which is the basis of care management.
What is important is the procedure support of the business trip application acceptance method by municipalities. We hope that the business trip application acceptance method will be expanded to each municipality, and a system in which long-term care support specialists can cooperate with municipalities, etc. upon request will be constructed. An environment in which it is easy to construct with a small burden is also necessary for municipalities. I have heard that it will not proceed if a large burden is imposed on municipalities.
In the spread of My Number Card, there are various people at the site, including not only long-term care support specialists, but also area organizations, specialists, and welfare commissioners. It is necessary for these people to be involved with each other to the extent possible without excessive burden. It is requested that the construction of a support system for diverse and multi-layered procedures, including families, be advanced.

Keiichi Kikumoto (Representative Director of the Japan Consultation Support Specialist Association, a specified non-profit corporation)

I realize that if I cannot apply for a representative, it will be difficult to make progress. If you do not respond in the form of proxy application plus business trip application, such as making it possible to apply for a representative in a place where many people share a living space, such as an admission facility, and making it possible to apply for a business trip by having an administrative office come to the place, the procedure in the form of taking each person to the administrative office will not proceed.
If the person himself / herself can go to the administrative counter, it is assumed that the consultation support specialist will also go to the counter. However, in that case, if the consultation support specialist is to assist from 1 to 10, it is not realistic from the viewpoint of the labor of the consultation support specialist. Isn't it necessary to have a method in which after going to the counter together, all the rest are supported by people who understand the disability by placing a specialist or the like at the administrative counter?
How to connect with disability card is also important. The complexity of having an insurance card, a disability card and a My Number Card can be solved with one card. Since there is a window for discounts in disability card, it will be easier to use at such a place. In order to promote My Number Card, I think that it is essential for people with disabilities to connect with a notebook.
If so, there will be a problem of password management. Since people with intellectual disabilities and people with communication disabilities cannot communicate with each other, it is Issue how to confirm the intention of the person. In addition, there are people who have difficulty taking a photo for identification. Therefore, if authentication is not made by using something like biometric authentication instead of a password, I think it will be a big barrier.
Unless there is a way to avoid some risk when the card is misused, including how to handle the card when it is lost and how to reissue it, I think it will be a big hurdle to promote it.

Kazuhito Ihara (Director-General of the Ministry of Health, Labor and Welfare Insurance Bureau)

If you use My Number Card as a health insurance card, you can share medical care information with doctors and receive good medical care, so I think it is valuable. On the other hand, I feel again that it is necessary to talk tenaciously and carefully about the fact that there are concerns about security.
We received opinions that it would be more convenient if My Number Card could be combined with, for example, publicly funded medical care, which is operated by a local government alone. As for publicly funded medical care, it seems to be a work that requires time, but it is a Issue to consider whether it can be expanded step by step.
Some people say that they cannot realistically expect to be asked to apply on their behalf, so I would like to consult with Digital Agency and Ministry of Internal Affairs and Communications on how much online procedures can be done. It is Issue that how to overcome the need to confirm identity once. Based on the current situation of people who are withdrawing in reality, I would like to further consider what kind of response we can take.
With regard to the issue of card management, I think that people living in special nursing homes for the elderly or facilities for the disabled have their health insurance card entrusted to the facility, and when they visit the medical care, the facility takes the medical care with them, but I would like to think carefully about whether the My Number Card has other functions and can be entrusted to the facility for management.
As for the opinions from the support side, we understand that there are expectations for support for the acquisition of My Number Card, but on the other hand, there are things that are difficult because of the relationship between the original business and the work of local government. We would like to ask for your cooperation. If you are not a supporter who is close to the person concerned and has the trust of the person concerned, it is difficult to apply for a card with an open mind. I think the circumstances differ depending on how you participate, but I would like to consult with you while considering what options there are depending on different circumstances in the future. In the future, by using My Number Card as a health insurance card, various medical care information and drug information can be used, but if you do not have a card, you cannot use the information, so it is not good for the medical care of the residents. Although it is difficult, we would like to ask for your understanding and support on what kind of wisdom can be made to acquire My Number Card.

Hirotami KIKKAWA (Ministry of Internal Affairs and Communications Director-General of Local Administration Bureau)

You pointed out the measures for people who are difficult to acquire. We have been considering what we can do in cooperation with municipalities and have been expanding the measures in various ways, such as opening the office on Saturdays and Sundays and accepting business trip applications. In such a situation, there are still people who are difficult to acquire, so I would like to consider what we should do to have such people acquire the measures while receiving wisdom in this review meeting.
Regarding proxy Issue, there was an opinion that we would like to allow proxy applications, but we would like you to understand that anyone can apply. For example, we send an application form with a QR code, and anyone can take a picture of it with their smartphone and apply for it on their behalf. The problem is that we think it is difficult to go to public office once before Issue and confirm their identity. In this regard, we can ask the facility to pick it up as a proxy Issue. At that time, I think there are people who do not have an identification document with a photo, but if the facility director takes a picture of their face and creates a certification, someone from the facility staff can go to public office with it and receive it on their behalf. This is a proxy Issue. I have an image of this as a series of things, for example, if you could support the facility.
I heard with interest that you were helped by a judicial scrivener. We also provide application support services to Certified Administrative Procedures Legal Specialists Associations, and I would like to hear your wisdom on how to make more use of them. I think that cases in which a request is made to a judicial scrivener will naturally cost money, but I think that it is possible for municipalities to see such expenses, so I would like to hear your wisdom on how to make it work.
Issue has always been aware of the PR of security, and I would like to ask how to advance the understanding of users. Regarding the acceptance of business trip applications, we are considering having municipalities visit each family individually in the end, and there are municipalities that are actually making such efforts, but I would like to ask your opinions on how to smoothly accept business trip applications from municipalities at each site.

Aoi Matamura (Managing Director and Secretary-General of the National Federation of Hand-Holding Training Associations)

Regarding the obstacles to obtaining applications and the parts that are considered to require support and consideration, it is no exaggeration to say that the acquisition procedure in My Number Card is full of barriers because the person himself is mentally disabled and his family is also aging.
In reality, it is extremely difficult to proceed with an online application by a person with intellectual disability alone, so it will be a face-to-face application. Although there are many municipalities that respond flexibly, there have been reports of cases in which the procedure of proxy is not substantially allowed, or cases in which the person is allowed to accompany the application or submit the application on behalf of the person, but the person is asked to set a password, but as a result, the person cannot set the password appropriately due to the intellectual disability, and the person gives up issuing the card. There is a concern about the same risk not only for new applications but also for renewals.
In terms of expectations for welfare support personnel and opinions on support for subsidies and proxy Issue, even if the contact response of municipalities is not unified and welfare personnel and families are willing to support in an insufficient situation, it often ends up being rejected at the contact point. Therefore, it is necessary to clarify to what extent support is allowed to the contact point of municipalities nationwide, to thoroughly implement the response, and to make arrangements to communicate the content to welfare personnel and families. Even if the government says it can be done, if you go to a municipality, it is possible that you have not heard such a story, so I would like you to improve ventilation.
It is conceivable for families to support online applications, but in some cases families themselves are in their 70s and 80s, so it is not possible to support online applications, and it is difficult to support online applications. Therefore, it is necessary to have a help desk for people who support the individual.
It is necessary to explain the system to people with intellectual disabilities who live alone and to provide individual support when they wish to apply. There have been reports of cases in which applications have arrived, but the supporters have avoided face-to-face support during the COVID-19 pandemic, and the applications have been discarded because they do not understand the content well if they are explained over the phone.
Even after obtaining a My Number Card, it is necessary to confirm the intention of each person for the renewal procedure and to provide individual support at the time of renewal. Isn't it important for people with intellectual disabilities who do not have family members to be guaranteed the necessary things for My Number Card, such as support for taking photos, management of personal identification numbers, public support to public office, and securing transportation, smoothly and without self-payment?
We have never heard that easy-to-understand explanatory materials are provided or explanatory meetings are held for people with intellectual disabilities. If people with intellectual disabilities themselves do not understand the content of what My Number Card is and what integration with the insurance card is, there is a great concern that they just hold the card even if they have acquired it. The Act on Promotion of Measures for Information Accessibility and Communication for Persons with Disabilities has been enacted and enforced, and we believe that there is a Issue in the current explanation situation from the purpose of the law.
People with severe intellectual disabilities are issued with a supplementary insurance card called Maru-sho to subsidize medical care expenses. However, even if My Number Card and health insurance card are integrated, if the insurance card for Maru-sho is carried separately, the benefit of having only one insurance card cannot be obtained. We would like to ask for consideration based on this actual situation.

Keisuke Murakami (Digital Agency For the public Group Director-General)

There were three points that I thought were common, so I would like to make a comment myself in order to discuss, organize my thoughts, or foster common understanding in the future.
I think the first keyword is confirmation of the intention of the person. The card is based on the application, and I understand that one of the problems is how to recognize the confirmation of the intention of the person and how to support it.
Second, I am talking to people who need a Guide Runners to obtain a card, and I am talking to those who are accompanying or in need of a Guide Runners. I think it is necessary to clarify the scope of what is required of a family member and how much is allowed, and to clarify the scope of what is required and allowed, and to sort out what will be asked of a family member who may be accompanied in multiple ways. I felt that I should not forget the problems of card storage and management and passwords and carefully consider them.
As for the third keyword, in terms of explanation, I think you pointed out that it is necessary to organize and implement what kind of message to send regarding the benefits of the card and your concerns, based on what I am asking you today. As for what kind of explanation will affect the person, I would like to implement it while listening to your story and receiving your wisdom.

Shohei Mori (Vice President of the Japan Pharmaceutical Association)

In the case of Hikikomori, if they have little contact with the outside world and their information is limited or biased, they may think that it is irrelevant or unnecessary for them to obtain a card, or they may give up because they have a hurdle to go outside to obtain a card. Careful response is necessary.
The operation of electronic prescriptions is scheduled to start at the end of January, but for the time being, we are trying not to be in trouble by handing out prescription details (copies) in paper form. We must continue to follow up with patients so that they will not be in trouble.

Hideki Endo (Vice President, Japan Dental Association)

The insurance card has been used in a simple system in a sense, but I felt that there was a Issue that My Number Card had to treat it very strictly.
It is necessary not only to spread the My Number Card but also to create a system to complement the parts that are difficult to deal with.

Seiya Okazaki (Chairman of the Central Association of National Health Insurance)

It is considered that the problem of confirmation of the person and how to manage the personal identification number, etc. when the facility, etc. is entrusted on behalf of the person are serious problems.
I always think that the people do not understand what information is in the My Number Card. I think many people think that detailed personal data is in the card. However, the card itself is the key, and not all the personal data is in the card. Therefore, it is better to explain carefully to the people again.
From the perspective of the municipality, in order to increase the diffusion rate in My Number Card, business trips to large mass retailers are being made, but there is still a lack of resources. In particular, it seems that business trip applications to individuals' homes are not being made in Ministry of Internal Affairs and Communications. How much follow-up will be provided in the future? In that case, the issue of the financial burden must be considered by the city.
When we must issue paper-based certificates, what should we do? This is one Issue. As I expressed my opinion last time, when we are forced to issue paper-based certificates, there is a proposal to charge for them. However, most of the opinions of the Japan Association of City Mayors are that it is better not to pay for them because it will cause opposition. I would like to reiterate this opinion this time.
In the future, we will continue to advance the content with Ministry of Internal Affairs and Communications, Digital Agency, etc., and there are parts where the contact point of the municipality must be in front, so we would like to work closely with the relevant ministries and agencies.

Etsuro Ito (Managing Director of the Federation of Health Insurance Societies)

If we can provide an application that functions like an insurance card in a smartphone, it will be useful even a little in spreading the integration of My Number and insurance card. We would appreciate if you could create a system that allows various people to feel the benefits of medical care and nursing care by utilizing such a system, not limited to the conventional method.

Nobuki Ando (President of Japan Health Insurance Association)

How to verify the identity of the person is also very important. We must thoroughly consider it in the future.

Kazuhito Ihara (Director-General of the Ministry of Health, Labor and Welfare Insurance Bureau)

They told us about things that we had not noticed yet. They also told us that it would be necessary to directly explain to the people concerned or their families.
My Number Card has been taken up in various ways, and I think there are times when I don't feel what it is or what it is useful for. I think it is necessary to tell people that when it is used as a health insurance card, it will be better for them to feel this way, and in the future, card readers will basically be spread in all medical institutions, so I think it is necessary to let everyone acquire a My Number Card and use it when they actually receive a medical examination. As mentioned by the supporters and the people concerned, I have found that it is difficult to understand and actually use it, especially for people who are far away, without wisdom, so I would like to think about it again.

Hirotami KIKKAWA (Ministry of Internal Affairs and Communications Director-General of Local Administration Bureau)

Just now, Mayor Okazaki told us about the actual situation of the municipalities, and we are also aware of that. There was a talk about the financial burden, but Ministry of Internal Affairs and Communications would like to firmly support the municipalities.
I heard about the opinions of the supporters of each organization who I interviewed today, which I had never heard before. I once again recognized that we must play a role in connecting municipalities and each organization. I would like to have thorough discussions from now on.

Keisuke Murakami (Digital Agency For the public Group Director-General)

The number of applications from My Number Card has reached 80 million, and I have renewed my intention that we must continue to work hard until the last one, with further ingenuity, mutual self-help efforts, and cooperation. The three ministries and agencies will work on this based on what I have heard so that today's discussions will not be wasted.