A survey by the prefectural government of Osaka, Japan, has found that visiting foreign patients who received treatment in the prefecture in the 2024 fiscal year left over ¥71.9 million (US$454,000) in unpaid bills.

The survey amalgamated responses from 285 Osaka-based institutions.

The figure in part reflects a rising number of international visitors to the prefecture, with numbers reaching a record high of 17.6 million inbound travellers in 2025, according to data from the Osaka Convention & Tourism Bureau.

However, the data also reflects a nationwide issue of foreign tourists leaving Japan without paying their bills.

According to a survey from the Japanese health ministry, which covered 5,500 facilities across the country – with approximately 52% saying they treat foreigners – around 16% of medical institutions that treated foreign patients in September 2024 saw bills go unpaid. The cost of those unpaid bills collectively exceeded ¥60 million for that month alone.

Overcoming the issue

To tackle the issue, the Osaka Convention & Tourism Bureau, in partnership with Osaka Prefecture, has strengthened information and guidance on Tokio Marine & Nichido Fire Insurance’s Japan Travel Insurance policy.

The company has a partnership with the prefecture, and offers it to visitors to the area, covering medical and repatriation costs of up to ¥10 million.

Additionally, multilingual flyers detailing the policy’s coverage will be distributed at Kansai Airport, tourist information centres, and hotels.

The Japanese health ministry has also been making efforts to combat the issue – it currently shares information on foreign visitors with significant unpaid medical bills with the Immigration Services agency, allowing stricter screenings should they attempt to re-enter the country.

According to a report by 1Cover Travel Insurance released in June 2025, medical claims for Australian travellers in Japan spiked by 46% in the preceding year.