More than 100,000 American military members and 10,000 Department of Defense employees are serving their country from Japan. Not one of them has guaranteed access to emergency medical care. This situation has resulted in hundreds of denials of care, at least 14 deaths, and threatens our nation's strategic mission.

U.S. Forces Japan (USFJ) reported 24 cases of denials of emergency care between 2022 and 2023, averaging 1 per month. At least 14 died between 2021 and 2024, including:

• A military spouse who was denied care for a severe head injury.
• A Department of Defense employee who was denied care by more than 10 hospitals during a heart attack.
• The 7-year-old child of a U.S. marine who was denied care after a multi-story fall. The child died after 30 minutes of oxygen deprivation. U.S. Naval Hospital Okinawa was located only 9 minutes away, but does not have a trauma-certified ER. Investigators into the child's death concluded "USFJ cannot depend on Japanese trauma hospitals as the primary source of trauma care. Japan EMS is not up to the US "Standard of Care" and relying on these hospitals exposes SOFA personnel to an unnecessary level of risk.

Over 340 American patients reported denials of care by both Japanese hospitals and U.S. military treatment facilities between Feb 2022 - Feb 2024, averaging one denial every two days. This caused multiple preventable disabilities and long-term loss of function.

As tensions mount in Asia, no U.S. military base in Japan is equipped with a trauma-certified Emergency Room (ER); the nearest adequate U.S. emergency care facility is more than 3,000 miles away in Hawaii.

This petition has been created to garner support for:

• Improvement of healthcare services on U.S. military bases in Japan for use by all SOFA-status patients, 
• Protection from denials of care, and
• Requirement of thorough informed consent language for all Americans prior to being stationed in Japan. 

HOW DID IT GET THIS BAD?

The root causes of this crisis are multifaceted, stemming from changes in administration, staffing shortages, and systemic issues within the Defense Health Agency (DHA). In 2022, the DHA took over Military Treatment Facilities in Japan and discovered that they were violating standards for military members, their priority patients. They severely restricted access for all non-military members, including DoD civilians, veterans, and healthcare providers working at those facilities, causing extreme retention issues. This situation pushed thousands American patients on to the Japanese healthcare system without warning the Japanese government. Japan is in a well-documented healthcare shortage; Japanese hospitals across the country immediately placed signs in their lobbies declaring that they would not accept foreign patients (including military members).

As of 2025, DHA’s efforts to improve access for military patients in Japan have failed. In three years, military patients’ wait times for appointments did not improve and the MTFs lost money and staff due to lack of civilian access.

WHAT IS DIFFERENT ABOUT HEALTHCARE IN JAPAN?

You might wonder why protection of healthcare on U.S. bases in Japan is so necessary, when other countries such as South Korea have an abundance of services off base:

• Investigators into one American death concluded that Japan is ‘the only major SOFA country (Korea, Italy, Spain, and Germany) that does not have a modern Emergency Medical Services (EMS) System or Trauma System.’ 
• Thousands of patients report refusals to provide anesthesia during colonoscopies, childbirth, sutures, and more, separation of children during procedures without consent, lack of early cancer screening services, up front payment required even in life-threatening situations, (such as a $90,000 bypass and $20,000 emergency eye surgery in 2023), refusal of American insurance, and lack of access to common medications which are illegal in Japan or reserved for Japanese citizens only, such as Epi Pens and Adderall.

Please sign our petition. Your support makes a difference: USFJ only began tracking denials of emergency care because of your signatures. DoD civilians were offered a pilot insurance program trial in 2025 which is testing direct billing relationships and physician-finder services because of your reports of denials of care. The Government Accountability Office began an official study on the reality of access to medical care in Japan in 2024 because of your letters. 

For more information check out our website, JCMAdvocacy.org, which includes a pre-written letter templates for your representatives, contact information for the Armed Services Committee complete with a short phone script, our requested solutions, and comprehensive data on healthcare access challenges in Japan.